Barriers to seeking care for accidental bowel leakage: a qualitative study.

PubMed

Brown, Heidi Wendell; Rogers, Rebecca G; Wise, Meg E

2017-04-01

Fewer than 50 % of women with urinary incontinence (UI) and 30 % of women with accidental bowel leakage (ABL) seek care. We sought to describe barriers to care seeking for ABL to inform development of an instrument to measure these barriers. We recruited women with ABL with varied prior care-seeking experiences to participate in focus groups and cognitive interviews so we could understand factors that may have prevented or delayed care seeking. Focus groups continued until thematic saturation was reached using conventional content analysis. Final themes were established and characterized by comparing within and across the focus groups and with previously described UI and ABL care-seeking barriers. Cognitive interviews were confirmatory. Thirty-nine women (aged 46-85) participated in six focus groups and ten cognitive interviews; 89 % were white, 8 % African American, and 3 % Latina. We identified 12 barriers to seeking care for ABL: (1) Lack of knowledge about the condition; (2) Lack of knowledge about treatment; (3) Fear of testing/treatment; (4) Normative thinking; (5) Avoidance/denial; (6) Life impact; (7) Embarrassment/shame; (8) Self-blame; (9) Stigma; (10) Isolation; (11) Provider barriers; (12) Access limitations. These 12 barriers encompassed three overarching themes: the internalized self in relation to ABL; perceptions about ABL and its treatments; and interaction with the healthcare system. ABL care-seeking barriers are similar to those described for UI, with the notable addition of lack of knowledge that ABL is a medical condition experienced by others. Interventions to promote access to effective treatments for ABL should include information about prevalence and treatability.

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

PubMed

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

2017-12-01

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

Seeking Refuge in Literacy from a Scorpion Bite

ERIC Educational Resources Information Center

Sarroub, Loukia K.

2007-01-01

The purpose of this study is to examine a refugee boy's experiences with literacy in and out of school in the US. Within these contexts, I explore this youth's literacy development in light of his identity as a poor Yezidi Kurdish refugee from Iraq. Central to the article are two main themes. The first, life as a scorpion sting, explicates the…

Redefining self: patients' decision making about treatment for multiple sclerosis.

PubMed

Lowden, Diane; Lee, Virginia; Ritchie, Judith A

2014-08-01

The treatment of multiple sclerosis (MS) has become possible with the advent of disease-modifying therapies, but little is known about patients' experiences when faced with a complex array of treatment options. The purpose of this phenomenological study was to explore the lived experience of making a first decision about treatment with disease-modifying therapies for relapsing-remitting MS. Nine participants shared their perspectives on negotiating the decision to accept, refuse, or delay treatment. All individuals described a core theme in which decision making about treatment was part of a process of coming to a "redefined self." This core theme included reflections about self-image, quality of life, goals, and being a person with MS. Six common themes supporting this core theme were (a) weighing and deciding what's important, (b) acknowledging the illness as part of oneself, (c) playing the mental game, (d) seeking credible resources, (e) evaluating symptoms and fit with quality of life, and (f) managing the roles and involvement of family. The findings of this study provide a greater understanding about the experience of making a therapeutic choice for those with MS and offer insights for nurses when supporting patients faced with options about treatment.

Strategies for Faith Engagement within One's Career: The Role of Uganda Christian University in Preparing Students for Postgraduation Life

ERIC Educational Resources Information Center

Rugyendo, Medard

2015-01-01

This article examines the role of Uganda Christian University (UCU) in devising strategies for the sustenance of Christian faith in one's career for the betterment of the society despite its social ills. The current theme of UCU is "A Complete Education for a Complete Person." As a Christian university, UCU seeks to provide a positive…

In Search of Excellence: The 2015 Notable Children's Books in the Language Arts

ERIC Educational Resources Information Center

Journal of Children's Literature, 2015

2015-01-01

As readers, we often seek out books that will help us find our way or will provide us with new insights. We select books for classrooms and children based on their interests, questions, and life situations. With this in mind, the selections this year are organized around the theme of searching. We search for peace around the world, among our own…

The distinguishing characteristics of narrative identity in adults with features of borderline personality disorder: an empirical investigation.

PubMed

Adler, Jonathan M; Chin, Erica D; Kolisetty, Aiswarya P; Oltmanns, Thomas F

2012-08-01

While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), and narrative coherence significantly distinguished the stories of those people with features of BPD from those without the disorder. In addition, associations between the theme of agency and psychopathology were evident six and twelve months following the life story interview. This study seeks to bridge the mutually-informative fields of research on personality disorders and normal identity processes.

The distinguishing characteristics of narrative identity in adults with features of Borderline Personality Disorder: An empirical investigation

PubMed Central

Adler, Jonathan M.; Chin, Erica D.; Kolisetty, Aiswarya P.; Oltmanns, Thomas F.

2011-01-01

While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), and narrative coherence significantly distinguished the stories of those people with features of BPD from those without the disorder. In addition, associations between the theme of agency and psychopathology were evident six and twelve months following the life story interview. This study seeks to bridge the mutually-informative fields of research on personality disorders and normal identity processes. PMID:22867502

Nutrition information-seeking behaviour of low-income pregnant Maghrebian women.

PubMed

Legault, Anik; Marquis, Marie

2014-01-01

Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women's nutrition decision-making. Environmental factors likely to influence information-seeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women's specific information needs.

Accustomed to enduring: experiences of African-American women seeking care for cardiac symptoms.

PubMed

Banks, Angela D; Malone, Ruth E

2005-01-01

Understand the meaning of delayed treatment seeking in African-American women with unstable angina and myocardial infarction. Phenomenologic analysis of in-depth interview data and field notes on 12 African-American women hospitalized with unstable angina or myocardial infarction. Women's interpretation of and response to symptoms were informed by experiences of marginalization and their self-understanding as people who were strong and who had endured life's hardships. When hospitalized, some women experienced trivialization of their complaints by clinicians and a focus on technological procedures over respectfully attending to their concerns, which provided further disincentives to seeking care. Three major themes emerged: misrecognition and discounting of symptoms, enduring, and influence of faith. Experiences of marginalization shape responses to symptoms, care-seeking behavior, and interpretation of subsequent care experiences for African-American women with cardiac disease, who may experience different symptoms as well as interpret them differently than members of other groups.

It's like a juggling act: rheumatoid arthritis patient perspectives on daily life and flare while on current treatment regimes.

PubMed

Flurey, Caroline A; Morris, Marianne; Richards, Pam; Hughes, Rodney; Hewlett, Sarah

2014-04-01

The objective of this study was to explore patients' experiences of RA daily life while on modern treatments. The methods of this study comprised semi-structured interviews with 15 RA patients, analysed using inductive thematic analysis. Four themes suggest patients experience life with RA along a continuum from RA in the background to the foreground of their lives, underpinned by constant actions to maintain balance. Living with RA in the background shows patients experience continuous, daily symptoms, which they mediate through micromanagement (mediating the impact of RA on daily life), while learning to incorporate RA into their identity (redefining me). RA moving into the foreground shows patients experience fluctuating symptoms (unwelcome reminders) that may or may not lead to a flare (trying to make sense of fluctuation). Dealing with RA in the foreground shows how patients attempt to manage RA flares (trying to regain control) and decide to seek medical help only after feeling they are losing control. Patients employ a stepped approach to self-management (mediation ladder) as symptoms increase, with seeking medical help often seen as the last resort. Patients seek to find a balance between managing their fluctuating RA and living their daily lives. Patients move back and forth along a continuum of RA in the background vs the foreground by balancing self-management of symptoms and everyday life. Clinicians need to appreciate that daily micromanagement is needed, even on current treatment regimes. Further research is needed to quantify the level and impact of daily symptoms and identify barriers and facilitators to seeking help.

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

PubMed

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

2016-05-01

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

Personal experiences of people with serious mental illness when seeking, obtaining and maintaining competitive employment in Queensland, Australia.

PubMed

Gladman, Beverley; Waghorn, Geoff

2016-02-15

High non-participation in the labour force and unemployment remain challenging for adults with serious mental illness. This study examined the personal experiences of people with serious mental illness when seeking, obtaining and maintaining competitive employment. The aim was to increase understanding of personal experiences of employment and how these experiences can be used to inform the assistance provided in support of clients' competitive employment goals. Qualitative data from a two-year period were thematically analysed from one participating site in a multi-site trial of employment services integrated with public funded community mental health treatment and care. Both positive and negative themes arose. Positive themes included: Aspirations for a better life, receiving feedback on good job performance, employment displacing preoccupation with illness, and employment improving self-esteem and reducing financial stress. Negative themes included stigma experiences, stress, and health difficulties. Both positive and negative experiences did not depend on type of employment service assistance nor key client characteristics such as age, sex, and diagnostic category. Despite its many benefits, employment can also increase the risk of negative personal experiences. These findings suggest that employment service providers could do more to assist people who commence employment, to reduce the risk of negative personal experiences and to enhance the benefits of competitive employment.

Surviving Sudden Cardiac Arrest: A Pilot Qualitative Survey Study of Survivors.

PubMed

Sawyer, Kelly N; Brown, Frances; Christensen, Roxanne; Damino, Colleen; Newman, Mary M; Kurz, Michael C

2016-06-01

Research describing survivors of sudden cardiac arrest (SCA) has centered on quantifying functional ability, perceived quality of life, and neurocognitive assessment. Many gaps remain, however, regarding survivors' psychosocial perceptions of life in the aftermath of cardiac arrest. An important influence upon those perceptions is the presence of support and its role in a survivor's life. An Internet-based pilot survey study was conducted to gather data from SCA survivors and friends and/or family members (FFMs) representing their support system. The survey was distributed to members of the Sudden Cardiac Arrest Foundation (SCAF) via the Internet by SCAF leadership. Questions included both discrete multiple-choice and open-ended formats. Inductive thematic analyses were completed by three independent researchers trained in qualitative research methodology to identify primary themes consistent among study participants until thematic saturation was achieved. No statistical inferences were made. A total of 205 surveys were returned over the 5-month study period (July to November 2013); nine were received blank, leaving 196 surveys available for review. Major themes identified for survivors (N = 157) include the significance of and desire to share experiences with others; subculture identification (unique experience from those suffering a heart attack); and the need to seek a new normal, both personally and inter-personally. Major themes identified for FFMs (N = 39) include recognition of loved one's memory loss; a lack of information at discharge, including expectations after discharge; and concern for the patient experiencing another cardiac arrest. This pilot, qualitative survey study suggests several common themes important to survivors, and FFMs, of cardiac arrest. These themes may serve as a basis for future patient-centered focus groups and the development of patient-centered guidelines for patients and support persons of those surviving cardiac arrest.

It’s like a juggling act: rheumatoid arthritis patient perspectives on daily life and flare while on current treatment regimes

PubMed Central

Morris, Marianne; Richards, Pam; Hughes, Rodney; Hewlett, Sarah

2014-01-01

Objective. The objective of this study was to explore patients’ experiences of RA daily life while on modern treatments. Methods. The methods of this study comprised semi-structured interviews with 15 RA patients, analysed using inductive thematic analysis. Results. Four themes suggest patients experience life with RA along a continuum from RA in the background to the foreground of their lives, underpinned by constant actions to maintain balance. Living with RA in the background shows patients experience continuous, daily symptoms, which they mediate through micromanagement (mediating the impact of RA on daily life), while learning to incorporate RA into their identity (redefining me). RA moving into the foreground shows patients experience fluctuating symptoms (unwelcome reminders) that may or may not lead to a flare (trying to make sense of fluctuation). Dealing with RA in the foreground shows how patients attempt to manage RA flares (trying to regain control) and decide to seek medical help only after feeling they are losing control. Patients employ a stepped approach to self-management (mediation ladder) as symptoms increase, with seeking medical help often seen as the last resort. Patients seek to find a balance between managing their fluctuating RA and living their daily lives. Conclusion. Patients move back and forth along a continuum of RA in the background vs the foreground by balancing self-management of symptoms and everyday life. Clinicians need to appreciate that daily micromanagement is needed, even on current treatment regimes. Further research is needed to quantify the level and impact of daily symptoms and identify barriers and facilitators to seeking help. PMID:24357813

Parents who use drugs: accounting for damage and its limitation.

PubMed

Rhodes, Tim; Bernays, Sarah; Houmoller, Kathrin

2010-10-01

Parents who use drugs parent in a context of heightened concern regarding the damaging effects of parental drug use on child welfare and family life. Yet there is little research exploring how parents who use drugs account for such damage and its limitation. We draw here upon analyses of audio-recorded depth qualitative interviews, conducted in south-east England between 2008 and 2009, with 29 parents who use drugs. Our approach to thematic analysis treated accounts as co-produced and socially situated. An over-arching theme of accounts was 'damage limitation'. Most damage limitation work centred on efforts to create a sense of normalcy of family life, involving keeping drug use secret from children, and investing heavily in strategies to maintain ambiguity regarding children's awareness. Our analysis highlights that damage limitation strategies double-up in accounts as resources of child protection as well as self protection. This illuminates tensions in the multiple functions that accounts of damage limitation can serve. We draw a distinction between accounts in which damage is qualified and those in which damage is accepted. Accounts of damage qualification highlight a theme of 'good enough' parenting. Accounts of damage acceptance highlight a theme of 'recovery'. We find that the interview accounts operate in response to a regulative norm of 'good parenting' in which one strives to deflect damaged identity through narratives of damage qualification and to seek understanding and acceptance through narratives of recovery. Noting the absence of space for parents who use drugs to openly reflect or talk about the challenges they face, we identify the need for social change interventions to create enabling environments for earlier help seeking and talking. Copyright © 2010 Elsevier Ltd. All rights reserved.

Stigma Experiences in Marginalized People Living With HIV Seeking Health Services and Resources in Canada.

PubMed

Donnelly, Leeann R; Bailey, Lauren; Jessani, Abbas; Postnikoff, Jonathan; Kerston, Paul; Brondani, Mario

HIV stigma may prevent people from obtaining a timely diagnosis and engaging in life-saving care. It may also prevent those who are HIV infected from seeking health and education resources, particularly if they are from marginalized communities. We inductively explored the roots of stigma and its impact on health services and resource seeking as experienced by HIV-infected members of marginalized communities in Vancouver, British Columbia, Canada, using a community-based participatory research framework. Five peer-facilitated focus groups were conducted with 33 Aboriginal, Latino, Asian, and African participants. Thematic analysis of the experiences revealed four dominant themes: beginnings of stigma, tensions related to disclosure, experiences of service seeking, and beyond HIV stigma and discrimination. Persons living with HIV from Aboriginal and refugee communities continue to experience disproportionate rates of stigma and discrimination. Fear remains a prime obstacle influencing these groups' abilities and willingness to access care in various settings. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Desistance and Treatment Seeking Among Women With Substance Use Disorders.

PubMed

Rhodes, Blythe E; Gottfredson, Nisha C; Hill, Lauren M

2018-04-01

Addiction rates are rising faster among women than men. However, women with substance use disorders are less likely to enter treatment than males. This study seeks to understand how turning-point events and other maturational processes affect "life course persistent" women's motivations for seeking treatment for their disorder. We conducted semi-structured in-depth interviews with 30 women who were receiving treatment for addiction using thematic analysis. Recurring themes were as follows: experiences of rock-bottom events prior to entering treatment, feeling "sick and tired" in regard to both their physical and mental health, and shifting identities or perceptions of themselves. We discuss the importance of motivating shifts in identity to prevent women from entering treatment as a result of more traumatic mechanisms as well as the possibility of intercepting women with substance dependence and chronic health conditions in primary care or hospital settings with the aim of encouraging treatment.

#MyDepressionLooksLike: Examining Public Discourse About Depression on Twitter

PubMed Central

Lachmar, E Megan; Bogen, Katherine W; McCauley, Heather L

2017-01-01

Background Social media provides a context for billions of users to connect, express sentiments, and provide in-the-moment status updates. Because Twitter users tend to tweet emotional updates from daily life, the platform provides unique insights into experiences of mental health problems. Depression is not only one of the most prevalent health conditions but also carries a social stigma. Yet, opening up about one’s depression and seeking social support may provide relief from symptoms. Objective The aim of this study was to examine the public discourse of the trending hashtag #MyDepressionLooksLike to look more closely at how users talk about their depressive symptoms on Twitter. Methods We captured 3225 original content tweets for the hashtag #MyDepressionLooksLike that circulated in May of 2016. Eliminating public service announcements, spam, and tweets with links to pictures or videos resulted in a total of 1978 tweets. Using qualitative content analysis, we coded the tweets to detect themes. Results The content analysis revealed seven themes: dysfunctional thoughts, lifestyle challenges, social struggles, hiding behind a mask, apathy and sadness, suicidal thoughts and behaviors, and seeking relief. Conclusions The themes revealed important information about the content of the public messages that people share about depression on Twitter. More research is needed to understand the effects of the hashtag on increasing social support for users and reducing social stigma related to depression. PMID:29046270

The Gull Sees Farthest Who Flies Highest

NASA Astrophysics Data System (ADS)

Pirri, Anthony N.

2005-04-01

The proverb from Richard Bach's book Jonathan Livingston Seagull expresses the theme that he in life who thinks and acts ahead of the flock lives live to the fullest and enjoys the freedom that is the very nature of being. This keynote address will give examples of three noted professionals who were not content to make small improvements in technology but strove to make giant leaps. Their work became the driving force for those of us who became their followers in seeking fulfillment from our professional lives.

Self-perception in Iranian adolescents with diabetes: a qualitative study.

PubMed

Rostami, Shahnaz; Parsa-Yekta, Zahra; Najafi-Ghezeljeh, Tahereh; Vanaki, Zohreh; Zarea, Kourosh

2015-01-01

It is obvious that self-perception can play an important role in the development of self-management behaviours among adolescents with diabetes to promote their health and quality of life. This study seeks to explain self-perception in adolescents with diabetes. This qualitative study, which is of "grounded theory" type, was performed in 2013 in Ahvaz, Iran, through semi-structured interviews with ten adolescents with type 1 diabetes, two parents and a nurse, who were chosen objectively. Data analysis was performed using Strauss and Corbin 1998 method. Four main theme was obtained from the analysis of data, and the consequence theme was inferred as follows: getting insight (knowledge acquisition and belief management), perceiving similarities with others (not hiding the disease, showing the illness is normal, and accepting an active role in the family), and self-care management (independent control of food and treatment regimen and understanding of capabilities to manage the future of life and manage the daily activities of life), and life satisfaction (perception of being healthy and having a normal life). Getting insight into the disease is the most important part of perceiving similarities with others and offering self-care, which can provide a person's positive perception of himself/herself and the illness, as well as life satisfaction for their adolescent over time. These results are an operational guide for personnel providing health care services, especially diabetes specialist nurses.

How online counselling can support partners of individuals with problem alcohol or other drug use.

PubMed

Wilson, Samara R; Rodda, Simone; Lubman, Dan I; Manning, Victoria; Yap, Marie B H

2017-07-01

Problematic alcohol and other drug (AOD) use impacts partners heavily, with an increased risk of experiencing domestic violence, financial stressors, health problems and relationship challenges. However, partners often do not seek help or support due to a range of barriers (e.g., shame, stigma, practical constraints). Online counselling may facilitate help-seeking by overcoming many of these barriers, however research is needed to explore what motivates partners to contact online counselling services, their experiences and needs, and how partners can be best supported online. One hundred transcripts of partners of individuals with problem AOD use were sampled from a 24-hour national AOD synchronous online chat counselling service. Descriptive content analysis was used to investigate themes related to help-seeking. Three broad themes, with seven sub-themes, were identified: (i) the reason for accessing online counselling (seeking advice, wanting to talk), (ii) discussing help-seeking and coping processes (past/present help-seeking or coping strategies, barriers and facilitators to seeking help and change), and (iii) planning for future assistance (future planning, treatment preferences). Partners wanted to talk about their concerns with a non-judgemental professional. However, the majority of help-seekers wanted advice and assistance in problem-solving, coping and the process of seeking further help. Future studies need to examine the impact of online help-seeking by partners. Copyright © 2017 Elsevier Inc. All rights reserved.

National Aeronautics and Space Administration Biological and Physical Research Enterprise Strategy

NASA Technical Reports Server (NTRS)

2003-01-01

As the 21st century begins, NASA's new Vision and Mission focuses the Agency's Enterprises toward exploration and discovery.The Biological and Physical Research Enterprise has a unique and enabling role in support of the Agency's Vision and Mission. Our strategic research seeks innovations and solutions to enable the extension of life into deep space safely and productively. Our fundamental research, as well as our research partnerships with industry and other agencies, allow new knowledge and tech- nologies to bring improvements to life on Earth. Our interdisciplinary research in the unique laboratory of microgravity addresses opportunities and challenges on our home planet as well as in space environments. The Enterprise maintains a key role in encouraging and engaging the next generation of explorers from primary school through the grad- uate level via our direct student participation in space research.The Biological and Physical Research Enterprise encompasses three themes. The biological sciences research theme investigates ways to support a safe human presence in space. This theme addresses the definition and control of physiological and psychological risks from the space environment, including radiation,reduced gravity, and isolation. The biological sciences research theme is also responsible for the develop- ment of human support systems technology as well as fundamental biological research spanning topics from genomics to ecologies. The physical sciences research theme supports research that takes advantage of the space environment to expand our understanding of the fundamental laws of nature. This theme also supports applied physical sciences research to improve safety and performance of humans in space. The research partnerships and flight support theme establishes policies and allocates space resources to encourage and develop entrepreneurial partners access to space research.Working together across research disciplines, the Biological and Physical Research Enterprise is performing vital research and technology development to extend the reach of human space flight.

The Enigma of Rapid Repeat Pregnancy: A Qualitative Study of Teen Mothers.

PubMed

Conroy, K N; Engelhart, T G; Martins, Y; Huntington, N L; Snyder, A F; Coletti, K D; Cox, J E

2016-06-01

Rapid repeat pregnancy accounts for 18% of teen pregnancies and leads to adverse health, economic, and developmental outcomes for teen mothers and their children. Few interventions have been successful in reducing rapid repeat pregnancy. In this qualitative study we examined adolescent mothers' perceptions of their decision-making and behaviors that helped prevent or promote a rapid repeat pregnancy. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Semistructured interviews were conducted with 31 adolescent mothers, aged 16-21 years; 15 of these subjects experienced a repeat pregnancy within a year of their first child's birth and 16 had not. Two researchers used a grounded, inductive technique to identify emergent themes; interviews were subsequently coded accordingly. Counts were tabulated of the number of times themes were endorsed among those with or without a repeat pregnancy. Four overarching themes emerged from the interviews: intentionality regarding pregnancy planning, patients' degree of independence in making contraceptive choices, sense of control over life experience, and barriers to follow-through on contraceptive planning. Teens who had not experienced a rapid repeat pregnancy more often endorsed themes of intentionality in preventing or promoting a pregnancy, independence in decision-making, and feelings of control over their experience. Ambivalence and lack of decision-making about seeking another pregnancy were frequently endorsed by mothers who had experienced a second pregnancy. Decision-making regarding seeking or preventing a rapid repeat pregnancy is complex for teen mothers; techniques to help support decision-making or to delay pregnancy until decision-repeat making is complete might be important in reducing rapid pregnancy. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Meaningful lives: elders in treatment for depression.

PubMed

Ragan, Meredith; Kane, Catherine F

2010-12-01

Depression among elderly persons is common. Major depression is disabling, highly prevalent, and adversely affects daily function and quality of life. Although studies have demonstrated that interpersonal psychotherapy (IPT) and medication can relieve the symptoms of depression, many elders do not seek treatment. Of those elders who do participate in treatment experience, 20% to 50% do not experience partial or full relief from depressive symptoms. Improvements in treatment strategies are needed to better serve this population. In this study, 20 elders in treatment for depression with IPT and medication were interviewed to better understand their day-to-day lives. These interviews provided insights and perspectives to inform clinical practice and improve treatment strategies. The major themes identified were independence, spirituality, family, depression, medical comorbidities, and motivation. Potential treatment strategies were derived from these themes. Copyright © 2010 Elsevier Inc. All rights reserved.

Policies of Inclusion

PubMed Central

Fairchild, Amy L.

2004-01-01

The racial politics of immigration have punctuated national discussions about immigration at different periods in US history, particularly when concerns about losing an American way of life or American population have coincided with concerns about infectious diseases. Nevertheless, the main theme running through American immigration policy is one of inclusion. The United States has historically been a nation reliant on immigrant labor and, accordingly, the most consequential public policies regarding immigration have responded to disease and its economic burdens by seeking to control the behavior of immigrants within our borders rather than excluding immigrants at our borders. PMID:15053996

Older partner selection in young African-American men who have sex with men.

PubMed

Arrington-Sanders, Renata; Leonard, Lori; Brooks, Durryle; Celentano, David; Ellen, Jonathan

2013-06-01

Young African-American (AA) men who have sex with men (YAAMSM) have experienced the greatest proportional increase in new HIV cases compared with other groups. Bridging sexual partnerships between YAAMSM and older aged cohorts with higher rates of primary HIV infection has emerged as an important independent risk factor for the development of HIV. We explored reasons young AAMSM cite for being attracted to and seeking an older partner and the interpersonal needs met within older sexual partnerships. Seventeen in-depth semistructured qualitative interviews were conducted in YAAMSM residing in a midsized urban city with high HIV prevalence. Two coders independently evaluated transcribed data to identify/collapse codes that emerged. We analyzed data using categorical and contextualizing analytic methods. Two themes emerged from the text for seeking an older sexual partner: the emotional maturity the older partner represented and the ability of the older partner to expose the younger partner to more life experiences. In addition, two themes emerged around attraction: support and physical attractiveness of the older partner. Few men described seeking age-discordant relationships for the sole purpose of exchange sex. Older partners during first same-sex experience helped younger partners sort through sexual position and how to perform in relationships. These interviews suggest that YAAMSM may be seeking older partners to fulfill desires to be in a stable, emotionally mature relationship and for exposure in the larger community. Prevention strategies aimed at targeting adolescent MSM age-discordant relationships will need to address the interpersonal needs met within older sexual partnerships. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

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

ERIC Educational Resources Information Center

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

2010-01-01

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

Being One with the Universe: Finding a Silver Lining in Dying.

PubMed

Caratao-Mojica, Rhea

2015-07-01

Woody Allen once quoted, "I don't mind dying so much, I just don't want to be there when it happens" (as cited in Ingram, 2002, p. 1). Oftentimes, death is not a happy subject, a reality that most of us fear, yet something we all must face. In this paper, three articles were reviewed that explored the living-dying (Phillips, 1992) process of the terminally ill and the material was conceptualized in light of Rogers (1994) science of unitary human beings. To further understand and explore the living-dying process, creative examples (movie screenplay, novel, song and others) were cited. During the living-dying process exploration, three common themes were expressed by the subjects (dying persons), namely: valuing own perspective of quality of life; choosing personal meanings with ways of moving beyond with the possibles (Lee & Pilkington, 1999), while focusing on life's meaning rather than life's details (Dobratz, 2002); and connecting to the world-as-unknown while self-separating to the world-as-known in actively seeking the union with death (Kubler-Ross, 1981; Callanan & Kelly, 1992; Dobratz, 2002). It is important for healthcare providers to recognize and acknowledge all three themes to be able to understand dying persons, to focus on their wholeness rather than their disease, and to help families discern symbolic messages conveyed by them. Moreover, knowing these themes also enables healthcare providers to help all parties to transition and be able to accept and embrace the most difficult process—the living-dying (Phillips, 1992) process. © The Author(s) 2015.

Life course experiences and lay diagnosis explain low-income parents' child dental decisions: a qualitative study.

PubMed

Muirhead, Vanessa; Levine, Alissa; Nicolau, Belinda; Landry, Anne; Bedos, Christophe

2013-02-01

This study aimed to better understand low-income parents' child dental care decisions through a life course approach that captured parents' experiences within the social context of poverty. We conducted 43 qualitative life history interviews with 10 parents, who were long-term social assistance recipients living in Montreal, Canada. Thematic analysis involved interview debriefing, transcript coding, theme identification and data interpretation. Our interviews identified two emergent themes: lay diagnosis and parental oral health management. Parents described a process of 'lay diagnosis' that consisted of examining their children's teeth and interpreting their children's oral signs and symptoms based on their observations. These lay diagnoses were also shaped by their own dental crises, care experiences and oral health knowledge gained across a life course of poverty and dental disadvantage. Parents' management strategies included monitoring and managing their children's oral health themselves or by seeking professional recourse. Parents' management strategies were influenced both by their lay diagnoses and their perceived ability to manage their children's oral health. Parents felt responsible for their children's dental care, empowered to manage their oral health and sometimes forgo dental visits for their children because of their own self-management life history. This original approach revealed insights that help to understand why low-income parents may underutilize free dental services. Further research should consider how dental programs can nurture parental empowerment and capitalize on parents' perceived ability to diagnose and manage their children's oral health.

Quality of Life of College Students Living With Type 1 Diabetes: A Qualitative View.

PubMed

Fredette, Judy; Mawn, Barbara; Hood, Korey; Fain, James

2016-12-01

The purpose of this phenomenological qualitative study was to examine the quality of life among college students living with Type 1 diabetes (T1D). Inclusion criteria included age 18 to 24, current college student, and a diagnosis of T1D for at least 1 year. Semi-structured interviews were conducted, in-person and by phone. During these interviews, college students shared stories of living with T1D and its impact on their quality of life. Three major themes emerged, which included "planning ahead," "thinking positive," and "seeking support." These findings provide a better understanding of the transitional experience of living with T1D and the impact on perceived quality of life while attending college. Techniques and strategies aimed at the enhancement of perceived quality of life for college students living with T1D were identified. These findings will provide valuable insight for professionals working with this population. © The Author(s) 2016.

The experiences of frequent users of crisis helplines: A qualitative interview study.

PubMed

Middleton, Aves; Gunn, Jane; Bassilios, Bridget; Pirkis, Jane

2016-11-01

To understand why some users call crisis helplines frequently. Nineteen semi-structured telephone interviews were conducted with callers to Lifeline Australia who reported calling 20 times or more in the past month and provided informed consent. Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis was used to generate common themes. Approval was granted by The University of Melbourne Human Research Ethics Committee. Three overarching themes emerged from the data and included reasons for calling, service response and calling behaviours. Respondents called seeking someone to talk to, help with their mental health issues and assistance with negative life events. When they called, they found short-term benefits in the unrestricted support offered by the helpline. Over time they called about similar issues and described reactive, support-seeking and dependent calling behaviours. Frequent users of crisis helplines call about ongoing issues. They have developed distinctive calling behaviours which appear to occur through an interaction between their reasons for calling and the response they receive from the helpline. The ongoing nature of the issues prompting frequent users to call suggests that a service model that includes a continuity of care component may be more efficient in meeting their needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Understanding the Health Needs and Barriers to Seeking Health Care of Veteran Students in the Community.

PubMed

Misra-Hebert, Anita D; Santurri, Laura; DeChant, Richard; Watts, Brook; Rothberg, Michael; Sehgal, Ashwini R; Aron, David C

2015-08-01

Access to care at Veterans Affairs facilities may be limited by long wait times; however, additional barriers may prevent US military veterans from seeking help at all. We sought to understand the health needs of veterans in the community to identify possible barriers to health-seeking behavior. Focus groups were conducted with veteran students at a community college until thematic saturation was reached. Qualitative data analysis involved both an inductive content analysis approach and deductive elements. A total of 17 veteran students participated in 6 separate focus groups. Health needs affecting health-seeking behavior were identified. Themes included lack of motivation to improve health, concern about social exclusion and stigma, social interactions and behavior, limited access to affordable and convenient health care, unmet basic needs for self and family, and academics competing with health needs. Veterans face a range of personal, societal, and logistical barriers to accessing care. In addition to decreasing wait times for appointments, efforts to improve the transition to civilian life; reduce stigma; and offer assistance related to work, housing, and convenient access to health care may improve health in veteran students.

Understanding the Health Needs and Barriers to Seeking Health Care of Veteran Students in the Community

PubMed Central

Misra-Hebert, Anita D.; Santurri, Laura; DeChant, Richard; Watts, Brook; Rothberg, Michael; Sehgal, Ashwini R.; Aron, David C.

2015-01-01

Objectives Access to care at Veterans Affairs facilities may be limited by long wait times; however, additional barriers may prevent US military veterans from seeking help at all. We sought to understand the health needs of veterans in the community to identify possible barriers to health-seeking behavior. Methods Focus groups were conducted with veteran students at a community college until thematic saturation was reached. Qualitative data analysis involved both an inductive content analysis approach and deductive elements. Results A total of 17 veteran students participated in 6 separate focus groups. Health needs affecting health-seeking behavior were identified. Themes included lack of motivation to improve health, concern about social exclusion and stigma, social interactions and behavior, limited access to affordable and convenient health care, unmet basic needs for self and family, and academics competing with health needs. Conclusions Veterans face a range of personal, societal, and logistical barriers to accessing care. In addition to decreasing wait times for appointments, efforts to improve the transition to civilian life, reduce stigma, and offer assistance related to work, housing, and convenient access to health care may improve health in veteran students. PMID:26280777

"We're going through a lot of struggles that people don't even know about": the need to understand African American males' help-seeking for mental health on multiple levels.

PubMed

Lindsey, Michael A; Marcell, Arik V

2012-09-01

Young adult Black males face challenges related to addressing their mental health needs, yet there is much more to know about their help-seeking experiences. Twenty-seven Black males, recruited from four community-based organizations, participated in four focus groups to explore perceptions of help-seeking for mental health. Identified themes, which function at individual, social network, community, and health care system levels, may facilitate or hinder Black males' mental health help-seeking. Themes included (a) "taking care of it oneself" as opposed to seeking help from someone; (b) issues engaging sources of help, including the ability to trust providers or the relationship closeness with social network members; and (c) "tipping points" that activate help-seeking to avert crises. Study findings provide initial evidence about the importance of addressing mental health interventions for Black males on multiple levels beyond the individual including engaging men's social supports, community, and the health care system.

Concerns, attitudes, beliefs and information seeking practices with respect to nutrition-related issues: a qualitative study in French pregnant women.

PubMed

Bianchi, Clélia M; Huneau, Jean-François; Le Goff, Gaëlle; Verger, Eric O; Mariotti, François; Gurviez, Patricia

2016-10-12

From a life course perspective, pregnancy leads to a rise in nutrition awareness and an increase in information flow in favour of adopting healthier eating behaviours. This qualitative study was designed to better understand the determinants of eating behaviours in French pregnant women by focusing on their concerns, attitudes and beliefs and their nutrition-related information seeking practices. Seven focus groups were conducted, involving a total of 40 French pregnant women. An inductive thematic approach, adapted from the grounded theory, was adopted to analyse the data. Two major themes were identified: eating behaviour and nutrition-related information behaviour. The eating behaviour theme was divided into four sub-themes using the attribution theory. Three external causes affected the eating behaviour of pregnant women (food restrictions, physiological changes and weight gain), and led to frustration and a perceived loss of control. By contrast the adoption of a healthier diet was perceived as internal by pregnant women, and resulted in self-fulfilment and empowerment regarding the health and the well-being of their baby and themselves, and their weight gain management. Greater attention was paid to nutrition-related information obtained from healthcare providers, the social environment and the mass media. Information was passively absorbed or actively sought by pregnant women, but most was perceived as contradictory, which led to confusion. Pregnancy is accompanied by a rise in nutrition awareness, substantiated by eating behaviour modifications due to external and internal causes. However, conflicts between and within information sources result in confusion that can limit the adoption of healthier eating behaviour.

"If I had been given that information back then": An interpretive description exploring the information needs of adults with cerebral palsy looking back on their transition to adulthood.

PubMed

Freeman, M; Stewart, D; Cunningham, C E; Gorter, J W

2018-06-11

Young people with cerebral palsy (CP) and their families have identified lack of information received during the transition to adulthood as a barrier to successful outcomes. To date, few studies have explored the information needs, preferences, timing, and method of provision from the perspective of individuals with CP. The methodological approach to this qualitative study was interpretive description. Nine adults living with CP, between the ages of 20 and 40, were purposively recruited in Ontario, Canada, to explore, retrospectively, their information needs during the transition to adulthood. Participants completed a 1-hour interview that explored their experiences seeking and receiving information. Interviews were transcribed verbatim, and data were analysed to create a thematic description of adults' experiences with information. Three themes emerged: (a) "Recognizing and supporting information needs," which highlighted the importance of support systems to assist young people in receiving and seeking information throughout the transition; (b) "Getting creative," which highlighted strategies young people use when confronted with environmental barriers when seeking information; and (c) "Gaps and advice for the future," which highlighted the need for real-life opportunities, during the transition to adulthood, to experience some of the responsibilities of adult life. Clinicians assisting young people with CP need purposefully to foster knowledge and skills during the transition to adulthood. They should be not only providers of information but also enablers of opportunities for immersion in real-life experiences to prepare for adult life. It is important for young people to have the opportunity to discuss challenges and exchange information with their peers. © 2018 John Wiley & Sons Ltd.

Women Empowerment through Health Information Seeking: A Qualitative Study

PubMed Central

Nikbakht Nasrabadi, Alireza; Sabzevari, Sakineh; Negahban Bonabi, Tayebeh

2015-01-01

Background Today, women empowering is an important issue.  Several methods have been introduced to empower women. Health information seeking is one of the most important activities in this regard. A wide range of capabilities have been reported as outcomes of health information seeking in several studies. As health information seeking is developed within personal-social interactions and also the health system context, it seems that the qualitative paradigm is appropriate to use in studies in this regard. This study aimed to explore how women’s empowerment through health information seeking is done. Methods In this qualitative content analysis study, data collection was done with regard to inclusion criteria, through purposive sampling by semi-structured interviews with 17 women and using documentation and field notes until data saturation. Qualitative data analysis was done constantly and simultaneous with data collection. Results Four central themes were emerged to explain women’s empowerment through health information seeking that included: a) Health concerns management with three subcategories of Better coping, Stress management, Control of situation, b) Collaborative care with two subcategories of Effective interaction with health professions and Participation in health decision making c) Individual development d) Self-protection with four sub- categories of Life style modification,  Preventive behaviors promoting, Self-care promoting, and  medication adherence. Conclusion The results of this study indicate the importance of women empowerment through foraging their health information seeking rights and comprehensive health information management. PMID:26005690

Nurses involved in whistleblowing incidents: sequelae for their families.

PubMed

Wilkes, Lesley M; Peters, Kath; Weaver, Roslyn; Jackson, Debra

2011-01-01

Nurses involved in whistleblowing often face economic and emotional retaliation, victimization and abuse. Yet for many nurses, one major part of their whistleblowing experience is the negative impact it has on their families. This paper reports findings from a qualitative study pertaining to the effects of whistleblowing on family life from the perspective of the nurses. Using a narrative inquiry approach, fourteen nurses were interviewed who were directly involved in whistleblowing complaints. Data analysis drew out three themes: strained relationships with family members, dislocation of family life, and exposing family to public scrutiny. The harm caused to the nurses involved in a whistleblowing event is not restricted to one party but to all those involved, as the harrowing experience and its consequences are echoed in the family life as well. It is important for organizations to seek strategies that will minimize the harmful effects on nurses' families during whistleblowing events.

Living with pain: the experience of children and adolescents in palliative care.

PubMed

Borghi, Camila Amaral; Rossato, Lisabelle Mariano; Damião, Elaine Buchhorn Cintra; Guedes, Danila Maria Batista; Silva, Ellen Maria Reimberg da; Barbosa, Silvia Maria de Macedo; Polastrini, Rita Tiziana

2014-08-01

A qualitative study was conducted with semi-structured interviews with the aim of understanding the experience of children and adolescents under palliative care when managing pain daily and how they describe the intensity, quality and location of pain. We used Piaget's theory of cognitive development as a theoretical framework and oral history as a methodological framework. We found four themes: describing pain; seeking a life closer to normality, despite pain and disease; using a variety of alternatives for pain control; and living with damaged physical appearance. Although pain is a limiting factor in the lives of children and adolescents, we found that they faced their daily pain and still had a life beyond pain and illness. In addition, we highlight the relevance of nurses' understanding that effective management of pain in children is essential for a normal life and less suffering.

Cosmic Origins Program Annual Technology Report

NASA Technical Reports Server (NTRS)

Pham, Bruce Thai; Neff, Susan Gale

2015-01-01

What is the Cosmic Origins (COR) Program? From ancient times, humans have looked up at the night sky and wondered: Are we alone? How did the universe come to be? How does the universe work? COR focuses on the second question. Scientists investigating this broad theme seek to understand the origin and evolution of the universe from the Big Bang to the present day, determining how the expanding universe grew into a grand cosmic web of dark matter enmeshed with galaxies and pristine gas, forming, merging, and evolving over time. COR also seeks to understand how stars and planets form from clouds in these galaxies to create the heavy elements that are essential to life starting with the first generation of stars to seed the universe, and continuing through the birth and eventual death of all subsequent generations of stars. The COR Programs purview includes the majority of the field known as astronomy, from antiquity to the present.

Program Annual Technology Report: Cosmic Origins Program Office

NASA Technical Reports Server (NTRS)

Pham, Thai; Neff, Susan

2017-01-01

What is the Cosmic Origins (COR) Program? From ancient times, humans have looked up at the night sky and wondered: Are we alone? How did the universe come to be? How does the universe work? COR focuses on the second question. Scientists investigating this broad theme seek to understand the origin and evolution of the universe from the Big Bang to the present day, determining how the expanding universe grew into a grand cosmic web of dark matter enmeshed with galaxies and pristine gas, forming, merging, and evolving over time. COR also seeks to understand how stars and planets form from clouds in these galaxies to create the heavy elements that are essential to life, starting with the first generation of stars to seed the universe, and continuing through the birth and eventual death of all subsequent generations of stars. The COR Programs purview includes the majority of the field known as astronomy.

Developing human functioning and rehabilitation research. Part II: Interdisciplinary university centers and national and regional collaboration networks.

PubMed

Stucki, Gerold; Celio, Marco

2007-05-01

There is a strong movement towards interdisciplinary research around common and scientifically competitive themes, both at universities and at the national and regional level. Human functioning and rehabilitation is a new, highly innovative and relevant theme. It has the potential to attract researchers from a wide range of disciplines, institutions and organizations. It is thus of interest for universities seeking to embark upon a new and unique research area. Similarly, it is a promising theme for individual researchers, institutions and organizations aiming to develop a national or regional collaboration network for interdisciplinary research. Human functioning and rehabilitation complements established themes from the biomedical perspective. In the context of the life sciences, it can be seen as an extension of the biosciences towards a comprehensive understanding of human life, including human interaction and communication, against the background of the natural and social environment. Based on a better understanding of human functioning and disability, there is a wide range of largely unexplored possibilities to optimize populations' functioning and minimize persons' experience of disability in the presence of a health condition. Rehabilitation research is uniquely positioned to integrate and translate scientific advances into benefits for people and the society. Rehabilitation research from the comprehensive perspective can thus become a catalyst of interdisciplinary research that crosses the boundaries of the natural sciences and engineering research, the human and behavioral sciences, the social sciences and a wide range of related scientific areas. Rehabilitation research is also uniquely positioned to cross the boundaries of medicine and the health sector at large, and to translate knowledge across sectors including education, labor and social affairs.

Information-seeking at a caregiving website: a qualitative analysis.

PubMed

Kernisan, Leslie P; Sudore, Rebecca L; Knight, Sara J

2010-07-28

The Internet is widely used for health information, yet little is known about the online activity of family caregivers of elders, a rapidly growing group. In order to better understand the online information-seeking activity of "e-caregivers" and other visitors at a caregiving website, we undertook a qualitative analysis of survey data from a website marketed as a comprehensive resource for adults caring for aging parents. The objectives were to better understand what types of information are sought by those visiting a website focused on elder-care issues and to identify overarching themes that might inform future development of Internet resources related to caregiving and aging. From March 2008 to March 2009, a 5-question pop-up survey was offered 9662 times and completed 2161 times. For 1838 respondents, included was a free text answer to the question "What were you looking for?" and 1467 offered relevant and detailed responses. The survey also asked about satisfaction with the site, gender of the respondent, and relationship to the individual being cared for. Content analysis was used to develop a coding dictionary, to code responses into information-seeking categories, and to identify overarching themes. Of the respondents (76% of whom were female), 50% indicated they were caring for parents, 17% for themselves only, and 31% for others. Over half (57%) reported finding what they were looking for, and 46% stated they were extremely likely to recommend the website. Frequently mentioned information-seeking categories included "health information," "practical caregiving," and "support." Respondents also requested information related to housing, legal, insurance, and financial issues. Many responses referred to multiple comorbid conditions and complex caregiving situations. Overarching themes included (1) a desire for assistance with a wide range of practical skills and information and (2) help interpreting symptoms and behavior, such as knowing what life impacts to expect over the course of a health condition or treatment. Visitors to a website targeting adults caring for aging parents reported seeking both general information on caregiving and specific assistance with the complex custodial, medical, emotional, and financial aspects of caregiving. Visitors requested both information to build caregiving skills as well as assistance in interpreting and knowing what to expect from symptoms, health conditions, and changes in behavior and relationships. Many desired communication with and support from other caregivers. Health care providers and eHealth developers should expect that many caregivers of elders are using the Internet as a resource. Further research and development is needed to fully realize the Internet's potential for education and support of caregivers.

The colour of creation: Gertrude Jekyll and the art of flowers.

PubMed

Bisgrove, Richard

2013-12-01

Flowers were central to the life and work of Gertrude Jekyll (1843-1932), one of the 20th century's most influential garden designers. Born of parents with interests across a broad range of the art-science spectrum, Miss Jekyll developed an early interest in many arts and crafts, including painting and gardening in particular. During her course at the Central School of Design in Kensington she studied closely the work of JMW Turner. Many of the compositional elements of Turner's paintings, especially his use of colour, can be seen in Miss Jekyll's subsequent designs for c. 250 gardens. The use of blue and yellow flowers to create a sense of light, and the contrast of cool blue flowers and grey foliage with vivid reds and oranges are recurrent themes in her planting schemes, but many other aspects of her designs also reflect her broad interest in the art, craft, and science of plant cultivation. She encouraged others to seek the satisfaction offered by gardening as an art, convinced that a life spent seeking perfection would gradually yield 'the power of intelligent combination, the nearest thing we can know to the mighty force of creation'.

Help seeking in a support group for recipients of implantable cardioverter defibrillators and their support persons.

PubMed

Dickerson, S S; Posluszny, M; Kennedy, M C

2000-01-01

To understand shared meanings of help-seeking experiences in support groups of people with implantable cardioverter defibrillator (ICD) and their support persons. ICD support group at an urban medical center. Fifteen individuals with ICD and 9 support persons. Six related themes and 1 constitutive pattern emerged. Themes included hearing and telling stories, help seeking encouraged by triggers, seeking meaningful information, forming a therapeutic friendship through group camaraderie, gaining assistance from the facilitator, and the sharing of a similar view by support persons. The constitutive pattern is coping with the possibility of death. Health care providers may recommend storytelling as the central mechanism of interactions in support groups that assist in coping with daily anxieties of living with an ICD. Nurses would be appropriate facilitators to guide discussion, to provide technical information, and to promote anticipatory guidance in coping with potential firing events.

A Thematic Analysis of Edwin L. Godkin's Editorials in the "Nation," 1865-1899.

ERIC Educational Resources Information Center

Lee, Richard W.

This thematic analysis of Edward L. Godkin's editorials appearing in the "Nation" seeks to reveal the major themes on which he wrote and then, by quantitative analysis, to provide some order to the themes and to study the interaction of the themes. Five hundred and twelve editorials, written over a period of 35 years and representing…

Seeking systemic change: risk and protective factors affecting low-income urban youth.

PubMed

Meyerson, David A; Grant, Kathryn E

2014-01-01

This themed issue presents five articles tackling the topic of risk and protective processes affecting children and adolescents living in urban poverty. Through their research, the authors seek understanding of the particular challenges that low-income urban youth face, with the ultimate goal of understanding how best to intervene at various levels of the ecological system. Within this broad theme, studies examine specific stressors, mediators, and moderators that impact the mental health of youth living in urban poverty. The final article presents a data-driven, community-based intervention for this population.

The Lived Experience of Iranian Women Confronting Breast Cancer Diagnosis.

PubMed

Mehrabi, Esmat; Hajian, Sepideh; Simbar, Masoomeh; Hoshyari, Mohammad; Zayeri, Farid

2016-03-01

The populations who survive from breast cancer are growing; nevertheless, they mostly encounter with many cancer related problems in their life, especially after early diagnosis and have to deal with these problems. Except for the disease entity, several socio-cultural factors may affect confronting this challenge among patients and the way they deal with. Present study was carried out to prepare clear understanding of Iranian women's lived experiences confronting breast cancer diagnosis and coping ways they applied to deal with it. This study was carried out by using qualitative phenomenological design. Data gathering was done through purposive sampling using semi-structured, in-depth interviews with 18 women who survived from breast cancer. The transcribed interviews were analyzed using Van Manen's thematic analysis approach. Two main themes were emerged from the interviews including "emotional turbulence" and "threat control". The first, comprised three sub themes including uncertainty, perceived worries, and living with fears. The second included risk control, recurrence control, immediate seeking help, seeking support and resource to spirituality. Emotional response was the immediate reflection to cancer diagnosis. However, during post-treatment period a variety of emotions were not uncommon findings, patients' perceptions have been changing along the time and problem-focused coping strategies have replaced. Although women may experience a degree of improvement and adjustment with illness, the emotional problems are not necessarily resolved, they may continue and gradually engender positive outcomes.

Astronomy and Cosmology of the Guarani of Southern Brazil

NASA Astrophysics Data System (ADS)

de Mello, Flávia Cristina

The Guarani Indians in South Brazil have a sophisticated system of thought about the cosmos. Presented here are some elements of their cosmology and cosmogony and the influences of the heavenly bodies in this people's everyday life, which have been collected in ethnographic research in the first decade of the 21st century. The main themes of cosmology and the origin of the Sun, Moon, and Earth are described, approximating this anthropological research to ethnoastronomy and cultural anthropology discussions. This research seeks to analyze comparatively this cosmological concept with other indigenous cosmological systems and to compare them with the Western cosmological system, thus including it in studies of cultural astronomy.

Policies of inclusion: immigrants, disease, dependency, and American immigration policy at the dawn and dusk of the 20th century.

PubMed

Fairchild, Amy L

2004-04-01

The racial politics of immigration have punctuated national discussions about immigration at different periods in US history, particularly when concerns about losing an American way of life or American population have coincided with concerns about infectious diseases. Nevertheless, the main theme running through American immigration policy is one of inclusion. The United States has historically been a nation reliant on immigrant labor and, accordingly, the most consequential public policies regarding immigration have responded to disease and its economic burdens by seeking to control the behavior of immigrants within our borders rather than excluding immigrants at our borders.

News and Views: Life on Mars? Astronomical model is world's biggest; Prizes for identifying dark matter; NAM 2013: call for sessions; Paintballing to save the planet; Happy Birthday ESO; Dark sky park grows

NASA Astrophysics Data System (ADS)

2012-12-01

The University of Edinburgh, crowdsourcing website Kaggle and Winton Capital Management have joined forces to launch a competition to identify dark matter haloes. The Scientific Organizing Committee of the RAS National Astronomy Meeting 2013, the UK Solar Physics and Magnetosphere, Ionosphere and Solar-Terrestrial meetings, are seeking nominations for parallel discussion session themes. A winner of the 2012 Move an Asteroid Technical Paper Competition suggests painting asteroids white in order to boost their albedo and take advantage of solar radiation pressure to alter their orbits.

Understanding mothers' perceptions of what is important about themselves and parenting.

PubMed

Riesch, S K; Coleman, R; Glowacki, J S; Konings, K

1997-01-01

The purpose of this article is to report what mothers of young adolescents perceive as important about themselves and parenting. Their perceptions were identified from brief written statements from a sample of 538 mothers of young adolescents. The women's statements were analyzed using content analysis techniques. Six themes emerged. Mothers described the challenges of putting their ideals about parenting into practice, including incorporating or discarding the influence of their own upbringing and the seeking of knowledge and skills to improve their parenting. Mothers described their values and goals. Feelings of self-doubt were made apparent through self-critical comments. Expressions of frustration were evident as were the serious life stressors managed by the sample. Repeated comments identified mothers' emphases on the importance of open family communication. Mothers had developed styles of parenting based on decision-making methods and understanding the child's perspective. We suggest community health nurses use the themes as guidelines for anticipatory guidance with families during adolescence.

Using Philosophical Liberalism and Philosophical Conservatism as an Organizing Theme in the First Half of the American History Survey

ERIC Educational Resources Information Center

Morris, Richard J.

2009-01-01

Since approximately 1970, many historians have been seeking a unifying theme for the American History Survey. Early in the twentieth century, Progressive historians identified class conflict as the main theme in American History, but during the 1950s and 1960s, this view was challenged by the Consensus Schools' assertion that Americans have always…

Sexually explicit racialised media targeting men who have sex with men online: a content analysis of high-risk behaviour depicted in online advertisements.

PubMed

White, Jaclyn M; Dunham, Emilia; Rowley, Blake; Reisner, Sari L; Mimiaga, Matthew J

2015-01-01

Sexually explicit media may perpetuate racial and sexual norms among men who have sex with men. While men may be exposed to sexually explicit media in the online settings where they seek sex with other men, no studies to our knowledge have explored the relationship between the racial and sexual content of advertisements appearing in these spaces. In 2011, using a detailed codebook, 217 sexually explicit advertisements on a male sex-seeking website were coded for themes, actor characteristics and sexual acts depicted. Multivariable logistic regression models examined the association between skin colour, theme, sexual acts and condomless sex acts. Nearly half (45%) featured a 'thug' theme (a style emphasising Black masculinity/hip-hop culture), 21% featured a college theme and 44% featured condomless sex. Advertisements featuring only Black men, advertisements featuring Black men with men of other skin tones and advertisements depicting a thug theme were positively associated with depictions of condomless sex. Online sexually explicit advertisements featuring Black themes and actors more frequently depicted condomless sex than advertisements with White men alone. Future research should examine whether depictions of Black men engaging in condomless sex in online advertisements influence the sexual norms and cognitions of Black men who have sex with men and their partners.

Sexually explicit racialised media targeting men who have sex with men online: A content analysis of high-risk behaviour depicted in online advertisements

PubMed Central

White, Jaclyn M.; Dunham, Emilia; Rowley, Blake; Reisner, Sari L.; Mimiaga, Matthew J.

2015-01-01

Sexually explicit media may perpetuate racial and sexual norms among men who have sex with men. While men may be exposed to sexually explicit media in the online settings where they seek sex with other men, no studies to our knowledge have explored the relationship between the racial and sexual content of advertisements appearing in these spaces. In 2011, 217 sexually explicit advertisements on a male sex-seeking website were coded for themes, actor characteristics, and sexual acts depicted using a detailed codebook. Multivariable logistic regression models examined the association between skin colour, theme, sexual acts, and condomless sex acts. Nearly half (45%) featured a ‘thug’ theme (style emphasising Black masculinity/hip-hop culture), 21% featured a college theme, and 44% featured condomless sex. Ads featuring only Black men, ads featuring Black men with men of other skin tones, and ads depicting a thug theme were positively associated with depictions of condomless sex. Online sexually explicit ads featuring Black themes and actors more frequently depicted risky sex than ads with White men alone. Future research should examine whether risky depictions of Black men in online ads influence the sexual norms and cognitions of Black men who have sex with men and their partners. PMID:25891135

The Development of Valid Subtypes for Depression in Primary Care Settings

PubMed Central

Karasz, Alison

2009-01-01

A persistent theme in the debate on the classification of depressive disorders is the distinction between biological and environmental depressions. Despite decades of research, there remains little consensus on how to distinguish between depressive subtypes. This preliminary study describes a method that could be useful, if implemented on a larger scale, in the development of valid subtypes of depression in primary care settings, using explanatory models of depressive illness. Seventeen depressed Hispanic patients at an inner city general practice participated in explanatory model interviews. Participants generated illness narratives, which included details about symptoms, cause, course, impact, health seeking, and anticipated outcome. Two distinct subtypes emerged from the analysis. The internal model subtype was characterized by internal attributions, specifically the notion of an “injured self.” The external model subtype conceptualized depression as a reaction to life situations. Each subtype was associated with a distinct constellation of clinical features and health seeking experiences. Future directions for research using explanatory models to establish depressive subtypes are explored. PMID:18414123

Things I wish I'd known: desiderata for early career psychiatrists.

PubMed

Ng, Lillian; Steane, Richard; Chacko, Emme; Scollay, Natalie

2017-02-01

The objective of this study was to disseminate advice imparted to early career psychiatrists by a panel of senior colleagues at a Royal Australian and New Zealand College of Psychiatrists symposium, reflecting on things they wished they had known at the earlier stage in their careers. Key themes were extracted from notes taken at the symposium, where opinions were expressed by three senior psychiatrists. There are components in building a sustainable career as a psychiatrist, which include considering one's work environment and relationships with colleagues; self-care, mentorship and reflective practice; and seeking opportunities to teach and research for career progression. The mentorship and advice from senior colleagues can be highly influential. In order to sustain a career that has reward, meaning and longevity, psychiatrists would do well to pay attention to aspects of self-care, stay connected to their loved ones, seek an optimal work-life balance and take an interest in their long term career plans.

The advantages and limitations of seeking sex online: a comparison of reasons given for online and offline sexual liaisons by men who have sex with men.

PubMed

Ross, Michael W; Rosser, B R Simon; McCurdy, Sheryl; Feldman, Jamie

2007-02-01

The Internet has developed as a major site for sexual activity, both cybersex and for making contacts for sex in real life (IRL). As part of a major study of HIV-risk behavior on the Internet and IRL , we obtained on-line responses from 1,017 Latino men who have sex with men (MSM) in the U.S. Open-ended questions solicited responses regarding whether respondents preferred to meet sexual partners first IRL (48.4%), on the Internet (31.6%), or "it depends" (20%), and "why?". Data were analyzed by theme, with themes grouped into overarching domains. Data indicate that for those preferring the Internet, themes represented were ease of Internet use, its advantages for people who were shy, and its anonymity, safety, the excitement and opportunity for experimentation of Internet contact, ability to avoid interpersonal contact, and control of visuals and the environment. Reasons for preferring meeting IRL included some of the same themes, but emphasizing the importance of a "real presence" and the possibility to build a relationship. Where "it depends", key themes were contextual: mood, time, setting, alcohol and drug use, sexual needs and urgency, and relationship intentions. Antagonistic advantages were often noted for cybersex and IRL. These data suggest that motivations for making Internet sexual contact in MSM are complex, depend on the context and nature of the relationship sought, and that the Internet has allowed the development of a class of sexual contacts located between IRL and fantasy.

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

PubMed Central

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

2012-01-01

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

The health-seeking behaviours of first-time mothers with persistent pelvic girdle pain after childbirth in Ireland: A descriptive qualitative study.

PubMed

Wuytack, Francesca; Curtis, Elizabeth; Begley, Cecily

2015-11-01

to explore the health-seeking behaviours of primiparous women with pelvic girdle pain persisting for more than three months post partum. a descriptive qualitative design involving face-to-face semi-structured interviews following institutional ethical approval. Transcripts were analysed using thematic analysis. an urban hospital in Ireland. a purposive sample of 23 consenting first-time mothers with pelvic girdle pain persisting for at least three months post partum. 'they didn't ask, I didn't tell' was a key theme, which included emerging categories of a perceived lack of follow-up post partum, and feeling ignored by healthcare professionals. The theme 'Seeking advice and support' describes women's role of talking to others, and triggers and barriers to getting help. 'Coping strategies' was the third theme emerging from the interviews, whereby participants described different strategies they used to deal with their symptoms, although many expressed uncertainty about what to do or who to see. our findings show the importance of appropriate information and follow-up care for women with pelvic girdle pain and highlight barriers they encounter in seeking help. They also question the duration of postnatal care as participants felt that postnatal care was stopped too early. The findings may assist maternity care providers in addressing mothers' expectations and needs related to persistent pelvic girdle pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Enhancing the vocational outcomes of people with chronic disabilities caused by a musculoskeletal condition: development and evaluation of content of self-management training modules.

PubMed

Johnston, V; Strong, J; Gargett, S; Jull, G; Ellis, N

2014-01-01

No self-management interventions have been developed to empower those chronically disabled by a musculoskeletal condition to find and/or remain at work. Developand evaluate the content of two self-management training modules to improve vocational outcomes for those with chronic musculoskeletal disorders. Stanford University's Chronic Disease Self-Management Program provided the framework for the new modules. Focus groups with the eightpersons with workdisabilities and concept-mapping sessions with the 12 experienced vocational rehabilitation professionals were conducted to identify factors and themes contributing to workers remaining/returning to work post-injury. Five experienced self-management trainers reviewed the modules for consistency with self-management principles. Two new self-management modules: 'Navigating the System' and 'Managing a Return to Work' were developed.The persons with work disabilitiesgenerated four themes: accepting and coping with injury; skills to manage pain and life; positive working relationships and, re-inventing self, whereas the rehabilitation professionals identified three themes:communication and support of others; the injured worker's abilities and resources, and knowledge and education. Anintervention developed to enhance self-management skills and facilitate positive vocational outcomes of those seeking to return to work post-injury was confirmed as relevant by persons with work disabilities, rehabilitation professionals and self-management trainers.

Trajectory of intimate partner violence and healthcare seeking over the life course: study of Japanese women in the Tokyo metropolitan area, Japan.

PubMed

Kamimura, A; Yoshihama, M; Bybee, D

2013-10-01

To describe the trajectory of, and examine factors affecting, intimate partner violence (IPV) and IPV-specific healthcare seeking among Japanese women over the life course. Life course study. One hundred and one women, aged 24-80 years, who had a lifetime history of IPV were interviewed in the Tokyo metropolitan area, Japan in 2005 and 2006. Life course data were collected according to the life history calendar method. Hierarchical linear modelling was used to examine IPV-specific healthcare seeking over the life course. Injury, formal or informal help seeking, public assistance, worse self-rated health status and smoking significantly increased the likelihood of IPV-specific healthcare seeking over the life course. There are significant cohort effects on healthcare seeking. The results suggest that women who experience IPV may seek healthcare services not only immediately after the first occurrence of IPV, but also later in life. IPV is not always associated with immediate healthcare seeking. In particular, sexual IPV is not significantly associated with healthcare seeking. Pursuing formal and informal help is associated with healthcare seeking. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Loss and Transcendence Life Themes.

ERIC Educational Resources Information Center

Weenolsen, Patricia

Psychologists have often observed an underlying pattern or theme in the accounts that individuals give of their lives. To test a humanistic-existential approach to human development, 48 women were interviewed with the Loss and Transcendence (L/T) Life History Form. The L/T Life Theme is expressed in two ways: the expanded version includes the…

Experiences of caring for a family member with Parkinson's disease: a meta-synthesis.

PubMed

Theed, Rachael; Eccles, Fiona; Simpson, Jane

2017-10-01

The aim of this qualitative meta-synthesis was to search and then synthesise family caregivers' experiences of providing care to individuals with Parkinson's disease (PD). A systematic search resulted in the identification of 11 qualitative studies. Noblit and Hare's seven-stage approach was used to provide a higher-order interpretation of how family caregivers' experienced the effects of taking on a caregiving role. The process of reciprocal translation resulted in four overarching themes: (1) the need to carry on as usual - 'the caregiver must continue with his life'; (2) the importance of support in facilitating coping - 'I'm still going back to the support group'; (3) the difficult balancing act between caregiving and caregiver needs - 'I cannot get sick because I'm a caregiver'; (4) conflicts in seeking information and knowledge - 'maybe better not to know'. The themes reflected different aspects of family caregivers' lives that were affected as a result of caring for a relative diagnosed with PD and these raise challenges for more simplistic theories of family caring and appropriate support structures. The findings also highlight several recommendations for clinical practice.

Blood transfusion sampling and a greater role for error recovery.

PubMed

Oldham, Jane

Patient identification errors in pre-transfusion blood sampling ('wrong blood in tube') are a persistent area of risk. These errors can potentially result in life-threatening complications. Current measures to address root causes of incidents and near misses have not resolved this problem and there is a need to look afresh at this issue. PROJECT PURPOSE: This narrative review of the literature is part of a wider system-improvement project designed to explore and seek a better understanding of the factors that contribute to transfusion sampling error as a prerequisite to examining current and potential approaches to error reduction. A broad search of the literature was undertaken to identify themes relating to this phenomenon. KEY DISCOVERIES: Two key themes emerged from the literature. Firstly, despite multi-faceted causes of error, the consistent element is the ever-present potential for human error. Secondly, current focus on error prevention could potentially be augmented with greater attention to error recovery. Exploring ways in which clinical staff taking samples might learn how to better identify their own errors is proposed to add to current safety initiatives.

False Fire Alarms: A Deviant Pattern of Seeking Help.

ERIC Educational Resources Information Center

Camblin, Louise; Weinland, Laura

1987-01-01

Discusses the phenomenon of false fire alarms, the deliberate, intentional false reporting of fires, by mentally troubled persons as a primitive kind of help-seeking behavior. Several common themes found by reviewing false alarm cases are presented. Suggests that identifying the intrapsychic dynamics of false alarm reporters could be useful in…

“I Was Just Trying To Stick It Out Until I Realized That I Couldn't”: A Phenomenological Investigation of Support Seeking Among Older Adults With Complicated Grief*

PubMed Central

Ghesquiere, Angela

2014-01-01

Complicated Grief (CG) is a prolonged, impairing mental health condition affecting about 7% of the bereaved. CG may be especially prevalent in older adults. Though evidence-based treatments for CG have been developed, little is known about support-seeking in older adults with CG. This study used the descriptive phenomenological approach to explore the CG support-seeking process. In-depth interviews were conducted with 8 CG-positive older adults who had completed participation in a randomized clinical trial of CG treatment. Five primary themes arose: observing that grief was causing a great deal of distress and impairment; grief not meeting expectations of what grief “should be”; an important influence of social relationships on support-seeking; lack of effectiveness of grief support groups and/or care from mental health professionals prior to study enrollment; and strong reactions to the label of CG. Themes may hep inform efforts to engage older adults with CG in effective care. PMID:24547662

Themes in the Research on Preservice Teachers' Views of Cultural Diversity: Implications for Researching Millennial Preservice Teachers

ERIC Educational Resources Information Center

Castro, Antonio J.

2010-01-01

This article traces themes found in the research on preservice teachers' views of cultural diversity published in peer-reviewed journals from 1985 to 2007. The article seeks to draw insights that inform education researchers interested in interrogating and unpacking views about diversity expressed by today's millennial college students. Findings…

Digital Inequalities of Family Life Information Seeking and Family Well-Being Among Chinese Adults in Hong Kong: A Population Survey

PubMed Central

2014-01-01

Background Inequalities in Internet use and health information seeking are well documented, but less is known about information for family life activities. Objective We investigated the social determinants of online family life information seeking behaviors and its associations with family well-being among Chinese adults in Hong Kong. Methods A probability-based telephone survey was conducted in 2012 to record family life information seeking behaviors, including frequency of seeking and paying attention to family life information, levels of trust, and perceived usefulness of family life information. Family well-being was assessed using 3 single items on perceived family harmony, happiness, and health, with higher scores indicating greater well-being. Adjusted odds ratios for family life information seeking behaviors by socioeconomic characteristics and lifestyle behaviors, and adjusted beta coefficients for family well-being by family life information seeking behaviors were calculated. Results Of 1537 respondents, 57.57% (855/1537) had ever and 26.45% (407/1537) sought monthly family life information through the Internet. Lower educational attainment and household income, smoking, and physical inactivity were associated with less frequent seeking and paying attention (all P<.05). Greater perceived family health was associated with more frequent attention (adjusted β=.32, 95% CI.11-.52), greater levels of trust (adjusted β=.28, 95% CI .07-.48), and perceived usefulness (adjusted β=.23, 95% CI .01-.45) of family life information. Frequent attention and higher level of trust were also associated with greater family harmony (adjusted β=.22, 95% CI .002-.41) and happiness (adjusted β=.23, 95% CI .003-.42), respectively. Conclusions This is the first study investigating family life information seeking behaviors and suggested inequalities of online family life information seeking behaviors. The association between family life information seeking behavior and family well-being needs to be confirmed in prospective studies. PMID:25281831

Assessing client self-narrative change in emotion-focused therapy of depression: an intensive single case analysis.

PubMed

Angus, Lynne E; Kagan, Fern

2013-12-01

Personality researchers use the term self-narrative to refer to the development of an overall life story that places life events in a temporal sequence and organizes them in accordance to overarching themes. In turn, it is often the case that clients seek out psychotherapy when they can no longer make sense of their life experiences, as a coherent story. Angus and Greenberg (L. Angus and L. Greenberg, 2011, Working with narrative in emotion-focused therapy: Changing stories, healing lives. Washington, DC: American Psychological Association Press) view the articulation and consolidation of an emotionally integrated self-narrative account as an important part of the therapeutic change process that is essential for sustained change in emotion-focused therapy of depression. The purpose of the present study was to investigate client experiences of change, and self-narrative reconstruction, in the context of one good outcome emotion-focused therapy dyad drawn from the York II Depression Study. Using the Narrative Assessment Interview (NAI) method, client view of self and experiences of change were assessed at three points in time--after session one, at therapy termination, and at 6 months follow-up. Findings emerging from an intensive narrative theme analyses of the NAI transcripts--and 1 key therapy session identified by the client--are reported and evidence for the contributions of narrative and emotion processes to self-narrative change in emotion-focused therapy of depression are discussed. Finally, the implications of assessing clients' experiences of self-narrative change for psychotherapy research and practice are addressed.

Lived experiences of parents caring for a child with a life-limiting condition in Australia: A qualitative study.

PubMed

Collins, Anna; Hennessy-Anderson, Nicole; Hosking, Sarah; Hynson, Jenny; Remedios, Cheryl; Thomas, Kristina

2016-12-01

Experiential studies in paediatric palliative care are needed to enable an ongoing international agenda which supports the development of responsive family supports. To provide an in-depth exploration of the prevalent lived experiences of parents who are currently providing care for a child with a life-limiting condition in Australia. Cross-sectional, prospective, qualitative study guided by an advisory group and reported according to the consolidated criteria for reporting qualitative studies. Transcripts were subjected to a thematic analysis, underpinned by an interpretative phenomenological framework. Purposively sampled parents (n = 14) recruited from a statewide paediatric hospice who self-identified as a 'primary caregiver' for one or more children and/or adolescents (⩽18 years) with a life-limiting condition. Four key themes represented the prevalent experiences of parents: (1) trapped inside the house, (2) the protector, (3) living with the shadow and (4) travelling a different pathway. They describe parents' physical and social isolation, exclusion from the workforce, pervasive grief and associated impacts to their health and well-being. Limited professional and diminished social supports resulted in full ownership of care responsibility. Yet, parents embraced their role as 'protector', reporting acquired meaning and purpose. This study builds upon the growing body of evidence available in paediatric palliative care internationally. The key themes highlight the substantial demand for both physical and emotional support beyond what is currently offered and call for the implementation of carefully planned support services and other societal initiatives which seek to alleviate the broad health impacts to caregivers. © The Author(s) 2016.

Health-seeking behaviour for schistosomiasis: a systematic review of qualitative and quantitative literature.

PubMed

Cronin, Thomas; Sheppard, James; de Wildt, Gilles

2013-01-01

Schistosomiasis is a chronic and debilitating parasitic disease acquired through contact with infested freshwater. An essential component of its control is passive case finding, which, in order to be effective, requires a detailed understanding of health-seeking behaviour. This study aimed to systematically review evidence on health-seeking behaviour for schistosomiasis, in order to determine factors influencing use or non-use of modern health services for the infection. Quantitative, qualitative and mixed method studies reporting on factors related to seeking treatment from modern health services for schistosomiasis were obtained, combining electronic and hand searching. Data extraction and quality assessment of the included articles were performed, with all studies qualitatively analysed using thematic synthesis. A total of 19 studies were included in the review. Six themes were identified from the analysis: biomedical knowledge on schistosomiasis, perceptions of modern treatment and health services, financial considerations of treatment, perceptions on the symptoms, stigma of the infection, and physical location and community. These findings were consistent across studies of different design, setting and quality. Many of the themes identified echo existing literature on health-seeking behaviour. The synthesis also highlighted the role of stigma, and aspects of the physical location and community that may affect treatment-seeking for schistosomiasis. Health education programmes that intend to improve the utilisation of modern health services for the infection need to acknowledge the multiple determinants influencing their use. Future research should move beyond describing health-seeking behaviour to identifying the factors that underlay such behaviour.

Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions.

PubMed

Lynch, Louise; Long, Maggie; Moorhead, Anne

2018-01-01

International research has identified young men as reluctant to seek help for mental health problems. This research explored barriers and solutions to professional help seeking for mental health problems among young men living in the North West of Ireland. A qualitative approach, using two focus groups with six participants each and five face-to-face interviews, was conducted with men aged 18 to 24 years (total N = 17). Data were analyzed using thematic analysis. Seven key themes of barriers to professional help seeking were identified: "acceptance from peers," "personal challenges," "cultural and environmental influences," "self-medicating with alcohol," "perspectives around seeking professional help," "fear of homophobic responses," and "traditional masculine ideals." Five key themes of solutions to these barriers included "tailored mental health advertising," "integrating mental health into formal education," "education through semiformal support services," "accessible mental health care," and "making new meaning." Interesting findings on barriers include fear of psychiatric medication, fear of homophobic responses from professionals, the legacy of Catholic attitudes, and the genuine need for care. This study offers an in-depth exploration of how young men experience barriers and uniquely offers solutions identified by participants themselves. Youth work settings were identified as a resource for engaging young men in mental health work. Young men can be encouraged to seek help if services and professionals actively address barriers, combining advertising, services, and education, with particular attention and respect to how and when young men seek help and with whom they want to share their problems.

Multimedia Educational CD-ROM - The Living Universe

NASA Astrophysics Data System (ADS)

Rosen, Ralev

2002-01-01

I and the other members of the team Celestial Generation dedicate this interactive CD-ROM to our Physics, Astronomy, Biology and English teachers. The members of the team that created the project are Rosen Ralev, Nadezhda Radeva, Iliyan Darganov and Yana Radeva from Technical University of Sofia, the English High schools - Varna, Technical University of Varna and Connecticut College. The leader of the project is Mrs. Veselka Radeva - an astronomer from the Astronomical Observatory in Varna. The main idea of the project " The Living Universe" is that water is a cradle of life in the Universe. As water so abundant in the Universe, life. The project has 4 main themes, combining knowledge from the fields of Biology and Astronomy, one Gallery with our photographs and one amusing theme with interesting and curious facts about life on the Earth and in the Universe. The statistics of our project is: 152 pages and 425 pictures. Over 2/3 from the pictures are ours and we used the rest of them with the kind permission of their authors.The theme Living Water starts with a lyric poem by Petya Dubarova. In the first under-theme- "Water-the cradle of life" introduce you graphics of the structure of the water molecule and its important biological properties. The thesis continues following out the origin and development of life in the oceans on our planet. The next to the last under-theme - sensitive life in water is devoted to dolphins. The third under-theme is " Water in the Universe". Here two of the themes show results from the observations with the space telescope Submillimeter Wave Astronomy Satellite, that found water steams in the interstellar space and around a star in the constellation Leo ( it is supposed that this is a huge comet cloud). This third theme is the most extensive one in this section- it examines the possibility of water being available on each planet in the Solar system: Mercury-most likely there is ice on the polar areas that are the coolest .On Venus it is assumed that there could be living bubble-like creatures in the clouds that are situated 55 km above the surface .A million years ago there was water on Mars. It shows the most recent pictures on which there can be seen the bottom of an ancient ocean. The theme about Mars is enormous and very interesting .The theme continues with the ice cover of Europa . In the places where that ice is broken there could be found life .What follows is the article about the icy satellite of Jupiter-Calisto that has salt oceans under the ice cover .The theme - comets-the space icebergs of the Solar system, leads to the end of the major theme about the water in the Universe. All pictures in this part were made by the group. The next main theme is "The miracle of life". This is the interesting and extensive biological part that includes many themes: it start with the origin of the Universe till the appearance of life on the Earth, the main differences between the living and the non-living; we examine the different definitions of life, the stages of origin of living organisms on our planet. The next main theme is "Habitable worlds". In the first under-theme "The unique planet" there are shown all the conditions in the Solar system that make it unique. Its uniqueness could be the reason why life had developed only in our Solar system. In the next under-theme about the Moon presents the views of the future of the Moon-where there could be situated Moon bases. The next under-theme "Europe-life in the ice breakings". It is most likely that living organisms could exist not only in the oceans under the ice, but also in huge ice breakings. The next information is about Ganymede and Calisto. What is interesting about Titan is that the spot that was seen by scientists most likely has organic composition. Life having been brought by comets is an interesting and disputed theme, but I think that comets spread life in the planet systems. The last theme is bacterial colonizing-it is known that space bacteria can exist in the interstellar. And a script about interstellar bacterial colonizing finishes that theme . Another main theme is SETI. The most interesting things here are the 7 projects for searching for extraterrestrial civilizations. For each project the group found information in 4 areas: by whom it is carried out; what are the goals of the project; what are the technical meanings and how it works. The next under-themes are "Alien forms of life" and "Are we alone?". "The wonderful Universe" is a theme, in which there are included 40 interesting and curious facts about life on the Earth, planets and stars. Here there are 6 images by NASA and the rest 34 were made by me, following the nice text. "The Gallery is my favorite part of the CD-ROM. Here you can find astrophotos made with telescopes in National Astronomical Observatory -Rozhen, space pictures and photo-collages.

Unravelling the Lifelong Learning Process for Canadian Workers and Adult Learners Acquiring Higher Skills

ERIC Educational Resources Information Center

Taylor, Maurice; Trumpower, David; Pavic, Ivana

2013-01-01

This article reports on a mixed methods study that investigated aspects of formal, non-formal and informal learning for workers and adult high school learners seeking literacy and essential skills. Three key themes emerged from the qualitative data: motivations for participation in various forms of learning; seeking out informal learning…

"Voices of fear and safety" women's ambivalence towards breast cancer and breast health: a qualitative study from Jordan.

PubMed

Taha, Hana; Al-Qutob, Raeda; Nyström, Lennarth; Wahlström, Rolf; Berggren, Vanja

2012-07-26

Breast cancer is the leading cause of cancer mortality among Jordanian women. Breast malignancies are detected at late stages as a result of deferred breast health-seeking behaviour. The aim of this study was to explore Jordanian women's views and perceptions about breast cancer and breast health. We performed an explorative qualitative study with purposive sampling. Ten focus groups were conducted consisting of 64 women (aged 20 to 65 years) with no previous history and no symptoms of breast cancer from four governorates in Jordan. The transcribed data was analysed using latent content analysis. Three themes were constructed from the group discussions: a) Ambivalence in prioritizing own health; b) Feeling fear of breast cancer; and c) Feeling safe from breast cancer. The first theme was seen in women's prioritizing children and family needs and in their experiencing family and social support towards seeking breast health care. The second theme was building on women's perception of breast cancer as an incurable disease associated with suffering and death, their fear of the risk of diminished femininity, husband's rejection and social stigmatization, adding to their apprehensions about breast health examinations. The third theme emerged from the women's perceiving themselves as not being in the risk zone for breast cancer and in their accepting breast cancer as a test from God. In contrast, women also experienced comfort in acquiring breast health knowledge that soothed their fears and motivated them to seek early detection examinations. Women's ambivalence in prioritizing their own health and feelings of fear and safety could be better addressed by designing breast health interventions that emphasize the good prognosis for breast cancer when detected early, involve breast cancer survivors in breast health awareness campaigns and catalyse family support to encourage women to seek breast health care.

“Voices of Fear and Safety” Women’s ambivalence towards breast cancer and breast health: a qualitative study from Jordan

PubMed Central

2012-01-01

Background Breast cancer is the leading cause of cancer mortality among Jordanian women. Breast malignancies are detected at late stages as a result of deferred breast health-seeking behaviour. The aim of this study was to explore Jordanian women’s views and perceptions about breast cancer and breast health. Methods We performed an explorative qualitative study with purposive sampling. Ten focus groups were conducted consisting of 64 women (aged 20 to 65 years) with no previous history and no symptoms of breast cancer from four governorates in Jordan. The transcribed data was analysed using latent content analysis. Results Three themes were constructed from the group discussions: a) Ambivalence in prioritizing own health; b) Feeling fear of breast cancer; and c) Feeling safe from breast cancer. The first theme was seen in women’s prioritizing children and family needs and in their experiencing family and social support towards seeking breast health care. The second theme was building on women’s perception of breast cancer as an incurable disease associated with suffering and death, their fear of the risk of diminished femininity, husband’s rejection and social stigmatization, adding to their apprehensions about breast health examinations. The third theme emerged from the women’s perceiving themselves as not being in the risk zone for breast cancer and in their accepting breast cancer as a test from God. In contrast, women also experienced comfort in acquiring breast health knowledge that soothed their fears and motivated them to seek early detection examinations. Conclusions Women’s ambivalence in prioritizing their own health and feelings of fear and safety could be better addressed by designing breast health interventions that emphasize the good prognosis for breast cancer when detected early, involve breast cancer survivors in breast health awareness campaigns and catalyse family support to encourage women to seek breast health care. PMID:22834874

Spiritual aspects of living with infertility: A synthesis of qualitative studies.

PubMed

Romeiro, Joana; Caldeira, Sílvia; Brady, Vivienne; Timmins, Fiona; Hall, Jenny

2017-12-01

To identify the spiritual aspects of patients experiencing infertility and seek a deeper and broader meaning of the involuntary childlessness experience. Infertility can be the cause for a spiritual crisis among some couples. Those who endure this involuntary childlessness condition frequently experience contradictory feelings and needs. In this context, core aspects of spirituality such as meaning and purpose in life are often questioned. A review and synthesis of qualitative empirical research was undertaken to seek a deeper understanding of the spiritual aspects of patients' experiences of infertility. An aggregative synthesis was conducted according to Saini and Shlonsky (Systematic synthesis of qualitative research, 2012, Oxford University Press, Oxford), using thematic analysis. A total of 26 studies included female, male and couples. Settings revealed interviewees in different infertility phases such as diagnosis, assisted reproductive technologies and following fertility treatments. Two main themes emerged: spiritual needs and spirituality as a coping resource for infertility. Infertility affects the holistic existence of the couples. This adversity awakens spiritual needs along with unmet needs of parenthood. Coping strategies incorporating spirituality can enhance the ability of couples to overcome childlessness and suffering. Infertile couples' experiences of infertility may offer an opportunity for spiritual care particularly related to the assessment of spiritual needs and the promotion of spiritual coping strategies. Effective holistic care should support couples in overcoming and finding meaning in this life and health condition. © 2017 John Wiley & Sons Ltd.

On the road again: patient perspectives on commuting for palliative care.

PubMed

Pesut, Barbara; Robinson, Carole A; Bottorff, Joan L; Fyles, Gillian; Broughton, Sandra

2010-06-01

The aim of this research project was to gain an understanding of the experiences of rural cancer patients who commute to an urban cancer center for palliative care. The study utilized a mixed method design. Fifteen individuals with a palliative designation participated in semi-structured interviews and filled out the Problems and Needs in Palliative Care Questionnaire. Qualitative findings included three major themes: cultures of rural life and care, strategies for commuting, and the effects of commuting. Participants valued their rural lifestyles and gained significant support from their communities. Strategies included preparing for the trip with particular attention to pain management, making the most of time, and maintaining significant relationships. Establishing a routine helped to offset the anxiety of commuting. Commuting was costly but the quality of life and supportive relationships obtained through treatment were significant benefits. Questionnaire data suggested that participants were experiencing a number of problems but few indicated they desired more professional attention to those problems. Rural lifestyles are often an important part of overall well-being and commuting for care is both costly and complex. Health care providers should assist individuals to weigh the relative contributions of staying in their rural locale versus commuting for care to their overall quality of life. Palliative-care individuals in this study indicated a number of ongoing problems but were not inclined to seek further assistance from health care providers in addressing those problems. Clinicians should actively inquire about problems and further research is needed to understand why patients are reluctant to seek help.

Themes of grief.

PubMed

Carter, S L

1989-01-01

A thematic analysis of 30 narrative accounts of bereavement revealed nine themes that included five core themes in bereavement--being stopped, hurting, missing, holding, and seeking; three meta-themes about bereavement--change, expectations, and inexpressibility; and a contextual theme--personal history. The themes were compared with three theoretical perspectives on bereavement by Freud, Kübler-Ross, and one defined as existential-phenomenological. Features of bereavement that are dissimilar or unaddressed by the theoretical perspectives were: (a) the quality of grief's changing character, including "waves" and intense pain which may be triggered years after the death; (b) holding, an individual process of preserving the fact and meaning of the loved one's existence; (c) expectations, both social and personal, as to how the bereaved should be overlaying the experience; and (d) the critical importance of personal history in affecting the quality and meaning of individual bereavement.

A qualitative investigation of specialist orthodontists in New Zealand: part 2. Orthodontists' working lives and work-life balance.

PubMed

Soma, Kieran J; Thomson, W Murray; Morgaine, Kate C; Harding, Winifred J

2012-11-01

Orthodontics is the most widely practised form of specialist dentistry in New Zealand. To date, no known qualitative research has been published examining the work-life balance of practitioners. The aim of this study was to investigate the working lives and work-life balance of NZ orthodontists in order to generate an understanding of the reality of orthodontic specialist practice and its effects on orthodontists' professional and personal lives. Semi-structured interviews were conducted involving 19 practising orthodontists (four females, 15 males; mean age 50 years) from throughout New Zealand and selected for maximum variation in the sample. Transcribed interviews were analysed for themes using an applied grounded theory approach. A core category of 'practising orthodontist' was derived, and related themes were grouped under the sub-categories of: (a) NZ orthodontic specialist practice; (b) NZ specialist orthodontists; and (c) Work-life balance. The present paper reports on the final sub-category. Themes emerging from the work-life sub-category were further divided into two sub-themes of 'work' and 'life'. Themes in the 'work' subgroup included time off, injuries and illness, regrets, personality traits, job stress and criticism, establishing a practice, peer support and contact, and success in orthodontics. Themes in the 'life' sub-group were personal development, family life, life balance and interests outside work, and financial security. This was the first qualitative investigation of the orthodontic profession in New Zealand. The findings provided a valuable insight into the working lives of New Zealand orthodontists and effects on their day-today lives. It will be revealing and interesting to observe how the modernisation of orthodontic practice will affect the work-life balance of New Zealand orthodontists in the future.

Leadership mindset in mental health.

PubMed

Ng, Lillian; Steane, Richard; Scollay, Natalie

2018-02-01

The objective of this study was to explore the concept of mindset for psychiatrists who are considering stepping into the leadership arena. Qualitative themes were extracted from dialogue on leadership development at a Royal Australian and New Zealand College of Psychiatrists forum for early career psychiatrists. Three key themes were identified: adapting to a professional identity as psychiatrists; developing a mindset for leadership; and acting intentionally to seek opportunities for leadership. Shifts in professional identity occur in the transition from trainee to specialist as early career psychiatrists become increasingly aware of broad systemic factors in clinical care. The concept of a mindset, distinct from a skillset of knowledge and expertise, may be an emergent quality for psychiatrists who are seeking to develop their leadership potential.

Relationship goals of middle-aged, young-old, and old-old Internet daters: an analysis of online personal ads.

PubMed

Alterovitz, Sheyna S R; Mendelsohn, Gerald A

2013-04-01

Research on courtship patterns and romantic relationship in later life has not kept pace with the burgeoning number of older adults interested in dating. We conducted content analyses of themes arising from 450 personal ads written by middle-aged (40-54), young-old (60-74), and old-old (75+) participants. Significant differences between the young-old and the middle-aged were few; those between the young-old and old-old were numerous. Compared to the old-old, the young-old and middle-aged were more likely to mention adventure, romance, sexual interests, and seeking a soul mate and less likely to mention health. This study increases our understanding of relationship goals in later life and highlights the error of treating all older adults as a homogeneous group. Practice and policy can benefit from more nuanced distinctions between age groups and an enhanced recognition of the vibrant emotional, romantic, and sexual lives of older adults. Copyright © 2013 Elsevier Inc. All rights reserved.

Iranian nurses' perception of spirituality and spiritual care: a qualitative content analysis study.

PubMed

Mahmoodishan, Gholamreza; Alhani, Fatemeh; Ahmadi, Fazlollah; Kazemnejad, Anoshirvan

2010-01-01

The purpose of the present study was to explore nurses' perception about spirituality and spiritual care. A qualitative content analysis approach was conducted on 20 registered nurses interviewed using unstructured strategy in 2009. Three themes emerged from the data analysis: 1) "meaning and purpose of work and life" including 'spiritualistic view to profession', 'commitment and professional responsibility', and 'positive attitude'; 2) "religious attitude" including 'God approval', 'spiritual reward', 'taking advice', 'inner belief in the Supreme Being', 'faith-based interactions and altruism'; 3) "transcendence-seeking" including 'need for respect' and 'personal-professional transcendence'. Therefore, the spirituality produces maintenance, harmony and balance in nurses in relation to God. Spiritual care focuses on respecting patients, friendly and sympathetic interactions, sharing in rituals and strengthening patients and nurses' inner energy. This type of spirituality gives a positive perspective to life and profession, peaceful interactions, a harmonious state of mind, and acts as a motivator among nurses to promote nursing care and spirituality.

"Putting one foot in front of the other": a qualitative study of emotional experiences and help-seeking in women with multiple sclerosis.

PubMed

Blundell Jones, Joanna; Walsh, Sue; Isaac, Claire

2014-12-01

Treatments for depression and anxiety in multiple sclerosis (MS) are effective but evidence suggests that individuals do not always seek help for emotional difficulties. This study explored how ten women with MS (aged 30-64), recruited via a hospital based MS clinic, coped with and understood their emotions. The semi-structured interviews were analysed using interpretative phenomenological analysis. Eight participants discussed the analytic process and themes. Four overarching themes emerged: Disclosure stress, Uncomfortable dependence, Facing deterioration and One step at a time. The women struggled emotionally with many aspects of living with MS yet coping alone provided a way of defying MS and maintaining independence and control. The women needed emotional support but reported thinking others either did not notice or understand; their emotions often felt invisible. More holistic care from services was desired. Non help-seeking for distress was partially influenced by a desire to keep things "normal" and a lack of knowledge regarding service provision.

"I Want a Second Chance": Experiences of African American Fathers in Reentry.

PubMed

Dill, LeConté J; Mahaffey, Carlos; Mosley, Tracey; Treadwell, Henrie; Barkwell, Fabeain; Barnhill, Sandra

2016-11-01

With over 700,000 people on average released from prison each year to communities, greater attention is warranted on the experiences and needs of those who are parents and seeking to develop healthy relationships with their children and families. This study seeks to explore the experiences of African American fathers in reentry. Qualitative data from 16 African American men enrolled in a fellowship program for fathers were collected from a focus group and analyzed for common themes and using standpoint theory. Four themes emerged that focused on fathers' commitment toward healthy and successful reintegration postincarceration: redemption, employment, health care, and social support. Focus group participants actively strive to develop and rebuild healthy relationships with their children through seeking gainful employment and through bonding with like-minded peers. Barriers in accessing health care are also discussed. Research findings may inform future programs and policies related to supporting fathers and their children in reentry. © The Author(s) 2015.

Focus on Infants & Toddlers (Ages 0-3): A Quarterly Newsletter for the Education Community, 1999-2000.

ERIC Educational Resources Information Center

Barry, Virginia M., Ed.; Cantor, Patricia, Ed.

2000-01-01

These four quarterly newsletter issues address various topics of interest to child caregivers. Each issue focuses on a theme and includes articles on that theme, along with regular news or vice president's columns. The Fall 1999 issue addresses family play and seeks to encourage families to regard play as a way of relaxing and finding contentment…

Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda.

PubMed

Umubyeyi, Aline; Persson, Margareta; Mogren, Ingrid; Krantz, Gunilla

2016-01-01

Despite its burden on a person's life, Intimate Partner Violence (IPV) is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals' experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda. Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis. The theme "Gendered norms and values defeat the violence legislation in women's health care seeking when women are abused" expressed the health care professionals' experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter. Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV.

Gender Inequality Prevents Abused Women from Seeking Care Despite Protection Given in Gender-Based Violence Legislation: A Qualitative Study from Rwanda

PubMed Central

Mogren, Ingrid; Krantz, Gunilla

2016-01-01

Objective Despite its burden on a person’s life, Intimate Partner Violence (IPV) is known to be poorly recognised and managed in most countries and communities. This study aimed to explore health care professionals’ experiences of the health care seeking processes of women exposed to intimate partner violence in Rwanda. Methods Six focus group discussions were conducted in three district hospitals and three mental health units in Rwanda. A sample of 43 health care professionals with various professions and length of work experience, who regularly took care of patients subjected to IPV, was selected for focus group discussions. The analysis was performed using qualitative content analysis. Results The theme “Gendered norms and values defeat the violence legislation in women’s health care seeking when women are abused” expressed the health care professionals’ experiences of the double-faced situation which women exposed to IPV met in their help seeking process. Positive initiatives to protect women were identified, but the potential for abused women to seek help and support was reduced because of poverty, gender inequality with prevailing strong norms of male superiority, and the tendency to keep abuse as a private family matter. Conclusion Legislative measures have been instituted to protect women from abuse. Still many Rwandan women do not benefit from these efforts. The role of the health care services needs to be reinforced as an important and available resource for help and support for abused women but further legislative changes are also needed. Initiatives to further improve gender equality, and institutionalised collaboration between different sectors in society would contribute to protecting women from IPV. PMID:27152680

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

PubMed

Carr, Kelly; Weir, Patricia L

2017-12-01

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

Sub-Saharan African migrant youths' help-seeking barriers and facilitators for mental health and substance use problems: a qualitative study.

PubMed

McCann, Terence V; Mugavin, Janette; Renzaho, Andre; Lubman, Dan I

2016-08-02

Many young migrants and their parents are reluctant to seek help for mental health and substance use problems. Help-seeking delays can result in longer duration of untreated problems and poorer outcomes. In this study, we aimed to identify the help-seeking barriers and facilitators for anxiety, depression and alcohol and drug use problems in young people from recently established sub-Saharan African migrant communities. A qualitative study, incorporating individual, in-depth interviews and focus group discussions, was undertaken in Melbourne, Australia. Twenty-eight young sub-Saharan African migrants participated in the individual interviews, and 41 sub-Saharan African-born parents and key community leaders participated in 4 focus groups. All participants were aged 16 years or over. A thematic analysis of the data was undertaken. Themes and related sub-themes were abstracted from the data, reflecting the young people's, parents' and key community leaders' beliefs about barriers and facilitators to help-seeking for mental health and substance use problems. Four help-seeking barriers were identified: stigma of mental illness, lack of mental health literacy in parents and young people, lack of cultural competency of formal help sources, and financial costs deterring access. Five help-seeking facilitators were abstracted: being open with friends and family, strong community support systems, trustworthiness and confidentiality of help-sources, perceived expertise of formal help-sources, increasing young people's and parents' mental health literacy. Programs that identify and build on help-seeking facilitators while addressing help-seeking barriers are needed to address mental health issues among young sub-Saharan African migrants. Strategies to address help-seeking barriers should consider counteracting stigma and increasing mental health literacy in sub-Saharan African communities, increasing health providers' cultural competency and perceived trustworthiness, and addressing financial barriers to accessing services.

Unique challenges of hospice for patients with heart failure: A qualitative study of hospice clinicians.

PubMed

Lum, Hillary D; Jones, Jacqueline; Lahoff, Dana; Allen, Larry A; Bekelman, David B; Kutner, Jean S; Matlock, Daniel D

2015-09-01

Patients with heart failure have end-of-life care needs that may benefit from hospice care. The goal of this descriptive study was to understand hospice clinicians' perspectives on the unique aspects of caring for patients with heart failure to inform approaches to improving end-of-life care. This qualitative study explored experiences, observations, and perspectives of hospice clinicians regarding hospice care for patients with heart failure. Thirteen hospice clinicians from a variety of professional disciplines and clinical roles, diverse geographic regions, and varying lengths of time working in hospice participated in semistructured interviews. Through team-based, iterative qualitative analysis, we identified 3 major themes. Hospice clinicians identified 3 themes regarding care for patients with heart failure. First, care for patients with heart failure involves clinical complexity and a tailored approach to cardiac medications and advanced cardiac technologies. Second, hospice clinicians describe the difficulty patients with heart failure have in trusting hospice care due to patient optimism, prognostic uncertainty, and reliance on prehospice health care providers. Third, hospice clinicians described opportunities to improve heart failure-specific hospice care, highlighting the desire for collaboration with referring cardiologists. From a hospice clinician perspective, caring for patients with heart failure is unique compared with other hospice populations. This study suggests potential opportunities for hospice clinicians and referring providers who seek to collaborate to improve care for patients with heart failure during the transition to hospice care. Published by Elsevier Inc.

Self-harm as a means to manage the public and private selves: A qualitative study of help seeking by adults

PubMed Central

Ogden, Jane; Bennett, Alice

2015-01-01

Adults (n = 25) completed online free text boxes about their self-harming behaviour. Thematic analysis identified three dominant themes: ‘managing the private self’, ‘managing the public self’ and ‘moving on’. Transcending these themes was the notion of thresholds of change. Self-harm enables people to manage both their private and public selves. When thresholds of change are surpassed, the public self communicates a need for help. Self-harm exists within a precarious balance of well-being and can be a form of self-care. Help seeking is instigated when this balance is disrupted and continued if it offers a better form of self-management than the individual’s own self-harming behaviour. PMID:28070372

Building a Progressive-Situational Model of Post-Diagnosis Information Seeking for Parents of Individuals With Down Syndrome

PubMed Central

Gibson, Amelia N.

2016-01-01

This grounded theory study used in-depth, semi-structured interview to examine the information-seeking behaviors of 35 parents of children with Down syndrome. Emergent themes include a progressive pattern of behavior including information overload and avoidance, passive attention, and active information seeking; varying preferences between tacit and explicit information at different stages; and selection of information channels and sources that varied based on personal and situational constraints. Based on the findings, the author proposes a progressive model of health information seeking and a framework for using this model to collect data in practice. The author also discusses the practical and theoretical implications of a responsive, progressive approach to understanding parents’ health information–seeking behavior. PMID:28462351

Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions

PubMed Central

Lynch, Louise; Long, Maggie; Moorhead, Anne

2016-01-01

International research has identified young men as reluctant to seek help for mental health problems. This research explored barriers and solutions to professional help seeking for mental health problems among young men living in the North West of Ireland. A qualitative approach, using two focus groups with six participants each and five face-to-face interviews, was conducted with men aged 18 to 24 years (total N = 17). Data were analyzed using thematic analysis. Seven key themes of barriers to professional help seeking were identified: “acceptance from peers,” “personal challenges,” “cultural and environmental influences,” “self-medicating with alcohol,” “perspectives around seeking professional help,” “fear of homophobic responses,” and “traditional masculine ideals.” Five key themes of solutions to these barriers included “tailored mental health advertising,” “integrating mental health into formal education,” “education through semiformal support services,” “accessible mental health care,” and “making new meaning.” Interesting findings on barriers include fear of psychiatric medication, fear of homophobic responses from professionals, the legacy of Catholic attitudes, and the genuine need for care. This study offers an in-depth exploration of how young men experience barriers and uniquely offers solutions identified by participants themselves. Youth work settings were identified as a resource for engaging young men in mental health work. Young men can be encouraged to seek help if services and professionals actively address barriers, combining advertising, services, and education, with particular attention and respect to how and when young men seek help and with whom they want to share their problems. PMID:27365212

Health care seeking among Mexican American men.

PubMed

Sobralske, Mary C

2006-04-01

This focused ethnography explored health care seeking beliefs and behaviors of Mexican American men living in south central Washington State. Data collection included interviews with 36 research participants living in the community, participant observation in the research setting, and examination of ethnographic documents and cultural artifacts. Four major themes were identified: the identity of manhood dictates health care seeking, health means being able to be a man by fulfilling cultural obligations, illness means not being able to be a man, and men seek health care when their manhood is threatened or impaired. Machismo, the cultural concept of manliness, persisted among men despite the level of acculturation and other factors. Women influenced men's health care seeking behaviors. To fulfill their obligations, men must stay healthy and seek care when needed. Knowing when and why men do not seek health care enables nurses to better understand and serve the Mexican American community.

Returning to work: The cancer survivor’s transformational journey of adjustment and coping

PubMed Central

Barnard, Antoni; Clur, Loraine; Joubert, Yvonne

2016-01-01

The aim of this study was to explore cancer survivors’ return to work (RTW) experience with a specific focus on the adjustment and coping process underlying their journey. The study was conducted in the Southern Cape, South Africa, with eight cancer survivors having returned to work following successful treatment of various types of cancer. Unstructured interviews were conducted and data were analysed following the principles of hermeneutic phenomenological reflection and analysis. Four themes emerged, representing the changing adjustment responses and coping during the RTW journey. Participants evolve from being overwhelmed with emotions and applying avoidant coping to seeking understanding and positive affectivity in their attempt to comprehend the reality of their situation. Participants’ external locus of control change to a more active approach and problem-solving orientation, demonstrating a need to take control and responsibility. Ultimately, adjustment and coping become most constructive when cancer survivors resolve to re-assess life and self through meaning-making, resulting in renewed appreciation of life, appropriate life style changes, and regained confidence in their relational role. A process perspective is proposed to facilitate an understanding of, and working with, cancer survivors’ transition through the RTW journey towards optimal coping phases. PMID:27852419

Experiencing patient death in clinical practice: nurses' recollections of their earliest memorable patient death.

PubMed

Anderson, Natalie Elizabeth; Kent, Bridie; Owens, R Glynn

2015-03-01

Death and dying are inevitable life encounters, but a nurse's first experience with patient death may pose considerable cognitive, emotional and clinical challenges. This paper reports the findings of the second phase of a study; the first has been reported elsewhere. This phase explored the earliest memorable patient death experiences of New Zealand registered nurses. A purposeful, self-selected sub-sample of a larger study of New Zealand registered nurses, took part in individual face-to-face semi-structured interviews. Interpretative phenomenological analysis was utilised to seek to understand participants' experiences. Thematic analysis was undertaken to identify emerging themes, with participants' own words used as theme headings, where their phrases provided succinct or powerful descriptors. A diverse participant group of twenty, currently practising, New Zealand registered nurses provided rich and detailed descriptions of their earliest memorable experience with patient death. Participants from a variety of training backgrounds described patient deaths, which occurred in a range of settings - some only a few months prior, others - more than thirty years ago. Seven emergent themes, and features of more positive, or negative experiences were identified: Event Significance; Emotional Challenges; Sharing the Experience; Learning; Feeling Unprepared, Responses to Death and Finding Benefits. For participants in this study, there was considerable evidence that their earliest memorable patient death was a significant event. Furthermore, although most participants' experiences were characterised by emphatic or poignant description, there was most often a balance of challenges and rewards. Copyright © 2014 Elsevier Ltd. All rights reserved.

Seeking help for perinatal psychological distress: a meta-synthesis of women's experiences.

PubMed

Button, Susan; Thornton, Alexandra; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

2017-10-01

Women may not seek help for perinatal psychological distress, despite regular contact with primary care services. Barriers include ignorance of symptoms, inability to disclose distress, others' attitudes, and cultural expectations. Much of the evidence has been obtained from North American populations and may not, therefore, extrapolate to the UK. To understand the factors affecting women's decision to seek help for perinatal distress. Meta-synthesis of the available published qualitative evidence on UK women's experiences of seeking help for perinatal distress. Systematic searches were conducted in accordance with PRISMA guidelines. Databases searched were PubMed, Scopus, PsycINFO, PsycARTICLES, CINAHL, and Academic Search Complete. Searches of grey literature and references were also conducted. Studies were eligible for inclusion if they reported qualitative data on UK women's experiences of perinatal distress and contact with healthcare professionals. The synthesis was conducted using meta-ethnography. In all, 24 studies were eligible for inclusion. Metasynthesis identified three main themes: identifying a problem, the influence of healthcare professionals, and stigma. These themes build on current understanding of help seeking by identifying the need for women to be able to frame their experience, for healthcare professionals to educate women about their roles, the need for continuity of care, and the way that being seen as a 'bad mother' causes women to self-silence. Perinatal care provision needs to allow for continuity of care and for staff training that facilitates awareness of factors that influence women's help seeking. Further research is required, particularly in relation to effective means of identifying perinatal psychological distress. © British Journal of General Practice 2017.

Living well to the end: A phenomenological analysis of life in extra care housing.

PubMed

Shaw, Rachel L; West, Karen; Hagger, Barbara; Holland, Carol A

2016-01-01

To understand older adults' experiences of moving into extra care housing which offers enrichment activities alongside social and healthcare support. A longitudinal study was conducted which adopted a phenomenological approach to data generation and analysis. Semi-structured interviews were conducted in the first 18 months of living in extra care housing. Interpretative phenomenological analysis was used because its commitment to idiography enabled an in-depth analysis of the subjective lived experience of moving into extra care housing. Themes generated inductively were examined against an existential-phenomenological theory of well-being. Learning to live in an extra care community showed negotiating new relationships was not straightforward; maintaining friendships outside the community became more difficult as capacity declined. In springboard for opportunity/confinement, living in extra care provided new opportunities for social engagement and a restored sense of self. Over time horizons began to shrink as incapacities grew. Seeking care illustrated reticence to seek care, due to embarrassment and a sense of duty to one's partner. Becoming aged presented an ontological challenge. Nevertheless, some showed a readiness for death, a sense of homecoming. An authentic later life was possible but residents required emotional and social support to live through the transition and challenges of becoming aged. Enhancement activities boosted residents' quality of life but the range of activities could be extended to cater better for quieter, smaller scale events within the community; volunteer activity facilitators could be used here. Peer mentoring may help build new relationships and opportunities for interactive stimulation. Acknowledging the importance of feeling-empathic imagination-in caregiving may help staff and residents relate better to each other, thus helping individuals to become ontologically secure and live well to the end.

Living well to the end: A phenomenological analysis of life in extra care housing

PubMed Central

Shaw, Rachel L.; West, Karen; Hagger, Barbara; Holland, Carol A.

2016-01-01

Objectives To understand older adults’ experiences of moving into extra care housing which offers enrichment activities alongside social and healthcare support. Design A longitudinal study was conducted which adopted a phenomenological approach to data generation and analysis. Methods Semi-structured interviews were conducted in the first 18 months of living in extra care housing. Interpretative phenomenological analysis was used because its commitment to idiography enabled an in-depth analysis of the subjective lived experience of moving into extra care housing. Themes generated inductively were examined against an existential–phenomenological theory of well-being. Results Learning to live in an extra care community showed negotiating new relationships was not straightforward; maintaining friendships outside the community became more difficult as capacity declined. In springboard for opportunity/confinement, living in extra care provided new opportunities for social engagement and a restored sense of self. Over time horizons began to shrink as incapacities grew. Seeking care illustrated reticence to seek care, due to embarrassment and a sense of duty to one's partner. Becoming aged presented an ontological challenge. Nevertheless, some showed a readiness for death, a sense of homecoming. Conclusions An authentic later life was possible but residents required emotional and social support to live through the transition and challenges of becoming aged. Enhancement activities boosted residents’ quality of life but the range of activities could be extended to cater better for quieter, smaller scale events within the community; volunteer activity facilitators could be used here. Peer mentoring may help build new relationships and opportunities for interactive stimulation. Acknowledging the importance of feeling—empathic imagination—in caregiving may help staff and residents relate better to each other, thus helping individuals to become ontologically secure and live well to the end. PMID:27172516

Experiences of Public Doctors on Managing Work Difficulties and Maintaining Professional Enthusiasm in Acute General Hospitals: A Qualitative Study.

PubMed

Luk, Andrew Leung; Yau, Adrian Fai To

2018-01-01

Overseas studies suggest that 10-20% of doctors are depressed, 30-45% have burnout, and many report dissatisfaction with work-life balance. A local study on public doctors showed that 31.4% of the respondents satisfied the criteria for high burnout. Young, but moderately experienced doctors who need to work shifts appeared most vulnerable. This study aims to explore the experiences of those public doctors who have managed their work difficulties and maintained professional enthusiasm for references in medical education and continuing professional training. Ten public doctors with reputation were invited respectively from three acute general hospitals for an in-depth interview. Interviews were audio recorded and transcribed. Content analysis was carried out to identify major themes in relation to the research questions. Three themes emerging from difficulties encountered were (1) managing people, mostly are patients, followed by colleagues and then patients' relatives; (2) constraints at work, include time and resources; and (3) managing self with decision-making within a short time. Three themes generating from managing work difficulties included (1) self-adjustment with practicing problem solving and learning good communication appeared more frequently, followed by maintaining a professional attitude and accumulating clinical experiences; (2) seeking help from others; and (3) organizational support is also a theme though it is the least mentioned. Four themes emerging from maintaining work enthusiasm were (1) personal conviction and discipline: believing that they are helping the needy, having the sense of vocation and support from religion; disciplining oneself by continuing education, maintaining harmonious family relationship and volunteer work. (2) Challenging work: different challenging natures of their job. (3) Positive feedback from patients: positive encounters with patients keep a connectedness with their clients. (4) Organization support: working with good colleagues and opportunity for continuous training. Some implications for medical education include, developing good communication skill for medical students and junior doctors, preparing senior doctors to be mentors, and exploring the motivating force of spirituality/religion.

May I long experience the joy of healing: professional and personal wellbeing among physicians from a Canadian province

PubMed Central

Lovell, Brenda L; Lee, Raymond T; Frank, Erica

2009-01-01

Background The development of best practices to promote physician wellbeing at the individual and organisational levels is receiving increased attention. Few studies have documented how physicians perceive their wellbeing in these contexts. The purpose of this qualitative study is to identify and discuss the reported factors that hinder wellbeing, as well as the reported factors that would promote wellbeing among physicians. Methods There were 165 physicians from a province of Canada who wrote their open-ended responses to two questions, as part of a larger self-report questionnaire. The questions asked what causes them stress, and what interventions should be implemented at organisational/institutional levels. The largest specialty was family medicine, followed by internal medicine, and surgical disciplines, with 58% of participants male. A general inductive approach was used to analyze the data and themes and sub-themes were discovered using the socio-ecological model as the framework. Results Reponses were both personal and professional which resulted in the emergence of four major themes to reflect this diversity. These themes were external constraints on the practice of medicine, issues at the professional/institutional levels, issues at the individual practice level, and work/life balance. The work/life balance theme received the highest number of responses followed by external constraints on the practice of medicine. In the major theme of work-life balance, work-life conflict received the most responses, and in the major theme of external constraints on practice of medicine, lack of resources (human and material) and restrictions to autonomy received the most responses. Ideas for interventions in the work/life balance theme were health promotion, and healthy workplace initiatives. In the second largest theme, suggested ideas for interventions were collegiality/professionalism and policy formulation at the health care system. Conclusion Our findings have implications for governance and health policy, health human resources and education. In particular, the socio-ecological framework was a useful framework to analyse physician wellbeing due to its applicability for issues at the structural, organisational, and individual levels. Future research should target interventions at the organisational and institutional levels to address work-life conflict and job dissatisfaction. PMID:19239695

May I long experience the joy of healing: professional and personal wellbeing among physicians from a Canadian province.

PubMed

Lovell, Brenda L; Lee, Raymond T; Frank, Erica

2009-02-24

The development of best practices to promote physician wellbeing at the individual and organisational levels is receiving increased attention. Few studies have documented how physicians perceive their wellbeing in these contexts. The purpose of this qualitative study is to identify and discuss the reported factors that hinder wellbeing, as well as the reported factors that would promote wellbeing among physicians. There were 165 physicians from a province of Canada who wrote their open-ended responses to two questions, as part of a larger self-report questionnaire. The questions asked what causes them stress, and what interventions should be implemented at organisational/institutional levels. The largest specialty was family medicine, followed by internal medicine, and surgical disciplines, with 58% of participants male. A general inductive approach was used to analyze the data and themes and sub-themes were discovered using the socio-ecological model as the framework. Reponses were both personal and professional which resulted in the emergence of four major themes to reflect this diversity. These themes were external constraints on the practice of medicine, issues at the professional/institutional levels, issues at the individual practice level, and work/life balance. The work/life balance theme received the highest number of responses followed by external constraints on the practice of medicine. In the major theme of work-life balance, work-life conflict received the most responses, and in the major theme of external constraints on practice of medicine, lack of resources (human and material) and restrictions to autonomy received the most responses. Ideas for interventions in the work/life balance theme were health promotion, and healthy workplace initiatives. In the second largest theme, suggested ideas for interventions were collegiality/professionalism and policy formulation at the health care system. Our findings have implications for governance and health policy, health human resources and education. In particular, the socio-ecological framework was a useful framework to analyse physician wellbeing due to its applicability for issues at the structural, organisational, and individual levels. Future research should target interventions at the organisational and institutional levels to address work-life conflict and job dissatisfaction.

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

PubMed

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

2015-04-01

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

Making Each Other’s Daily Life: Nurse Assistants’ Experiences and Knowledge on Developing a Meaningful Daily Life in Nursing Homes

PubMed Central

James, Inger; Fredriksson, Carin; Wahlström, Catrin; Kihlgren, Annica; Blomberg, Karin

2014-01-01

Background: In a larger action research project, guidelines were generated for how a meaningful daily life could be developed for older persons. In this study, we focused on the nurse assistants’ (NAs) perspectives, as their knowledge is essential for a well-functioning team and quality of care. The aim was to learn from NAs’ experiences and knowledge about how to develop a meaningful daily life for older persons in nursing homes and the meaning NAs ascribe to their work. Methods: The project is based on Participatory and Appreciative Action and Reflection. Data were generated through interviews, participating observations and informal conversations with 27 NAs working in nursing homes in Sweden, and a thematic analysis was used. Result: NAs developed a meaningful daily life by sensing and finding the “right” way of being (Theme 1). They sense and read the older person in order to judge how the person was feeling (Theme 2). They adapt to the older person (Theme 3) and share their daily life (Theme 4). NAs use emotional involvement to develop a meaningful daily life for the older person and meaning in their own work (Theme 5), ultimately making each other’s daily lives meaningful. Conclusion: It was obvious that NAs based the development of a meaningful daily life on different forms of knowledge: the oreticaland practical knowledge, and practical wisdom, all of which are intertwined. These results could be used within the team to constitute a meaningful daily life for older persons in nursing homes. PMID:25246997

Heightened vulnerabilities and better care for all: disability and end-of-life care.

PubMed

Stienstra, Deborah; D'Aubin, April; Derksen, Jim

2012-03-01

The purpose of this study was to assess the extent to which vulnerability was present or heightened as a result of either disability or end-of-life policies, or both, when people with disabilities face end of life. People with disabilities and policy makers from four Canadian provinces and at the federal level were interviewed or participated in focus groups to identify interactions between disability policies and end-of-life policies. Relevant policy documents in each jurisdiction were also analyzed. Key theme analysis was used on transcripts and policy documents. Fact sheets identifying five key issues were developed and shared in the four provinces with policy makers and people with disabilities. Examples of heightened vulnerability are evident in discontinuity from formal healthcare providers with knowledge of conditions and impairments, separation from informal care providers and support systems, and lack of coordination with and gaps in disability-related supports. When policies seek to increase the dignity, autonomy, and capacity of all individuals, including those who experience heightened vulnerability, they can mitigate or lessen some of the vulnerability. Specific policies addressing access to community-based palliative care, coordination between long-standing formal care providers and new care providers, and support and respect for informal care providers, can redress these heightened vulnerabilities. The interactions between disability and end-of-life policies can be used to create inclusive end-of-life policies, resulting in better end-of-life care for all people, including people with disabilities.

A Qualitative Approach on Motives and Aspects of Risks in Freeriding

PubMed Central

Frühauf, Anika; Hardy, Will A. S.; Pfoestl, Daniel; Hoellen, Franz-Georg; Kopp, Martin

2017-01-01

Recent research has shown that there are multiple motives for participation in high-risk sport; however these results have come from studies that consider a number of different sports. Therefore, the aim of the present study was to better understand the motives and risk-related aspects of freeriding, using a qualitative approach. Semi-structured interviews were conducted with 40 professional and semi-professional freeride skiers and snowboarders. All freeriders were highly experienced, of different age (19–44 years; 27.5 ± 4.5 years), gender (female = 13), and profession (professional athletes = 11). Analyses were done using MAXQDA software following a code theme approach. Mixed methods analyses using χ2-tests were computed for age (<25 years ≥) and gender (female/male) on motives and risk factors. Five emerging themes were found, namely Challenge (n = 36), Friends (n = 31), Nature (n = 27), Balance (n = 26), and Freedom (n = 26). A sixth theme Habit (n = 13) was allocated as a subtheme due to minor responses. With regard to risk management, participants decided upon a risk calculation strategy which included multiple factors (e.g., planning, conditions, current situation, knowledge, and experience). Trusting in one's own abilities, avoiding negative fear and having trusted partners were among the risk factors. Deliberately seeking out dangerous situations was not a motive. χ2-tests revealed no gender or age differences regarding aspects of risk (range of p-scores: p = 0.17–1.00) or motives (p = 0.16–1.00). Freeriding was shown to provide positive effects through participation. Some important factors seem to be motivational drivers for freeriders: challenging oneself, experiencing nature, contributing to deep friendships, freeriding as a counterbalance to everyday life and escape from restrictions. Contrary to prior research reports on sensation seeking, experienced freeriders do not search the risk; they seem to minimize it based on knowledge and experience. Analyses of the present data did not show any gender or age differences, which may suggest that experience plays a more important role in high-risk sports than age or gender. Future research should qualitatively investigate further terrain based activities and implement motives and risk-related factors in quantitative research. PMID:29184524

Digital Ethnography of Zoophilia - A Multinational Mixed-Methods Study.

PubMed

Sendler, Damian Jacob; Lew-Starowicz, Michal

2018-05-10

This study investigates people who have sex with animals (PSA) by describing their living situation, sexual activity, beliefs, and attitudes toward stigmatization. These data are highly applicable to the work of psychiatric and forensic professionals investigating paraphilias. We apply mixed-methods approach, using qualitative and quantitative analyses. The findings come from anonymous forum postings of 953 participants; of which 345 agreed to complete a survey upon advertising the study. We identify several themes, describing concerns of zoosexuals chatting within online communities: living situation; sex life; social acceptability; getting help. First, we provide data on how PSA justify their relationships with animal sex partners - with particular emphasis on sex practices and physical features most attractive to them. Second, we elaborate on the stigma associated with being a zoosexual, including the coping mechanism for dealing with social ostracism. Third, we elaborate, in detail, on why PSA find animals sexually appealing. Lastly, we present evidence that online discussion spaces serve as the platform for help-seeking behavior for individuals with paraphilias. This study presents the largest analyses of zoophiles in modern history, using mixed-methods approach, uncovering their daily activities, sexual preferences, and help-seeking behavior.

Physicians' pharmacogenomics information needs and seeking behavior: a study with case vignettes.

PubMed

Heale, Bret S E; Khalifa, Aly; Stone, Bryan L; Nelson, Scott; Del Fiol, Guilherme

2017-08-01

Genetic testing, especially in pharmacogenomics, can have a major impact on patient care. However, most physicians do not feel that they have sufficient knowledge to apply pharmacogenomics to patient care. Online information resources can help address this gap. We investigated physicians' pharmacogenomics information needs and information-seeking behavior, in order to guide the design of pharmacogenomics information resources that effectively meet clinical information needs. We performed a formative, mixed-method assessment of physicians' information-seeking process in three pharmacogenomics case vignettes. Interactions of 6 physicians' with online pharmacogenomics resources were recorded, transcribed, and analyzed for prominent themes. Quantitative data included information-seeking duration, page navigations, and number of searches entered. We found that participants searched an average of 8 min per case vignette, spent less than 30 s reviewing specific content, and rarely refined search terms. Participants' information needs included a need for clinically meaningful descriptions of test interpretations, a molecular basis for the clinical effect of drug variation, information on the logistics of carrying out a genetic test (including questions related to cost, availability, test turn-around time, insurance coverage, and accessibility of expert support).Also, participants sought alternative therapies that would not require genetic testing. This study of pharmacogenomics information-seeking behavior indicates that content to support their information needs is dispersed and hard to find. Our results reveal a set of themes that information resources can use to help physicians find and apply pharmacogenomics information to the care of their patients.

Conservation of Life as a Unifying Theme for Process Safety in Chemical Engineering Education

ERIC Educational Resources Information Center

Klein, James A.; Davis, Richard A.

2011-01-01

This paper explores the use of "conservation of life" as a concept and unifying theme for increasing awareness, application, and integration of process safety in chemical engineering education. Students need to think of conservation of mass, conservation of energy, and conservation of life as equally important in engineering design and analysis.…

Health-seeking behaviour in Pakistan: a narrative review of the existing literature.

PubMed

Anwar, M; Green, J; Norris, P

2012-06-01

This narrative review was carried out to collate the work of researchers on health-seeking behaviour in Pakistan, to discuss the methods used, highlight the emerging themes and identify areas that have yet to be studied. Review. An overview of studies on health-seeking behaviour in Pakistan, found via searches on scholarly databases intended to locate material of medical and anthropological relevance. In total, 29 articles were reviewed with a range of different methodologies. A retrospective approach was the most common. A variety of medical conditions have been studied in terms of health-seeking behaviour of people experiencing such conditions. However, a wide range of chronic illnesses have yet to be studied. Nevertheless, some studies highlighting unusual issues such as snake bites and health-seeking behaviour of street children were also found. In terms of geographical area, the majority of studies reviewed were performed in the provinces of Sind and Punjab, with little research targeting the people from the two other provinces (Balochistan and Khyber Pakhtunkhwa) of Pakistan. Predominant utilization of private healthcare facilities, self-medication, involvement of traditional healers in the healthcare system, women's autonomy, and superstitions and fallacies associated with health-seeking behaviour were found to be the themes that repeatedly emerged in the literature reviewed. The sociocultural and religious background of Pakistan means that health-seeking behaviour resembles a mosaic. There is a need to improve the quality of service provided by the public healthcare sector and the recruitment of female staff. Traditional healers should be trained and integrated into the mainstream to provide adequate healthcare. Serious efforts are required to increase the awareness and educational level of the public, especially women in rural areas, in order to fight against myths and superstitions associated with health-seeking behaviour. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Defense Acquisition Research Journal. Volume 19, Number 1, Issue 61, January 2012

DTIC Science & Technology

2012-01-01

format (author-date-page number form of citation) as outlined in the Publication Manual of the American Psycho- logical Association ( 6th Edition ). For all...other style questions, please refer to the Chicago Manual of Style (15th Edition ). Contributors are encouraged to seek the advice of a reference...theme editions . Please consult the DAU home page for current themes being solicited. See print schedule below. 2012 Due Date Publication Date July 1

Themes addressed by couples with advanced cancer during a communication skills training intervention.

PubMed

Porter, Laura S; Fish, Laura; Steinhauser, Karen

2018-04-25

Couple-based communication interventions have beneficial effects for patients with cancer and their partners. However, few studies have targeted patients with advanced stages of disease and little is known about how best to assist couples in discussing issues related to life-limiting illness. The purpose of the present study was to identify themes couples addressed during a couple communication skills intervention, and the frequency with which they discussed issues related to end-of-life. Content analyses were conducted on recordings of 72 sessions from 12 couples facing advanced gastrointestinal (GI) cancer. Coding was based six themes identified a priori from the framework for understanding what patients and family value at end of life. The percent of couples addressing each theme was calculated to gauge level of importance and acceptability of these topics. The majority of couples addressed topics previously identified as salient at end-of-life, including clear decision making, affirmation of the whole person, pain and symptom management, contributing to others, and preparation for death. In addition, novel aspects to these themes emerged in the context of couples' conversations, illustrating the importance of the couple relationship in adjusting to life with a life-limiting illness and anticipating the transition to end-of-life. Findings suggest that couples likely would be receptive to an intervention that combines training in communication skills with guidance in focusing on issues related to life completion to assist with transitions at end of life. Such interventions might enhance both individuals' abilities to cope with illness-related symptoms and demands, enjoy the time they have together, and derive meaning from the experience. Copyright © 2018. Published by Elsevier Inc.

Interviews with children of persons with a severe mental illness: investigating their everyday situation.

PubMed

Ostman, Margareta

2008-01-01

Research on children of persons with a severe mental illness focuses predominantly on parents' and others' perceptions. Children of mentally ill parents form a vulnerable group that has not been adequately paid attention to in psychiatric care institutions. Comparatively little is known about the children's recognition of their parents and the everyday situation of these families. The aim of the study was to investigate experiences of their life situation in children 10-18 years of age in a family with a parent with a severe mental illness. Eight children were interviewed concerning their everyday life situation. The interviews were analysed inspired from using thematic analysis. From the analysis of the material emerged aspects concerning the following themes: need for conversation, love for their family, maturity, experience of fear and blame, feelings of loneliness, responsibility and associated stigma. This study highlights the situation experienced by children of severely mentally ill persons who also are parents. The study may be found to be a basis for inspiring structured interventions and treatments programmes including children of the adult patients seeking psychiatric treatment.

Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury.

PubMed

Manns, P J; Chad, K E

2001-11-01

This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.

Understanding the medicines information-seeking behaviour and information needs of South African long-term patients with limited literacy skills.

PubMed

Patel, Sonal; Dowse, Ros

2015-10-01

Although much health information-seeking behaviour (HISB) research has been reported in patients with good literacy skills, little is known about HISB in patients with limited literacy skills served by under-resourced health-care systems. To investigate medicine information-seeking behaviour and information needs in patients with limited literacy. Using a question guide, four focus group discussions (FGDs) were conducted to explore themes related to information needs, information-seeking practices and awareness of and ability to utilize information sources. Twenty-two isiXhosa-speaking long-term patients with limited formal education were recruited from a primary health-care clinic in South Africa. Discussions were audio-recorded and transcribed verbatim. NVivo(®) was used for initial coding of transcripts. Codes were analysed, and potential themes and subthemes in the entire data set were identified and refined. The results of this study reflect a passive, disempowered patient. Poor awareness of information sources, lack of health-related knowledge and stigma contributed to a lack of information-seeking practice, thus potentially adversely influencing patient-provider interactions. Patients neither asked questions nor were encouraged to ask questions. All expressed an unmet need for information and a desire for receiving the illustrated written medicines-related information displayed in the FGDs. The main sources of information were health-care professionals, followed by family and friends. The significant level of patient disempowerment and passivity reported amongst patients underpinned their inability to actively seek information. Neither sources of information nor types of appropriate medicines information could be identified. Unmet information needs and a desire for information were reported. © 2013 John Wiley & Sons Ltd.

Health care seeking behaviours in pregnancy in rural Sindh, Pakistan: a qualitative study.

PubMed

Qureshi, Rahat Najam; Sheikh, Sana; Khowaja, Asif Raza; Hoodbhoy, Zahra; Zaidi, Shujaat; Sawchuck, Diane; Vidler, Marianne; Bhutta, Zulfiqar A; von Dadeslzen, Peter

2016-06-08

Pakistan has alarmingly high numbers of maternal mortality along with suboptimal care-seeking behaviour. It is essential to identify the barriers and facilitators that women and families encounter, when deciding to seek maternal care services. This study aimed to understand health-seeking patterns of pregnant women in rural Sindh, Pakistan. A qualitative study was undertaken in rural Sindh, Pakistan as part of a large multi-country study in 2012. Thirty three focus group discussions and 26 in-depth interviews were conducted with mothers [n = 173], male decision-makers [n = 64], Lady Health Workers [n = 64], Lady Health Supervisors [n = 10], Women Medical Officers [n = 9] and Traditional Birth Attendants [n = 7] in the study communities. A set of a priori themes regarding care-seeking during pregnancy and its complications as well as additional themes as they emerged from the data were used for analysis. Qualitative analysis was done using NVivo version 10. Women stated they usually visited health facilities if they experienced pregnancy complications or danger signs, such as heavy bleeding or headache. Findings revealed the importance of husbands and mothers-in-law as decision makers regarding health care utilization. Participants expressed that poor availability of transport, financial constraints and the unavailability of chaperones were important barriers to seeking care. In addition, private facilities were often preferred due to the perceived superior quality of services. Maternal care utilization was influenced by social, economic and cultural factors in rural Pakistani communities. The perceived poor quality care at public hospitals was a significant barrier for many women in accessing health services. If maternal lives are to be saved, policy makers need to develop processes to overcome these barriers and ensure easily accessible high-quality care for women in rural communities. NCT01911494.

'I wouldn't want it on my CV or their records': medical students' experiences of help-seeking for mental health problems.

PubMed

Chew-Graham, Carolyn A; Rogers, Anne; Yassin, Nuha

2003-10-01

Medical education is reported to be demanding and stressful and previous work with doctors suggests that there is a resistance within the profession to help-seeking and an ad hoc approach to dealing with stress and distress. To explore the attitudes of medical students at the University of Manchester, UK to the causes of stress and to examine their views on help-seeking. A qualitative study using semistructured interviews, with analysis of the data using the technique of constant comparison. Medical students at the University of Manchester were invited to participate in the study. Sampling made the research representative of medical students in terms of gender, ethnicity and UK/overseas students. Semistructured interviews, with open questions, were conducted and audio-taped with consent. The tapes were transcribed verbatim. The schedule was revised in the light of the emerging themes. Medical students recognised that studying medicine contributes to stress, as experienced in their undergraduate careers. Students reported that perceptions of stigma associated with mental illness, including stress, were prevalent in the student body and were perceived to continue throughout the medical profession. Avoidance of appropriate help-seeking behaviour starts early and is linked to perceived norms which dictate that experiencing a mental health problem may be viewed as a form of weakness and has implications for subsequent successful career progression. The preparation of medical students for life as doctors involves more than facilitation of the acquisition of knowledge and skills, so that new doctors can conform to the principals of professional conduct. Support and mentoring are required so that stress can be identified early and dealt with appropriately.

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

PubMed

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

2013-11-01

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

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

PubMed Central

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

2014-01-01

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

Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission

DOE PAGES

Parham, Paul E.; Waldock, Joanna; Christophides, George K.; ...

2015-02-16

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is due not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but, perhaps most crucially, the multitude of epidemiological, ecological, and socioeconomic factors that drive VBD transmission, and this complexity has generated considerable debate over the last 10-15 years. Inmore » this article, and Theme Issue, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions, and, crucially, offer some solutions for the field moving forwards. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector-pathogen systems. This Theme Issue seeks to cover both, reflected in the breadth and depth of the topics and VBD-systems considered, itself strongly indicative of the challenging, but necessary, multidisciplinary nature of this research field.« less

Barriers and Facilitators to Deaf Trauma Survivors' Help-Seeking Behavior: Lessons for Behavioral Clinical Trials Research.

PubMed

Anderson, Melissa L; Wolf Craig, Kelly S; Ziedonis, Douglas M

2017-01-01

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility during the design of study methodology. To inform such considerations, we conducted an exploratory secondary analysis of a mixed-methods study that originally explored 16 Deaf trauma survivors' help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that could be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged were not wholly dissimilar from the general preferences of members of other sociolinguistic minority groups-a need for communication access, empathy, respect, strict confidentiality procedures, trust, and transparency of the research process. Yet, how these themes are applied to the inclusion of Deaf research participants is distinct from any other sociolinguistic minority population, given Deaf people's unique sensory and linguistic characteristics. We summarize our findings in a preliminary "Checklist for Designing Deaf Behavioral Clinical Trials" to operationalize the steps researchers can take to apply Deaf-friendly approaches in their empirical work. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Self-Injury, Help-Seeking, and the Internet: Informing Online Service Provision for Young People.

PubMed

Frost, Mareka; Casey, Leanne; Rando, Natalie

2016-01-01

Although increasing numbers of young people are seeking help online for self-injury, relatively little is known about their online help-seeking preferences. To investigate the perspectives of young people who self-injure regarding online services, with the aim of informing online service delivery. A mixed-methods exploratory analysis regarding the perspectives of a subsample of young people who reported a history of self-injury and responded to questions regarding preferences for future online help-seeking (N = 457). The sample was identified as part of a larger study (N = 1,463) exploring self-injury and help-seeking. Seven themes emerged in relation to preferences for future online help-seeking: information, guidance, reduced isolation, online culture, facilitation of help-seeking, access, and privacy. Direct contact with a professional via instant messaging was the most highly endorsed form of online support. Young people expressed clear preferences regarding online services for self-injury, supporting the importance of consumer consultation in development of online services.

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

ERIC Educational Resources Information Center

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

2009-01-01

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

Achieving work-life balance in the National Collegiate Athletic Association Division I setting, part II: perspectives from head athletic trainers.

PubMed

Goodman, Ashley; Mazerolle, Stephanie M; Pitney, William A

2015-01-01

Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role. To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university. Qualitative study. Web-based management system. A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered. Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data. Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work.

Older women's experiences of depression: a hermeneutic phenomenological study.

PubMed

Allan, J; Dixon, A

2009-12-01

This hermeneutic phenomenological study, informed by Max van Manen and Martin Heidegger, describes what it is like for four older women to live with depression. Each participant was interviewed up to three times. Interviews were semi-structured, audiotaped and transcribed verbatim. Data were analysed using van Manen's methodological themes and Heidegger's philosophical concepts of Being-in-the-world and Being-with-others. The themes that emerged were: self-loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being-alone; misinterpreting self and other people; the stigma of mental illness - society and self; and seeking understanding from other people. The findings revealed that depression had a major effect on the women's beliefs about themselves, resulting in a self-loathing and a feeling of failure. The participants described how their self-loathing caused them to believe that other people thought badly of them, which led to their withdrawal. Their inability to connect contributed to them feeling alone and isolated. These women were more able to talk to other people when they were met with understanding. This has implications for the therapeutic nurse-patient relationship, which is fundamental to mental health nursing, because the relationship should be based upon an understanding of the patient's world.

"Why do you want your child to have braces?" Investigating the motivations of Hispanic/Latino and white parents.

PubMed

Davis, Blake B; Bayirli, Burcu; Ramsay, Douglas S; Turpin, David L; Paige, Andrew; Riedy, Christine A

2015-11-01

Many psychological, social, and cultural factors influence parents' motivation to seek orthodontic care for their children. In this study, we used Q methodology to identify and categorize shared motives and determine whether cultural differences exist between Hispanic/Latino (H/L) and non-Hispanic/Latino, white (W) parents. The fundamental question posed to the parents was "Why do you want your child to have braces?" Q methodology involves 3 stages. (1) Interviews of H/L (n = 5) and W (n = 5) parents generated 35 statements that represented different motives to seek orthodontic care. (2) In the Q sort, 70 new parents (22 H/L, 48 W) ranked statements in order of relative importance using a forced distribution grid. (3) Factor analysis was performed separately for the H/L and W groups to uncover cultural differences. Four motivational profiles were described for both the H/L and W parents based on the significant factors identified in each group. More H/L parents (18 of 22 parents) than W parents (22 of 48 parents) were characterized by 1 of their group's 4 profiles. Comparisons of the motivational profiles across the groups showed 4 global themes: well-timed treatment that prevents future dental problems, parental responsibility, perceived benefits, and perceived need instilled by the dentist. Four global themes captured the motives of most parents seeking orthodontic treatment for their children. Understanding these global themes can help clinicians frame their treatment discussions with parents. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

A Synthesis of Spiritual Intelligence Themes from Islamic and Western Philosophical Perspectives.

PubMed

Hanefar, Shamsiah Banu; Sa'ari, Che Zarrina; Siraj, Saedah

2016-12-01

Spiritual intelligence is an emerging term that is widely discussed and accepted as one of the main components that addresses and solves many life problems. Nonetheless there is no specific study being done to synthesize the spiritual intelligence themes from Western and Islamic philosophical perspectives. This research aimed to identify common spiritual intelligence themes from these two perspectives and elucidated its contents by the view of two well-known Islamic scholars; al-Ghazali and Hasan Langgulung. Seven spiritual intelligence themes were identified through thematic analysis; meaning/purpose of life, consciousness, transcendence, spiritual resources, self-determination, reflection-soul purification and spiritual coping with obstacles. These findings will be the groundwork for centered theory of spiritual intelligence themes that synthesize the Islamic and Western philosophical perspectives. It is hoped that this study will contribute significantly to the development of valid and reliable spiritual intelligence themes beyond the social and cultural boundaries.

Ethnic Differences for Public Health Knowledge, Health Advocacy Skills, and Health Information Seeking Among High School Students: Community Agents of Change.

PubMed

Kratzke, Cynthia; Rao, Satya; Marquez, Ruben

2018-03-06

Although adult health advocacy programs have been examined in communities, little is known about integrated adolescent health advocacy programs in high schools. The purpose of this study was to examine the health advocacy program impact and ethnic differences among high school students. Using a cross-sectional study, high school students participating in the school-based program completed evaluation surveys. The program domains included upstream causes of health, community assets, and public health advocacy. Bivariate analyses were conducted to examine ethnic differences for public health knowledge, health advocacy skills, and health information seeking behaviors. Using thematic analysis, open-ended survey item responses were coded to identify themes for students' perceptions of community health. Non-Hispanic (n = 72) and Hispanic high school students (n = 182) in ten classes reported owning smartphones (95%) and laptops (76%). Most students (72%) reported seeking online health information. Non-Hispanic students reported significantly higher health advocacy skills for speaking with the class about health issues, identifying community services, or creating health awareness at school than Hispanic students. Non-Hispanic students were more likely to seek health information from fathers and television than Hispanic students. Hispanic students were more likely to seek health information from hospital or clinic staff than non-Hispanic students. Emergent themes included health advocacy skills, community awareness, and individual and community health changes. High schools benefit from integrating health advocacy programs into the core curriculum. Adolescents gain important skills to improve their individual health and engage in changing community health.

Dysphonia, Perceived Control, and Psychosocial Distress: A Qualitative Study.

PubMed

Misono, Stephanie; Haut, Caroline; Meredith, Liza; Frazier, Patricia A; Stockness, Ali; Michael, Deirdre D; Butcher, Lisa; Harwood, Eileen M

2018-05-11

The purpose of this qualitative study was to examine relationships between psychological factors, particularly perceived control, and voice symptoms in adults seeking treatment for a voice problem. Semistructured interviews of adult patients with a clinical diagnosis of muscle tension dysphonia were conducted and transcribed. Follow-up interviews were conducted as needed for further information or clarification. A multidisciplinary team analyzed interview content using inductive techniques. Common themes and subthemes were identified. A conceptual model was developed describing the association between voice symptoms, psychological factors, precipitants of ongoing voice symptoms, and perceived control. Thematic saturation was reached after 23 interviews. No participants reported a direct psychological cause for their voice problem, although half described significant life events preceding voice problem onset (eg, miscarriage and other health events, interpersonal conflicts, and family members' illnesses, injuries, and deaths). Participants described psychological influences on voice symptoms that led to rapid exacerbation of their voice symptoms. Participants described the helpfulness of speech therapy and sometimes also challenges of applying techniques in daily life. They also discussed personal coping strategies that included behavioral (eg, avoiding triggers and seeking social support) and psychological (eg, mind-body awareness and emotion regulation) components. Voice-related perceived control was associated with adaptive emotional and behavioral responses, which appeared to facilitate symptom improvement. In this qualitative pilot study, participant narratives suggested that psychological factors and emotions influence voice symptoms, facilitating development of a preliminary conceptual model of how adaptive and maladaptive responses develop and how they influence vocal function. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Understanding the Experience of Miscarriage in the Emergency Department.

PubMed

MacWilliams, Kate; Hughes, Jean; Aston, Megan; Field, Simon; Moffatt, Faith Wight

2016-11-01

Up to 20% of pregnancies end in miscarriage, which can be a significant life event for women with psychological implications. Because the only preventative measure for a miscarriage is risk factor modification, the treatment focuses on confirming the miscarriage has occurred and medical management of symptoms. Although women experiencing a miscarriage are frequently directed to seek medical care in emergency departments, the patients are often triaged as nonemergent patients unless they are unstable, which exposes women to potentially prolonged wait times. Research about miscarriages and emergency departments predominantly focus on medical management with little understanding of how emergency care shapes the experience of miscarriage for women. Seeking to describe the experiences of women coming to the emergency department for care while having a miscarriage, interpretive phenomenology-a form of qualitative research-guided this study. Eight women were recruited to participate in semi-structured face-to-face interviews of 60 to 90 minutes in length. Data were analyzed using hermeneutics and thematic analysis. Five themes emerged: "Pregnant/Life: Miscarriage/Death"; "Deciding to go to the emergency department: Something's wrong"; "Not an illness: A different kind of trauma"; "Need for acknowledgement"; and "Leaving the emergency department: What now?". Participants believed their losses were not acknowledged but instead dismissed. These experiences, combined with a perceived lack of discharge education and clarity regarding follow-up, created experiences of marginalization. This study describes the experience of miscarrying in emergency departments and provides insights regarding how nursing and physician care may affect patient perceptions of marginalization. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Commentary on Becoming a Daughter: Trauma is a powerful teacher.

PubMed

Veach, Patricia McCarthy

2006-06-01

Personal life crises profoundly impact genetic counselor practice. In this commentary, themes from Matloff's (in press) article, Becoming a Daughter are highlighted and expanded upon. These themes include: personal impact of a life crisis, and professional impact vis a vis empathy countertransference, self-disclosure, nondirectiveness, and self-confidence. Strategies that help genetic counselors manage personal life crises within their clinical practice and also promote their professional development are emphasized, including normalization of life crises, self-reflection, boundary-setting, and use of peer supervision and consultation.

The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis.

PubMed

Guise, Andy; Horyniak, Danielle; Melo, Jason; McNeil, Ryan; Werb, Dan

2017-12-01

Understanding the experience of initiating injection drug use and its social contexts is crucial to inform efforts to prevent transitions into this mode of drug consumption and support harm reduction. We reviewed and synthesized existing qualitative scientific literature systematically to identify the socio-structural contexts for, and experiences of, the initiation of injection drug use. We searched six databases (Medline, Embase, PsychINFO, CINAHL, IBSS and SSCI) systematically, along with a manual search, including key journals and subject experts. Peer-reviewed studies were included if they qualitatively explored experiences of or socio-structural contexts for injection drug use initiation. A thematic synthesis approach was used to identify descriptive and analytical themes throughout studies. From 1731 initial results, 41 studies reporting data from 1996 participants were included. We developed eight descriptive themes and two analytical (higher-order) themes. The first analytical theme focused on injecting initiation resulting from a social process enabled and constrained by socio-structural factors: social networks and individual interactions, socialization into drug-using identities and choices enabled and constrained by social context all combine to produce processes of injection initiation. The second analytical theme addressed pathways that explore varying meanings attached to injection initiation and how they link to social context: seeking pleasure, responses to increasing tolerance to drugs, securing belonging and identity and coping with pain and trauma. Qualitative research shows that injection drug use initiation has varying and distinct meanings for individuals involved and is a dynamic process shaped by social and structural factors. Interventions should therefore respond to the socio-structural influences on injecting drug use initiation by seeking to modify the contexts for initiation, rather than solely prioritizing the reduction of individual harms through behavior change. © 2017 Society for the Study of Addiction.

"The Church of Online Support": Examining the Use of Blogs Among Family Caregivers of Persons With Dementia.

PubMed

Anderson, Joel G; Hundt, Elizabeth; Dean, Morgan; Keim-Malpass, Jessica; Lopez, Ruth Palan

2017-02-01

Many individuals, including dementia caregivers, use blogs to share their experiences. These blogs contain rich narratives representing an untapped resource for understanding the psychosocial impact of caring for a person with dementia at the family level. The present study used blogs written by caregivers of persons with dementia to explore how these individuals leveraged this medium as part of the caregiving experience. Blogs written by self-identified informal caregivers of persons with dementia were identified using a systematic search method, and data were analyzed using a qualitative thematic analysis. Four themes emerged from the narratives: social support through communication and engagement, information gathering and seeking, reminiscing and legacy building, and altruism. By understanding the ways in which individuals providing care for persons with dementia use social media as part of the caregiving experience, family nurses can develop interventions and services aimed at improving caregiver burden and quality of life.

Fetishes and factishes: Durkheim and Latour.

PubMed

Schiermer, Bjørn

2016-09-01

This paper defends the concept of 'fetishism' as an explanatory parameter in sociological theorizing on Durkheimian grounds, while at the same time paying due attention to important insights regarding the role of objects in social life, originating from Actor-Network Theory (ANT). It critically assesses the current critique of the concept of fetishism propagated by ANT protagonist Bruno Latour. Latour and suggests a compromise between these two 'schools'. First, to place the paper firmly in context, I analyse some examples of modern fetishism and outline the themes of the ensuing discussion. Next, I turn to Durkheim, seeking to develop a distinct interpretation of the concept of the social and of fetishism, and then point to some of Durkheim's shortcomings and attempt to make room for Latourian perspectives. Finally, I critically assess Latour's dismissal of forms of social 'explanation' and of the concept of fetishism. © London School of Economics and Political Science 2016.

Religious and spiritual resources, CAM, and conventional treatment in the lives of cancer patients.

PubMed

Tatsumura, Yvonne; Maskarinec, Gertraud; Shumay, Dianne M; Kakai, Hisako

2003-01-01

In addition to seeking conventional treatment from physicians, cancer patients will often use religious and spiritual resources (RSR) and complementary and alternative medicine (CAM). Patients' beliefs about the relationships among RSR, CAM, and conventional treatments may reflect belief systems not readily apparent to physicians. 1) Identify the RSR used and explore themes in beliefs regarding RSR, CAM, and conventional treatment. 2) Investigate the nature of the relationships among RSR, CAM, and conventional treatment in the lives of cancer patients. Cancer patients in Hawaii were recruited from a group who had previously completed a questionnaire on CAM use. In-depth interviews were conducted with a selected subset of survey participants. 143 cancer patients were interviewed 2 to 3 years following diagnosis. Participants reported using a variety of RSR, including personal faith, individual (self) prayer, relationship/dialog with God, prayers from fellow church members and others, counseling from pastor/priest or leader of faith, reading the bible, attending religious services, meditation, finding and spending time at locations of spiritual energy (i.e., churches, specific geographical locations, or certain natural settings), and help or counseling by ancestor(s). They also expressed beliefs that RSR, CAM, and conventional treatment have both shared and distinct purposes. RSR themes included providing treatment or cure, supporting treatment or cure, and being part of life. CAM themes included providing treatment or cure, supporting treatment or cure, preventing cancer and recurrence, substitution for conventional treatment, and as a last resort. Participants believed the purposes of conventional treatment were to fight/cure cancer and to improve quality of life. RSR, CAM, and conventional treatment served both spiritual and physical purposes. When participants perceived a relationship between RSR, CAM, and conventional treatment, it reflected shared spiritual and physical purposes. Such associations were especially strong when RSR, CAM, and conventional treatment shared the common goals of providing treatment or cure and/or supporting treatment or cure. Perceptions of shared purpose were individual to each participant, with religious congruence and life history playing a role in beliefs about the relationship between RSR and CAM. Such beliefs can affect issues of control, spiritual well-being, coping, depression, decision-making, and possibly health outcomes in cancer patients. Therefore, they should be addressed by clinicians in discussions with their patients.

Evidence based practice in traditional & complementary medicine: An agenda for policy, practice, education and research.

PubMed

Leach, Matthew J; Canaway, Rachel; Hunter, Jennifer

2018-05-01

To develop a policy, practice, education and research agenda for evidence-based practice (EBP) in traditional and complementary medicine (T&CM). The study was a secondary analysis of qualitative data, using the method of roundtable discussion. The sample comprised seventeen experts in EBP and T&CM. The discussion was audio-recorded, and the transcript analysed using thematic analysis. Four central themes emerged from the data; understanding evidence and EBP, drivers of change, interpersonal interaction, and moving forward. Captured within these themes were fifteen sub-themes. These themes/sub-themes translated into three broad calls to action: (1) defining terminology, (2) defining the EBP approach, and (3) fostering social movement. These calls to action formed the framework of the agenda. This analysis presents a potential framework for an agenda to improve EBP implementation in T&CM. The fundamental elements of this action plan seek clarification, leadership and unification on the issue of EBP in T&CM. Copyright © 2018 Elsevier Ltd. All rights reserved.

Achieving Work-Life Balance in the National Collegiate Athletic Association Division I Setting, Part II: Perspectives From Head Athletic Trainers

PubMed Central

Goodman, Ashley; Mazerolle, Stephanie M.; Pitney, William A.

2015-01-01

Context: Work-life balance has been examined at the collegiate level from multiple perspectives except for the athletic trainer (AT) serving in a managerial or leadership role. Objective: To investigate challenges and strategies used in achieving work-life balance from the perspective of the head AT at a National Collegiate Athletic Association Division I university. Design: Qualitative study. Setting: Web-based management system. Patients or Other Participants: A total of 18 head ATs (13 men, 5 women; age = 44 ± 8 years, athletic training experience = 22 ± 7 years) volunteered. Data Collection and Analysis: Participants journaled their thoughts and experiences in response to a series of questions. To establish data credibility, we included multiple-analyst triangulation, stakeholder checks, and peer review. We used a general inductive approach to analyze the data. Results: Two higher-order themes emerged from our analysis of the data: organizational challenges and work-life balance strategies. The organizational challenges theme contained 2 lower-order themes: lack of autonomy and role demands. The work-life balance strategies theme contained 3 lower-order themes: prioritization of commitments, strategic boundary setting, and work-family integration. Conclusions: Head ATs are susceptible to experiencing work-life imbalance just as ATs in nonsupervisory roles are. Although not avoidable, the causes are manageable. Head ATs are encouraged to prioritize their personal time, make efforts to spend time away from their demanding positions, and reduce the number of additional responsibilities that can impede time available to spend away from work. PMID:25098746

Biobased Organic Chemistry Laboratories as Sustainable Experiment Alternatives

ERIC Educational Resources Information Center

Silverman, Julian R.

2016-01-01

As nonrenewable resources deplete and educators seek relevant interdisciplinary content for organic chemistry instruction, biobased laboratory experiments present themselves as potential alternatives to petroleum-based transformations, which offer themselves as sustainable variations on important themes. Following the principles of green chemistry…

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

PubMed

Iheduru-Anderson, Kechinyere C; Wahi, Monika M

2018-04-01

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

The Experience of Women Veterans Coming Back from War.

PubMed

Maiocco, Gina; Smith, Mary Jane

2016-06-01

Issues surrounding mental health are common for women veterans who have served in Iraq and Afghanistan wars. The goal of this phenomenological study was to document themes in the stories gathered from eight women veterans who had come back from war. Themes in the stories were: arriving with mixed sentiments; evolving to a changed view of self; permeating aggravation; confounding broken relationships, frequent deployments, and change in military status; remembering war experiences; and seeking opportunity for what is possible. Mental health issues can be observed in the themes. Including story as part of the mental health visit with veterans may be beneficial to veterans as they deal with the transition of coming back. Copyright © 2016 Elsevier Inc. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Math and Science. IDRA Focus.

ERIC Educational Resources Information Center

IDRA Newsletter, 1995

1995-01-01

This theme issue contains six articles on improving math and science education for minority group students, particularly language-minority students. "Accelerating Content Area Gains for English Language Learners" (Laura Chris Green) describes the Young Scientists Acquiring English project, which seeks to improve the content-area…

Counseling Taiwan Chinese in America: Training Issues for Counselors.

ERIC Educational Resources Information Center

Miller, Geri; Yang, Julia; Chen, M.

1997-01-01

Examines cultural influences (such as Confucianism, family, and immigration) on Taiwan Chinese in America who seek counseling. Addresses typical counseling struggles, effective counseling strategies and theoretical approaches, and training implications. Uses a case study to elaborate on the above themes. (RJM)

Why we need more poetry in palliative care.

PubMed

Davies, Elizabeth A

2018-03-23

Although many well-known poems consider illness, loss and bereavement, medicine tends to view poetry more as an extracurricular than as a mainstream pursuit. Within palliative care, however, there has been a long-standing interest in how poetry may help patients and health professionals find meaning, solace and enjoyment. The objective of this paper is to identify the different ways in which poetry has been used in palliative care and reflect on their further potential for education, practice and research. A narrative review approach was used, drawing on searches of the academic literature through Medline and on professional, policy and poetry websites to identify themes for using poetry in palliative care. I identified four themes for using poetry in palliative care. These concerned (1) leadership, (2) developing organisational culture, (3) the training of health professionals and (4) the support of people with serious illness or nearing the end of life. The academic literature was mostly made up of practitioner perspectives, case examples or conceptual pieces on poetry therapy. Patients' accounts were rare but suggested poetry can help some people express powerful thoughts and emotions, create something new and feel part of a community. Poetry is one way in which many people, including patients and palliative care professionals, may seek meaning from and make sense of serious illnesses and losses towards the end of life. It may have untapped potential for developing person-centred organisations, training health professionals, supporting patients and for promoting public engagement in palliative care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of social relationships on antiretroviral medication adherence for people living with HIV and substance use disorders and transitioning from prison.

PubMed

Rozanova, Julia; Brown, Shan-Estelle; Bhushan, Ambika; Marcus, Ruthanne; Altice, Frederick L

This paper examines how family and social relations facilitate and inhibit adherence to antiretroviraltherapy (ART) for people living with HIV (PLH) who have underlying substance use disorders and are transitioningto the community post-incarceration. Combining the methods of inductive close reading and constantcomparison, we analyzed the data from 30 semi-structured interviews of PLH who had recently transitioned to thecommunity within the previous 90 days. Three central themes were anticipated as important socialrelationships post-release: self-reported family, friends and clinicians. Among these, four sub-themes (social isolation, 'double jeopardy', search for belonging, and trust and respect) emerged, highlighting how they impacted ART adherence. Post-release, participants returned to resource-poor communities where they experienced socialisolation. ART adherence was enabled by having a purpose in life, which correlated with having robust family support structures. Many former prisoners felt that a chasm between them and their families existed, both because of HIV stigma and their addiction problems. In this context, relationships with untrustworthy friends from their druguse networks led to relapse of drug use and risky behaviors, jeopardizing participants' ART adherence and persistence. To avoid the double jeopardy, defined as seeking friends for support but who were also the ones who contributed to drug relapse, participants searched for new social anchors, which often included their healthcare providers who represented trusted and respected persons in their life. While some former prisonersperceived doctors as uncaring and their relationships asymmetrical, positive relationships with these providers,when respect and trust was mutual, reinforced the participants' sense of belonging to what they called 'the world that don't do drugs' and motivated them to adhere to ART.

An in-depth examination into pharmacy technician worklife through an organizational behavior framework.

PubMed

Desselle, Shane P

2016-01-01

Pharmacy technicians are a vital part of the health care workforce. Little is known about perceptions of their own work environment that would engender more effective recruitment, retention, and management strategies by pharmacists and employers. The purpose of this study was to gain a greater understanding of certified pharmacy technician worklife. Specific objectives included the identification of themes of worklife phenomena to assist with the development of appropriate responses by other pharmacy stakeholders and to ascertain the contribution of various factors engendering or discouraging career commitment of pharmacy technicians. Semi-structured in-depth interviews were carried out with a convenience sample of pharmacy technicians in one U.S. state, who varied by their work settings and level of experience. The interview guide and corresponding participant responses were framed from around an organizational cultural basis rooted in organizational behavior theory. Notes from the interviews were analyzed thematically using directed content analysis. Four primary themes emerged, including: career impetus, job responsibilities, quality of work life, and equitable partnership. The data revealed pharmacy technicians' need for self-actualization and recognition of the value they bring to the organization. The participants identified primary responsibilities that contribute to their sense of worth and those that if not managed adequately potentially detract from their well-being and effectiveness. Findings in regard to rate of pay corroborate previous work on wages as both an intrinsic and extrinsic motivator. Pharmacy technicians seek equity among each other (their peers) and in a mutually beneficial relationship with their employing organization. This study provides the impetus for interventions and further study that should serve to enhance pharmacy technician effectiveness, quality of work life, and longevity in an emerging profession. Copyright © 2015 Elsevier Inc. All rights reserved.

Food as a Theme in Social Studies Classes: Connecting Daily Life to Technology, Economy, and Culture

ERIC Educational Resources Information Center

Resor, Cynthia Williams

2010-01-01

Connecting wider economic, technological, or cultural trends to the everyday life of students can be a challenge. Food can serve as a course-long theme that helps students comprehend the essential connection between personal actions and national or international trends and develop skills of critical analysis. The author describes four activities…

Inclusion and Participation in Everyday School Life: Experiences of Children with Physical (Dis)Abilities

ERIC Educational Resources Information Center

Asbjørnslett, Mona; Engelsrud, Gunn Helene; Helseth, Sølvi

2015-01-01

This study explores the school experiences of children with physical (dis)abilities. Based on 39 interviews with 15 Norwegian children, participation in everyday school life is introduced as a central theme and divided into three sub-themes: community and independence; adequate help and influence in the classroom; and influence in planning and…

The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study

PubMed Central

Hasanpoor-Azghdy, Seyede Batool; Simbar, Masoumeh; Vedadhir, Abouali

2014-01-01

Background: Infertility is a major life event that brings about social and psychological problems. The type and rate these problems in the context of socio-cultural of different geographical areas and sex of people is different. Objective: The aim of this qualitative study was to explain the psychological consequences of infertility in Iranian infertile women seeking treatment. Materials and Methods: This qualitative study was done using qualitative content analysis on 25 women affected by primary and secondary infertility with no surviving children in 2012. They were purposefully selected with maximum sample variation from a large Fertility Health Research Center in Tehran, Iran. Data were collected using 32 semi-structured interviews and analyzed by the conventional content analysis method. Results: The findings of this study include four main themes: 1. Cognitive reactions of infertility (mental engagement; psychological turmoil). 2. Cognitive reactions to therapy process (psychological turmoil; being difficult to control in some situations; reduced self-esteem; feelings of failure). 3. Emotional-affective reactions of infertility (fear, anxiety and worry; loneliness and guilt; grief and depression; regret). 4. Emotional-affective reactions to therapy process (fear, anxiety and worry; fatigue and helplessness; grief and depression; hopelessness). Conclusion: This study revealed that Iranian infertile women seeking treatment face several psychological-emotional problems with devastating effects on the mental health and well-being of the infertile individuals and couples, while the infertility is often treated as a biomedical issue in Iranian context with less attention on the mental-emotional, social and cultural aspects. This article extracted from Ph.D. thesis. (Seyede Batool Hasanpoor-Azghady) PMID:24799871

Powerful Literacies.

ERIC Educational Resources Information Center

Crowther, Jim, Ed.; Hamilton, Mary, Ed.; Tett, Lyn, Ed.

These 15 papers share a common theme: seeking to promote literacy as a powerful tool for challenging existing inequalities and dependencies. "Powerful Literacies" (Jim Crowther et al.) is an introduction. Section 1 establishes the theoretical and policy frameworks that underpin the book and shows how literacy is situated in different…

Textual Carnivals: The Politics of Composition.

ERIC Educational Resources Information Center

Miller, Susan

This book examines the status of composition in English studies and the uneasy relationship between composition and literature. The three parts of the book (entitled "Where the Carnival Has Been,""The Carnival in the Great American Theme Park: Established Composition," and "Alternative Entertainments") seek to clarify…

Witches, Ghosts, and Other Apparitions (Rainbow Teachers, Rainbow Students).

ERIC Educational Resources Information Center

Cruz, MaryCarmen; Duff, Ogle Burks

1996-01-01

Describes a number of ghost stories from American cultures, all of which, despite their different origins, seek to stimulate horror, escapism, and fantastic pleasure. Suggests that the stories may be used to improve reading and writing and incorporate "rainbow" themes in the classroom. (TB)

Understanding Student Motivation

ERIC Educational Resources Information Center

Seifert, Timothy

2004-01-01

Contemporary theories of academic motivation seek to explain students' behaviours in academic settings. While each theory seems to possess its own constructs and unique explanations, these theories are actually closely tied together. In this theoretical study of motivation, several theories of motivation were described and an underlying theme of…

Early Childhood Indicators.

ERIC Educational Resources Information Center

Bartlett, Kathy; Zimanyi, Louise

2001-01-01

Recognizing the need to identify the level, nature, and impact of Early Childhood Care and Development (ECCD) programs on children and their families, this theme issue of "Coordinators' Notebook" seeks to complement and further the international efforts at collecting information on ECCD for use at national and international levels.…

How definition of mental health problems can influence help seeking in rural and remote communities.

PubMed

Fuller, J; Edwards, J; Procter, N; Moss, J

2000-06-01

The present study sought to understand the rural and remote influences on people's identification of, and response to, mental health problems. Twenty-two key informants living in northern and western South Australia were interviewed. They included mental health and generalist health professionals, other human service workers and mental health consumers. Three themes are reported here: reluctance to acknowledge mental health problems and the avoidance of appropriate help; stigma and the avoidance of mental health services; and the influence of rural and remote circumstances. Most informants considered that many mental health problems were amenable to help from generalist workers, with backup support from mental health specialists. Informants thought this intervention to be appropriate because a common view of mental health problems as 'insanity' and a culture of self-reliance created a reluctance to seek help from a mental health specialist. These themes need to be taken into account when designing mental health interventions for rural and remote communities.

[Combating poverty and rebuilding social ties: the lessons of Citizens' Action in the Struggle Against Hunger and Destitution and in Defense of Life].

PubMed

Magalhães, Rosana

2002-01-01

To reflect on Citizens' Action in the Struggle Against Hunger and Destitution and in Defense of Life is to seek to approach the dilemmas and challenges involving the consolidation of citizenship and social justice, as well as the forces in action in contemporary Brazilian society. However, many questions remain open in this effort. The intertwining issues of poverty, politics, and solidarity and the concrete shapes and multiple social developments of Brazil's "Campaign Against Hunger" leave room for various possible interpretations. Thus, considering the breadth of the theme on the one hand and the limits of this article on the other, the objective is to explore some relevant issues in the debate on destitution and exclusion and the process of constructing new kinds of public social intervention and civic participation, arising over the course of the study conducted by the "Citizens' Action Committees" in Rio de Janeiro during 1996 and 1997. The basic idea is to focus on volunteer practices to discuss the dilemmas posed for solving impoverishment and social fragmentation through cooperative activities and mutual help in Brazil.

Recovery: what does this mean to patients with low back pain?

PubMed

Hush, Julia M; Refshauge, Kathryn; Sullivan, Gerard; De Souza, Lorraine; Maher, Christopher G; McAuley, James H

2009-01-15

To explore patients' perceptions of recovery from low back pain, about which little is known. A qualitative study was conducted in which 36 participants, either recovered or unrecovered from low back pain, participated in focus groups. Interviews were audiorecorded and transcribed verbatim. Framework analysis was used to identify emergent themes and domains of recovery. Patients' views of recovery encompassed a range of factors that can be broadly classified into the domains of symptom attenuation, improved capacity to perform a broad scope of self-defined functional activities, and achievement of an acceptable quality of life. An interactive model is proposed to describe the relationships between these domains, cognitive appraisal of the pain experience, and self-rated recovery. Pain attenuation alone was not a reliable indicator of recovery. The construct of recovery for typical back pain patients seeking primary care is more complex than previously recognized and is a highly individual construct, determined by appraisal of the impact of symptoms on daily functional activities as well as quality of life factors. These findings will be valuable for reassessing how to optimize measures of recovery from low back pain by addressing the spectrum of factors patients consider meaningful.

Fighting for control in an unpredictable life – a qualitative study of older persons’ experiences of living with chronic dizziness

PubMed Central

2014-01-01

Background Dizziness in older people is associated with disability and reduced quality of life. Few studies have investigated how daily life is affected from the older person’s perspective. Identifying barriers and resources in daily life could guide health care in how to direct efficient interventions. The aim of this study was to explore older persons’ experiences of living with chronic dizziness. Methods In this qualitative study seven women aged 74–84 years and six men aged 73–87 years with chronic dizziness (≥3 months) recruited from a primary health care centre in 2012 participated in semi-structured interviews. The interviews were analysed by content analysis. Results Interpretation of the interviews resulted in the overall theme “Fighting for control in an unpredictable life” with two themes. The first theme “Striving towards normality” revealed a struggle in daily life in searching for a cure or improvement and finding a way to maintain ordinary life. This process could result in feelings of resignation or adaption to daily life, and factors that supported living with chronic dizziness were described. The second theme “Having a precarious existence” revealed that daily life included being exposed to threats such as a fear of recurrent attacks or of falling, which resulted in an insecure and inflexible way of life. A feeling that symptoms were not taken seriously was described. Conclusions The present study showed that older persons with chronic dizziness have needs that are not met by health care. Despite the fact that frequent contact with health care was described, the respondents described barriers in daily life that led to a restricted, inflexible and insecure daily life. Health care should therefore be individually tailored with focus on aspects of daily life, especially safety aspects. Support should also be continued until the older persons with chronic dizziness have developed coping strategies to gain control of their daily life. PMID:25175932

Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue

PubMed Central

Meier, Emily A.; Gallegos, Jarred V.; Montross-Thomas, Lori P.; Depp, Colin A.; Irwin, Scott A.; Jeste, Dilip V.

2016-01-01

There is little agreement about what constitutes good death or successful dying. The authors conducted a literature search for published, English-language, peer-reviewed reports of qualitative and quantitative studies that provided a definition of a good death. Stakeholders in these articles included patients, prebereaved and bereaved family members, and healthcare providers (HCPs). Definitions found were categorized into core themes and subthemes, and the frequency of each theme was determined by stakeholder (patients, family, HCPs) perspectives. Thirty-six studies met eligibility criteria, with 50% of patient perspective articles including individuals over age 60 years. We identified 11 core themes of good death: preferences for a specific dying process, pain-free status, religiosity/spiritualty, emotional well-being, life completion, treatment preferences, dignity, family, quality of life, relationship with HCP, and other. The top three themes across all stakeholder groups were preferences for dying process (94% of reports), pain-free status (81%), and emotional well-being (64%). However, some discrepancies among the respondent groups were noted in the core themes: Family perspectives included life completion (80%), quality of life (70%), dignity (70%), and presence of family (70%) more frequently than did patient perspectives regarding those items (35%–55% each). In contrast, religiosity/spirituality was reported somewhat more often in patient perspectives (65%) than in family perspectives (50%). Taking into account the limitations of the literature, further research is needed on the impact of divergent perspectives on end-of-life care. Dialogues among the stakeholders for each individual must occur to ensure a good death from the most critical viewpoint—the patient’s. PMID:26976293

Embedding the perceptions of people with dementia into quantitative research design.

PubMed

O'Rourke, Hannah M; Duggleby, Wendy; Fraser, Kimberly D

2015-05-01

Patient perspectives about quality of life are often found in the results of qualitative research and could be applied to steer the direction of future research. The purpose of this paper was to describe how findings from a body of qualitative research on patient perspectives about quality of life were linked to a clinical administrative dataset and then used to design a subsequent quantitative study. Themes from two systematic reviews of qualitative evidence (i.e., metasyntheses) identified what affects quality of life according to people with dementia. Selected themes and their sub-concepts were then mapped to an administrative dataset (the Resident Assessment Instrument 2.0) to determine the study focus, formulate nine hypotheses, and select a patient-reported outcome. A literature review followed to confirm existence of a knowledge gap, identify adjustment variables, and support design decisions. A quantitative study to test the association between conflict and sadness for people with dementia in long-term care was derived from metasynthesis themes. Challenges included (1) mapping broad themes to the administrative dataset; (2) decisions associated with inclusion of variables not identified by people with dementia from the qualitative research; and (3) selecting a patient-reported outcome, when the dataset lacked a valid subjective quality-of-life measure. Themes derived from a body of qualitative research capturing a target populations' perspective can be linked to administrative data and used to design a quantitative study. Using this approach, the quantitative findings will be meaningful with respect to the quality of life of the target population.

The Tree Theme Method in psychosocial occupational therapy: a case study.

PubMed

Gunnarsson, A Birgitta; Jansson, Jan-Ake; Eklund, Mona

2006-12-01

This study aimed to describe the Tree Theme Method (TTM) as a method for intervention in psychosocial occupational therapy. The TTM is based on theories concerning creative activities and occupational storytelling and story making. In order to exemplify the method a case study of a treatment process with follow up was undertaken. The participant was a female client suffering from anxiety and depression. During an interview the client painted symbolic trees on five different occasions with specific variations of the tree theme: a tree symbolizing her present life, her childhood, adolescence, adulthood, and, finally, a tree representing her future. The trees were used as starting points for the client to tell her life story. The intention was that she would find new strategies for how to change her daily life. Three years later there was a follow up stage where the client painted new trees and told her story. Some life themes were identified. The TTM appears suitable for intervention in psychosocial occupational therapy. In future studies the TTM should be subjected to evaluation research based on several clients in order to develop a deeper understanding of the process and what kind of results changes in the TTM intervention may provide.

OAST Space Theme Workshop. Volume 3: Working group summary. 7: Material (M-1). A. Statement. B. Technology needs (form 1). C. Priority assessment (form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

The approach of matching technology areas with various themes needs was not effective for the materials and thermal control discipline because of the diversity of requirements for each. Top priorities were evolved from the advanced space transportation system and the space power platform because these are essential building blocks in fulfilling some of the other themes. Important needs identified include life long-life cryogenic cooling systems for sensors, masers, and other devices and the needs for lightweight nuclear shielding materials for nuclear electric propulsion.

A Randomized Controlled Trial for Veterans with PTSD and Substance Use Disorder: Creating Change versus Seeking Safety.

PubMed

Najavits, Lisa M; Krinsley, Karen; Waring, Molly E; Gallagher, Matthew W; Skidmore, Christopher

2018-02-20

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) co-occur in military veterans and other populations. To conduct a randomized controlled trial to compare a new past-focused treatment (Creating Change; CC), to a well-established, evidence-based present-focused treatment for PTSD/SUD (Seeking Safety; SS), on symptoms of both disorders. CC guides patients to process the past through exploration of PTSD/SUD life themes and memories whereas SS focuses on coping skills in the present. Fifty-two male and female veterans with current PTSD/SUD were randomized (n = 26 per treatment) and assessed at baseline, end-of-treatment and 3-month follow-up. They received 17 individual one-hour sessions. Intent-to-treat analyses indicated that both conditions improved over time, with no difference between conditions, on PTSD, alcohol use, and drug use (our primary outcomes) as well as mental health symptoms, quality of life, self-efficacy, and SUD cognitions. Effect sizes were medium except for alcohol use, which was large. Change over time reflected improvement from baseline to end-of-treatment, with gains sustained at follow-up, although alcohol use showed continued improvement from end-of-treatment to follow-up. Both treatments evidenced a strong safety profile; and attendance, alliance, and treatment satisfaction were also very strong. Conclusions/importance: CC has promise as a PTSD/SUD therapy with strong public health relevance and the potential to fill important gaps in the field. We used minimal exclusionary criteria to obtain a real-world sample, which was severe-predominantly substance-dependent with chronic PTSD and additional psychiatric diagnoses. Future research is warranted, especially on nonveteran samples and treatment mechanisms of action.

The deathly hallows: Harry Potter and adolescent development.

PubMed

Rosegrant, John

2009-12-01

The enormous popularity of the Harry Potter books points to the deep resonance readers feel with the psychological issues they bring to life. Three developmental issues provide central themes: the necessity for partial disenchantment and increasing attunement to reality, while retaining a capacity for wonder; repudiation or endorsement of the narcissistic solution to life's difficulties; and aggression and castration fantasies while growing into adult power. These developmental issues are particularly acute during adolescence but start earlier and continue to be reworked throughout the life span, accounting for the books' appeal to a wide age-range of readers despite their apparent focus on adolescence. These developmental themes are explored in order to better understand the Harry Potter books, as, conversely, the books are explored in order to better understand these themes.

The Voices of Survivors Documentary

PubMed Central

Nicolaidis, Christina

2002-01-01

This article describes a method of developing physician education materials using analysis of domestic violence patient experiences and patients' descriptions of their experiences. The process began with interviews of 21 domestic violence survivors, focusing on what they wanted to teach physicians. Qualitative analysis of these interviews identified 4 main themes regarding what survivors wanted physicians to understand about life in an abusive relationship: that domestic violence is universal, that it is more than just physical assaults, that it is all about power and control, and that it affects the entire family. Because what survivors wanted from physicians differed depending on where they were in their abusive relationships, recommendations were developed for each of 5 common situations: when a patient may not yet recognize the abuse, when s/he may not be ready or able to disclose the abuse, when s/he chooses to remain in an abusive relationship, when s/he is seeking care for an acute assault, and when s/he has left the relationship but not yet healed. Interview excerpts representing each of the identified themes are used to create a 30-minute educational documentary. A written companion guide covers the traditional aspects of domestic violence education. In teaching about domestic violence or other health problems where it is difficult for physicians to understand their patients intuitively, an educator's most important role may be to direct learners to listen to the experience and wisdom of patients. PMID:11841527

Social and Environmental Barriers to Nutrition Therapy for Diabetes Management Among Underserved Pregnant Women: A Qualitative Analysis.

PubMed

Yee, Lynn M; McGuire, Jamie M; Taylor, Shaneah M; Niznik, Charlotte M; Simon, Melissa A

2016-03-01

To identify social and environmental barriers to nutrition therapy for diabetes management during pregnancy among a population of low-income, minority pregnant women. Prospective, in-depth, semi-structured interviews performed serially during pregnancy and continued until thematic saturation was reached. Urban academic medical center. Ten pregnant low-income, minority women with gestational diabetes and type 2 diabetes mellitus. Social and environmental barriers to nutrition therapy for diabetes management during pregnancy. Qualitative analysis of interview data using electronic coding software was performed using theme analysis. Participants perceived limited ability and self-efficacy to adopt nutrition recommendations. Specific themes identified as barriers included (1) feeling overwhelmed by the unfamiliar; (2) using and decoding nutrition labels; (3) managing nutrition choices and seeking control in the setting of food insecurity; (4) experiencing lack of control and motivation, and limited self-efficacy; (5) balancing recommendations with taste preferences and cultural food norms; (6) maintaining a healthy eating schedule; and (7) accommodating diabetes in family and social life. Pregnant women with diabetes encounter a number of knowledge-based, attitudinal, and resource-related barriers that reduce capacity for nutrition therapy adherence. Provision of culturally informed, practical nutrition support that addresses the needs of women in low-resource communities is an important component of comprehensive diabetes care during pregnancy. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

A systematic review and thematic synthesis of patients' experience of medicines adherence.

PubMed

Rathbone, A P; Todd, A; Jamie, K; Bonam, M; Banks, L; Husband, A K

Medicines non-adherence continues to be problematic in health care practice. After decades of research, few interventions have a robust evidence-based demonstrating their applicability to improve adherence. Phenomenology has a place within the health care research environment. To explore patients' lived experiences of medicines adherence reported in the phenomenonologic literature. A systematic literature search was conducted to identify peer-reviewed and published phenomenological investigations in adults that aimed to investigate patients' lived experiences of medicines adherence. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Research Tool. Thematic synthesis was conducted using a combination of manual coding and NVivo10 [QSR International, Melbourne] coding to aid data management. Descriptive themes identified included i) dislike for medicines, ii) survival, iii) perceived need, including a) symptoms and side-effects and b) cost, and iv) routine. Analytic themes identified were i) identity and ii) interaction. This work describes adherence as a social interaction between the identity of patients and medicines, mediated by interaction with family, friends, health care professionals, the media and the medicine, itself. Health care professionals and policy makers should seek to re-locate adherence as a social phenomenon, directing the development of interventions to exploit patient interaction with wider society, such that patients 'get to know' their medicines, and how they can be taken, throughout the life of the patient and the prescription. Copyright © 2016 Elsevier Inc. All rights reserved.

Comfort as a basic need in hospitalized patients in Iran: a hermeneutic phenomenology study.

PubMed

Yousefi, Hojatollah; Abedi, Heidar Ali; Yarmohammadian, Mohammad Hossein; Elliott, Doug

2009-09-01

This paper is a report of a study conducted to explore the comfort experiences of hospitalized patients during their admission to medical-surgical wards in an Iranian hospital. Comfort has various definitions, ranging from a basic human need, to a process, function or an outcome of nursing. As comfort is a substantive need throughout life in health and illness, providing comfort is a major function and challenge for holistic nursing care. This hermeneutic phenomenological study was conducted between July 2006 and April 2007 in six medical-surgical wards of one of a university hospital in Iran. Data were generated with 22 participants (16 hospitalized patients and six nurses), using in-depth interviews to capture their detailed experiences of comfort. Analysis based on the framework of Diekelmann enabled data interpretation and elaboration of shared themes. One constitutive pattern, 'Comfort: a need of hospitalized patients' and four related themes - A friend in hospital, Relief of suffering within a calm environment, Seeking God, and Presence among family - were identified in the data. These findings offer unique insight for planning and implementing appropriate clinical practices in Iran, especially in caring for Muslim patients. Two major implications are to: (1) consider comfort criteria during nursing assessment and planning of care during a patient's hospitalization and (2) note that Shiite people in particular are more comfortable and feel better when they are able to follow their religious principles.

An Analysis of the Climate Data Initiative's Data Collection

NASA Astrophysics Data System (ADS)

Ramachandran, R.; Bugbee, K.

2015-12-01

The Climate Data Initiative (CDI) is a broad multi-agency effort of the U.S. government that seeks to leverage the extensive existing federal climate-relevant data to stimulate innovation and private-sector entrepreneurship to support national climate-change preparedness. The CDI project is a systematic effort to manually curate and share openly available climate data from various federal agencies. To date, the CDI has curated seven themes, or topics, relevant to climate change resiliency. These themes include Coastal Flooding, Food Resilience, Water, Ecosystem Vulnerability, Human Health, Energy Infrastructure, and Transportation. Each theme was curated by subject matter experts who selected datasets relevant to the topic at hand. An analysis of the entire Climate Data Initiative data collection and the data curated for each theme offers insights into which datasets are considered most relevant in addressing climate resiliency. Other aspects of the data collection will be examined including which datasets were the most visited or popular and which datasets were the most sought after for curation by the theme teams. Results from the analysis of the CDI collection will be presented in this talk.

Patients understanding of depression associated with chronic physical illness: a qualitative study

PubMed Central

2014-01-01

Background Detection of depression can be difficult in primary care, particularly when associated with chronic illness. Patient beliefs may affect detection and subsequent engagement with management. We explored patient beliefs about the nature of depression associated with physical illness. Methods A qualitative interview study of patients registered with general practices in Leeds, UK. We invited patients with coronary heart disease or diabetes from primary care to participate in semi-structured interviews exploring their beliefs and experiences. We analysed transcripts using a thematic approach, extended to consider narratives as important contextual elements. Results We interviewed 26 patients, including 17 with personal experience of depression. We developed six themes: recognising a problem, complex causality, the role of the primary care, responsibility, resilience, and the role of their life story. Participants did not consistently talk about depression as an illness-like disorder. They described a change in their sense of self against the background of their life stories. Participants were unsure about seeking help from general practitioners (GPs) and felt a personal responsibility to overcome depression themselves. Chronic illness, as opposed to other life pressures, was seen as a justifiable cause of depression. Conclusions People with chronic illness do not necessarily regard depression as an easily defined illness, especially outside of the context of their life stories. Efforts to engage patients with chronic illness in the detection and management of depression may need further tailoring to accommodate beliefs about how people view themselves, responsibility and negative views of treatment. PMID:24555886

Common meanings of good and bad sleep in a healthy population sample.

PubMed

Dickerson, Suzanne S; Klingman, Karen J; Jungquist, Carla R

2016-09-01

The study's purpose was to understand the common meanings and shared practices related to good and bad sleep from narratives of a sample of healthy participants. Interpretive phenomenology was the approach to analyze narratives of the participants' everyday experiences with sleep. Participants were interviewed and asked to describe typical good and bad nights' sleep, what contributes to their sleep experience, and the importance of sleep in their lives. Team interpretations of narratives identified common themes by consensus. Medium sized city in New York State (upper west region). A sample of 30 healthy participants were from a parent study (n=300) on testing the sleep questions from the Behavioral Risk Factor Surveillance System from the Centers for Disease Control and Prevention. Interpretations of good and bad sleep. Participants described similar experiences of good and bad sleep often directly related to their ability to schedule time to sleep, fall asleep, and maintain sleep. Worrying about life stresses and interruptions prevented participants from falling asleep and staying asleep. Yet, based on current life priorities (socializers, family work focused, and optimum health seekers), they had differing values related to seeking sleep opportunities and strategizing to overcome challenges. The participants' priorities reflected the context of their main concerns and stresses in life that influenced the importance given to promoting sleep opportunities. Public health messages tailored to life priorities could be developed to promote healthy sleep practices. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Chemistry in Context: Analysis of Thematic Chemistry Videos Available Online

ERIC Educational Resources Information Center

Christensson, Camilla; Sjöström, Jesper

2014-01-01

United Nations declared 2011 to be the International Year of Chemistry. The Swedish Chemical Society chose twelve themes, one for each month, to highlight the connection of chemistry with everyday life. Examples of themes were fashion, climate change, love, sports, communication, health issues, and food. From the themes various context-based…

Life goals and social identity in people with severe acquired brain injury: an interpretative phenomenological analysis.

PubMed

Martin, Rachelle; Levack, William M M; Sinnott, K Anne

2015-01-01

While there is a growing body of literature exploring life goals in rehabilitation, little research has been undertaken that includes the voice of the end-user. This study examined the views and experiences of people with severe acquired brain injury regarding the place of "life goals" in residential rehabilitation. Interpretative phenomenological analysis was used to collect and analyze data from five semi-structured interviews with participants in a residential rehabilitation setting. Three inter-related themes emerged from this study. Social connectedness (being 'part of things') emerged as a life goal of central importance for all participants (Theme 1). However, in order to achieve this sense of belonging, the participants needed to tentatively balance the opportunities arising within their environmental milieu (Theme 2) with the interpersonal factors relating to their unchanged, changed and changing self-identity (Theme 3). This study suggests that social identity and social connectedness ought to be primary foci of rehabilitation rather than matters only of secondary concern. Consideration needs to be given to both the environmental contexts and the intrapersonal strategies that support people who require residential rehabilitation services to achieve social connection, and thus their life goals, following a severe acquired brain injury. Implications for Rehabilitation There is a need to better support people with severe acquired brain injury (ABI) in terms of their social relationships and social identity during the delivery of person-centered rehabilitation services. Within the clinical setting there should be regular, in depth and open dialogue in which the individuals' values and preferences are discovered. A focus on the coherence between daily activities and the person's life goals is required for people with severe ABI. Clinicians need to consider how life goals for individual people change or are re-prioritized over the life span.

Helper Therapy in an Online Suicide Prevention Community

ERIC Educational Resources Information Center

Greidanus, Elaine; Everall, Robin D.

2010-01-01

Individuals who feel comfortable using Internet-based communication often seek help online when they are feeling distressed. This study examines an online community formed to provide support for distressed adolescents. Content analysis revealed themes in a series of online postings from youth who were experiencing suicidal thoughts. Youth…

School Counselors: A Review of Contemporary Issues

ERIC Educational Resources Information Center

Bain, Steve F.

2012-01-01

This article seeks to review the topic of school counselors and the contemporary issues surrounding this profession. An introduction to the profession and overview of its history provides a comprehensive basis on which to understand today's school counseling profession. An examination of contemporary themes of school counseling will include job…

The future of arid grasslands: identifying issues, seeking solutions

Treesearch

Barbara Tallman; Deborah M. Finch; Carl Edminster; Robert Hamre

1998-01-01

This conference was designed to provide a non-confrontational setting for a variety of people from differing viewpoints to discuss the threats facing arid grasslands of the Southwest. Participants included ranchers and other private economists, scientists, and students. The sessions were organized around the major themes of understanding grasslands, identifying...

Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue.

PubMed

Meier, Emily A; Gallegos, Jarred V; Thomas, Lori P Montross; Depp, Colin A; Irwin, Scott A; Jeste, Dilip V

2016-04-01

There is little agreement about what constitutes good death or successful dying. The authors conducted a literature search for published, English-language, peer-reviewed reports of qualitative and quantitative studies that provided a definition of a good death. Stakeholders in these articles included patients, prebereaved and bereaved family members, and healthcare providers (HCPs). Definitions found were categorized into core themes and subthemes, and the frequency of each theme was determined by stakeholder (patients, family, HCPs) perspectives. Thirty-six studies met eligibility criteria, with 50% of patient perspective articles including individuals over age 60 years. We identified 11 core themes of good death: preferences for a specific dying process, pain-free status, religiosity/spirituality, emotional well-being, life completion, treatment preferences, dignity, family, quality of life, relationship with HCP, and other. The top three themes across all stakeholder groups were preferences for dying process (94% of reports), pain-free status (81%), and emotional well-being (64%). However, some discrepancies among the respondent groups were noted in the core themes: Family perspectives included life completion (80%), quality of life (70%), dignity (70%), and presence of family (70%) more frequently than did patient perspectives regarding those items (35%-55% each). In contrast, religiosity/spirituality was reported somewhat more often in patient perspectives (65%) than in family perspectives (50%). Taking into account the limitations of the literature, further research is needed on the impact of divergent perspectives on end-of-life care. Dialogues among the stakeholders for each individual must occur to ensure a good death from the most critical viewpoint-the patient's. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

A second chance at life: people's lived experiences of surviving out-of-hospital cardiac arrest.

PubMed

Forslund, Ann-Sofie; Jansson, Jan-Håkan; Lundblad, Dan; Söderberg, Siv

2017-12-01

There is more to illuminate about people's experiences of surviving out-of-hospital cardiac arrest (OHCA) and how such an event affects people's lives over time. This study aimed to elucidate meanings of people's lived experiences and changes in everyday life during their first year after surviving OHCA. A qualitative, longitudinal design was used. Eleven people surviving OHCA from northern Sweden agreed to participate and were interviewed 6 and 12 months after the event. A phenomenological hermeneutic interpretation was used to analyse the transcribed texts. The structural analysis resulted in two themes: (i) striving to regain one's usual self and (ii) a second chance at life, and subthemes (ia) testing the body, (ib) pursuing the ordinary life, (ic) gratitude for help to survival, (iia) regaining a sense of security with one's body, (iib) getting to know a new self, and (iic) seeking meaning and establishing a future. To conclude, we suggest that people experienced meanings of surviving OHCA over time as striving to regain their usual self and getting a second chance at life. The event affected them in many ways and resulted in a lot of emotions and many things to think about. Participants experienced back-and-forth emotions, when comparing their present lives to both their lives before cardiac arrest and those lives they planned for the future. During their first year, participants' daily lives were still influenced by 'being dead' and returning to life. As time passed, they wanted to resume their ordinary lives and hoped for continued lives filled with meaning and joyous activities. © 2017 Nordic College of Caring Science.

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

PubMed

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

2014-12-02

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

Accepting transitions: African Americans discuss end of life.

PubMed

Yancu, Cecile N; Farmer, Deborah F; Graves, Mara J; Rhinehardt, April; Leahman, Dee

2015-06-01

African Americans typically underuse hospice care; this study explores their end of life attitudes. An iterative focus group strategy generated qualitative data using 4 baseline groups and 1 confirmatory focus group recruited from predominantly African American churches. Each group consisted of 8 to 14 adults. Investigators analyzed data for dominant themes, representatives from baseline groups returned to discuss the results. A total of 43 African Americans (male: 8 [18.6]; female: 35 [81.4]) participated in initial discussions, with 10 returning for follow-up. The prevailing theme was transitions; with life to death dominating discourse; other themes included curative to palliative care and acceptance of death as inevitable. Among African Americans, outreach efforts may be strengthened by reframing the dying process as the product of many transitions and reaching out to faith-based communities. © The Author(s) 2014.

A comparison of thematic apperceptions of sibling affiliation, conflict, and separation at two periods of adulthood.

PubMed

Bedford, V H

1989-01-01

The quality and stability of sibling relationships during adulthood were assessed by comparing TAT themes of sibling affiliation, conflict, and separation at the period of active child-rearing (CR) and the empty nest (EN). Thirty men and thirty women, divided equally between the two life stages, were randomly selected from a pool of individuals who had a same-sex, closely-spaced sibling. The Sibling Thematic Apperception Test (S-TAT) was developed to elicit underlying feelings about the relationship, because traditional methods of assessment have failed to tap its negative qualities. Contrary to previous findings, results showed no differences in affiliation or conflict theme frequencies between the CR and EN periods. Separation themes, however, were more frequent during the CR than the EN period, suggesting that concerns over separation from siblings reflect a developmental process which might be related to bonding with the family of procreation. Although there were no sex differences within life periods, women's stories about sisters across life period had more conflict themes than did men's stories about brothers.

Coping strategies used by poorly adherent patients for self-managing bipolar disorder.

PubMed

Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

2016-01-01

Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual's coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness.

"I knew what was going to happen if I did nothing and so I was going to do something": faith, hope, and trust in the decisions of Canadians with multiple sclerosis to seek unproven interventions abroad.

PubMed

Snyder, Jeremy; Adams, Krystyna; Crooks, Valorie A; Whitehurst, David; Vallee, Jennifer

2014-09-30

Chronic cerebrospinal venous insufficiency (CCSVI) treatment is an unproven intervention aimed at relieving some of the symptoms of multiple sclerosis (MS). Despite limited evidence of the efficacy and safety of this intervention, Canadians diagnosed with MS have been traveling abroad to access this procedure as it is not available domestically outside of limited clinical trials. This paper discusses the experiences of Canadians with MS seeking CCSVI treatment abroad. This paper presents a secondary analysis of 15 interviews with participants who had gone abroad for CCSVI treatment. Interviews were conducted over the phone between October 2012 and December 2012. All interviews were digitally recorded and transcribed verbatim. Transcripts were hand coded for: 1) why CCSVI treatment was sought and where it was obtained; 2) the role of having hope for a cure in seeking CCSVI; 3) the impact of MS on everyday life; and 4) the role other people played in the decision to go abroad. The authors identified loss of faith, hope, and trust as themes emerging from the transcripts. The participants experienced a loss of faith with the Canadian health system and especially the neurologists who were responsible for their care and the classification of MS as a neurological disease. Access to CCSVI treatment abroad generated hope in these participants, but they were cautious in their expectations, focusing on symptom management rather than a cure. Trust in their caregivers abroad was generated through the recommendations of other MS sufferers and the credentials of their caregivers abroad. By deciding to seek an unproven intervention abroad, these individuals took on responsibility for their care from the Canadian health system. While evidence of the efficacy of CCSVI treatment is limited, the participants felt that they were making a rational care decision, focusing on the empowerment and renewed hope generated by seeking this intervention. Health professionals and policy makers globally should consider the causes of loss of faith in their domestic care systems and balance the benefits of empowerment and renewed hope against concerns that unproven interventions may create new health risks.

Innovative Ideas on How Work-Family Research Can Have More Impact.

PubMed

Kossek, Ellen Ernst; Baltes, Boris B; Matthews, Russell A

2011-09-01

The commentaries on our focal article agreed with its main premise that work-family research should follow new strategies to improve its practical impact, and made suggestions clustering into three main themes. The first theme built on our suggestion to improve the research focus, terminology, and framing of work-family research. These essays offered additional ideas such as decoupling work-family from work-life research, and examining contextual factors more deeply. The second theme focused on how to better apply the findings from work family research. These commentaries provided social change approaches for making work-family issues more central to key stakeholders and to organizations. The third theme focused on broadening our scope to the societal level. These editorials advocated tactics supporting the development of basic rights of work-life balance within and across nations.

Innovative Ideas on How Work–Family Research Can Have More Impact

PubMed Central

Kossek, Ellen Ernst; Baltes, Boris B.; Matthews, Russell A.

2011-01-01

The commentaries on our focal article agreed with its main premise that work–family research should follow new strategies to improve its practical impact, and made suggestions clustering into three main themes. The first theme built on our suggestion to improve the research focus, terminology, and framing of work-family research. These essays offered additional ideas such as decoupling work-family from work-life research, and examining contextual factors more deeply. The second theme focused on how to better apply the findings from work family research. These commentaries provided social change approaches for making work-family issues more central to key stakeholders and to organizations. The third theme focused on broadening our scope to the societal level. These editorials advocated tactics supporting the development of basic rights of work–life balance within and across nations. PMID:22247738

Alaska Wildlife Week, Primary Teacher's Guide. Unit 4. We All Need Each Other--The Web of Life. April 20-26, l986.

ERIC Educational Resources Information Center

Quinlan, Susan E.

The ecological theme of "We all need each other--the web of life" serves as the focus of Alaska's fourth annual wildlife week and as the emphasis for the activities in this guide for primary teachers. The packet of materials contains: (l) an introduction (explaining the theme); (2) table of contents (indicating each lesson's objective…

Alaska Wildlife Week, Upper Elementary Teacher's Guide. Unit 4. We All Need Each Other--The Web of Life. April 20-26, l986.

ERIC Educational Resources Information Center

Quinlan, Susan E.

The ecological theme of "We all need each other--the web of life" serves as the focus of Alaska's fourth annual wildlife week and as the emphasis for the activities in this guide for upper elementary teachers. The packet of materials contains: (1) an introduction (explaining the theme); (2) table of contents (indicating each lesson's…

Effectiveness of integrated science instructional material on pressure in daily life theme to improve digital age literacy of students

NASA Astrophysics Data System (ADS)

Asrizal; Amran, A.; Ananda, A.; Festiyed; Khairani, S.

2018-04-01

Integrated science learning and literacy skills are relevant issues in Indonesian’s education. However, the use of the integrated science learning and the integration of literacy in learning cannot be implemented well. An alternative solution of this problem is to develop integrated science instructional material on pressure in daily life theme by integrating digital age literacy. Purpose of research is to investigate the effectiveness of the use of integrated science instructional material on pressure in daily life theme to improve knowledge competence, attitudes competence and literacy skills of students. This research was a part of development research which has been conducted. In the product testing stage of this research and development was used before and after design of treatment for one sample group. Instruments to collect the data consist of learning outcomes test sheet, attitude observation sheet, and performance assessment sheet of students. Data analysis techniques include descriptive statistics analysis, normality test, homogeneity test, and paired comparison test. Therefore, the important result of research is the use of integrated science instructional material on pressure in daily life theme is effective in scientific approach to improve knowledge competence, attitudes competence, and digital age literacy skills of grade VIII students at 95% confidence level.

Using the Three Delays Model to Examine Civil Registration Barriers in Indonesia.

PubMed

Bennouna, Cyril; Feldman, Brooke; Usman, Rahmadi; Adiputra, Rama; Kusumaningrum, Santi; Stark, Lindsay

2016-01-01

The Three Delays Model has proven a useful framework for examining barriers to seeking obstetric care and preventing maternal and child mortality. This article demonstrates the applicability of the Three Delays Model to the case of civil registration in rural Indonesia and examines ways that efforts to strengthen civil registration services can draw on lessons from maternal and child health programming. Twenty focus group discussions were conducted using a participatory ranking exercise in four Indonesian districts. Focus groups were stratified into four groups: (1) government officials involved in civil registration, (2) civil society organization members that assist communities in civil registration, and (3) female and (4) male community members. Transcripts were analyzed using constant comparative method and thematic analysis, revealing barriers that communities commonly faced in accessing civil registration services. In examining the categories and themes related to these barriers, the research team found a significant overlap with the factors and phases of the Three Delays Model. Participants were delayed from seeking registration services by a range of sociocultural factors and by the perceived inaccessibility and poor quality of services. Once they decided to seek care, long distances to services and poor transportation options delayed their access to registration offices. Finally, a series of bottlenecks in service provision created extended delays once applicants reached registration offices. Ownership of civil registration documents in Indonesia remains exceptionally low, with just over half of children and youth possessing a birth certificate. To strengthen civil registration and health systems more generally, it is important to understand the factors that enable and constrain civil registration, how these factors relate to one another, and how they change over a child's life.

Using the Three Delays Model to Examine Civil Registration Barriers in Indonesia

PubMed Central

Bennouna, Cyril; Feldman, Brooke; Usman, Rahmadi; Adiputra, Rama; Kusumaningrum, Santi

2016-01-01

The Three Delays Model has proven a useful framework for examining barriers to seeking obstetric care and preventing maternal and child mortality. This article demonstrates the applicability of the Three Delays Model to the case of civil registration in rural Indonesia and examines ways that efforts to strengthen civil registration services can draw on lessons from maternal and child health programming. Twenty focus group discussions were conducted using a participatory ranking exercise in four Indonesian districts. Focus groups were stratified into four groups: (1) government officials involved in civil registration, (2) civil society organization members that assist communities in civil registration, and (3) female and (4) male community members. Transcripts were analyzed using constant comparative method and thematic analysis, revealing barriers that communities commonly faced in accessing civil registration services. In examining the categories and themes related to these barriers, the research team found a significant overlap with the factors and phases of the Three Delays Model. Participants were delayed from seeking registration services by a range of sociocultural factors and by the perceived inaccessibility and poor quality of services. Once they decided to seek care, long distances to services and poor transportation options delayed their access to registration offices. Finally, a series of bottlenecks in service provision created extended delays once applicants reached registration offices. Ownership of civil registration documents in Indonesia remains exceptionally low, with just over half of children and youth possessing a birth certificate. To strengthen civil registration and health systems more generally, it is important to understand the factors that enable and constrain civil registration, how these factors relate to one another, and how they change over a child’s life. PMID:27992515

Postpartum Depression Among Asian Indian Mothers.

PubMed

Goyal, Deepika; Park, Van Ta; McNiesh, Susan

2015-01-01

To explore Asian Indian mothers' perspectives of postpartum depression (PPD) and mental health help-seeking behavior. Qualitative exploratory design. Using convenience sampling, postpartum mothers were recruited through flyers posted in public places and on social media sites. Postpartum depression risk was assessed with the Edinburgh Postnatal Depression Scale (EPDS) prior to qualitative interviews. Content analysis methods were used to extract themes from participant narratives. Twelve self-identified, married, Asian Indian mothers, aged between 29 and 40 years, living in Northern California, who gave birth to a healthy infant within the last 12 months, took part in this study. Scores on the EPDS indicated two participants were at an increased risk for developing PPD. Content analysis revealed two emerging themes: (1) Culture-specific postpartum practices and ceremonies and their role in maternal-infant postpartum recovery; and (2) Maternal mental health help-seeking behavior. Nurses taking care of women during the extended prenatal and postpartum period have the unique opportunity to build rapport with their patients which can offer a window of opportunity to educate and help dispel myths about PPD symptoms and treatment. To promote successful maternal-infant outcomes, PPD education should be initiated at the first prenatal appointment, continue during the pregnancy, and be incorporated into well-baby visits through the first postpartum year. Education should include signs and symptoms of PPD as well as importance of timely mental-health help-seeking.

'Learning to live your life again': An interpretative phenomenological analysis of weblogs documenting the inside experience of recovering from anorexia nervosa.

PubMed

Smethurst, Laura; Kuss, Daria

2016-06-01

This study aimed to explore the construct of recovery from anorexia nervosa through the medium of weblogs, focusing on the benefits and barriers to the recovery process. Data were extracted from female ( n = 7) and male ( n = 1) participants' textual pro-recovery weblogs, all of which were posted between 2013 and 2015 in the public domain. Data were analysed using interpretative phenomenological analysis. Three superordinate themes were identified: (1) barriers to recovery, (2) factors increasing the likelihood of recovery and (3) support. Results suggest supportive relationships, regaining control and recognising the consequences of the eating disorder benefit recovery, whereas public perceptions, the anorexia nervosa voice and time act as barriers to recovery. Out of eight participants, four described seeking professional help as part of their recovery, of which three believed their professional therapy experience helped aid recovery. Implications for anorexia nervosa treatment are discussed in detail.

The nature and meaning of insulin pump use in emerging adults with type 1 diabetes.

PubMed

Hood, Donna G; Duke, Gloria

2015-05-01

Objective. The purpose of this study is to investigate the meaning of living with an insulin pump for the management of type 1 diabetes during the period of emerging adulthood. Through a phenomenological narrative, this study contributes to the reflective understanding of the everyday life experiences of this population. Methods. A hermeneutic phenomenological design was used for this study of nine emerging adults (aged 19-24 years). Data were generated through face-to-face interviews and analyzed using the phenomenological approach of Max van Manen. Results. Four themes represent the essence of the day-to-day experiences of these emerging adults: seeking control, becoming responsible, staying connected, and accepting me. Conclusions. An in-depth understanding of the meaning of daily experiences with insulin pump technology has the potential to promote a developmentally appropriate approach to this age-group. The human understanding gained through this study is essential to the development of evidence-based practice guidelines and resources for this vulnerable population.

Promoting and Protecting Against Stigma in Assisted Living and Nursing Homes

PubMed Central

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

2016-01-01

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

Pathways to help-seeking in bulimia nervosa and binge eating problems: a concept mapping approach.

PubMed

Hepworth, Natasha; Paxton, Susan J

2007-09-01

To conduct an in-depth study, using concept mapping, of three factors related to help-seeking for bulimia nervosa and binge eating: problem recognition, barriers to help-seeking, and prompts to help-seeking. Semistructured interviews were conducted to elicit information about help-seeking with 63 women (18-62 years) with past or present bulimic behaviors. Using Leximancer software, factors identified as associated with problem recognition were Changes in Behavior, Interference with Life Roles, Comments about Changes and Psychological Problems. Salient barriers to help-seeking were Fear of Stigma, Low Mental Health Literacy/Perception of Need, Shame, Fear of Change and Cost. Prompts to help-seeking were increased Symptom Severity, Psychological Distress, Interference with Life Roles, Health Problems, and Desire to Get Better. Results highlighted the need for awareness campaigns to reduce both self and perceived stigma by others towards bulimic behaviors, and the need to enhance awareness of available interventions for people ready to engage in treatment, to increase help-seeking. (c) 2007 by Wiley Periodicals, Inc.

Religiousness, spiritual seeking, and personality: findings from a longitudinal study.

PubMed

Wink, Paul; Ciciolla, Lucia; Dillon, Michele; Tracy, Allison

2007-10-01

The hypothesis that personality characteristics in adolescence can be used to predict religiousness and spiritual seeking in late adulthood was tested using a structural equation modeling framework to estimate cross-lagged and autoregressive effects in a two-wave panel design. The sample consisted of 209 men and women participants in the Berkeley Guidance and Oakland Growth studies. In late adulthood, religiousness was positively related to Conscientiousness and Agreeableness, and spiritual seeking was related to Openness to Experience. Longitudinal models indicated that Conscientiousness in adolescence significantly predicted religiousness in late adulthood above and beyond adolescent religiousness. Similarly, Openness in adolescence predicted spiritual seeking in late adulthood. The converse effect, adolescent religiousness to personality in late adulthood, was not significant in either model. Among women, adolescent Agreeableness predicted late-life religiousness and adolescent religiousness predicted late-life Agreeableness; both these effects were absent among men. Adolescent personality appears to shape late-life religiousness and spiritual seeking independent of early religious socialization.

"Ya Me Fui" When English Learners Consider Leaving School

ERIC Educational Resources Information Center

Boone, Jeanmarie Hamilton

2013-01-01

This study examines narratives of English learners who have either dropped out or considered dropping out as a result of their experience in high school. This research seeks to determine at which point students left or considered leaving school, which often goes undetected in traditional quantitative data collection methods. The common themes that…

Introductory Guide to Africa.

ERIC Educational Resources Information Center

Wyss, Esther, Ed.

This guide seeks to be a tool for action and a resource for understanding some of the key issues concerning Africa today. Through a series of six sessions, participants focus on a particular theme or issue that links their community with the African context. The six sessions focus on: (1) "Building Connections with Africa"; (2)…

New Perspectives on Documenting Employment and Earnings Outcomes in Vocational Education.

ERIC Educational Resources Information Center

Stevens, David W.; Shi, Jinping

This guide is designed for local and state authorities who seek a better understanding of the performance of their vocational education programs. Its basic theme is management diagnostics. The first section provides a brief introduction to three decades of research that has been conducted on wage records submitted by employers under unemployment…

Child Protection Assessment in Humanitarian Emergencies: Case Studies from Georgia, Gaza, Haiti and Yemen

ERIC Educational Resources Information Center

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-01-01

Objectives: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of…

Peace Crane Project: An Interdisciplinary Approach.

ERIC Educational Resources Information Center

LeBert, Linda L.; Calais, Jerry; Cuevas, Phyllis; Fruge', Hugh; Gardiner, Judy Carter; Larmon, Marilyn; Rees, Jocelyn

To model collaboration and to "practice what we teach," a group of faculty members at McNeese State University in Louisiana developed a college-wide theme based on the book, "Sadako and the Thousand Paper Cranes." This book was selected because of the importance of seeking and achieving peace in a world that is struggling and,…

"White Port and Lemon Juice": Notes on Ritual in the New Black Theatre

ERIC Educational Resources Information Center

Steele, Shelby

1973-01-01

The New Black Theatre dramatizes the values it seeks to reaffirm from play to play: ritual is here achieved through the repetition of patterns, symbols and values from drama to drama, using the six literary devices of allegory, symbol, characterization, recurring themes, language styles, and repetition. (Author/JM)

Ballot Measures Reflect K-12 Funding Jitters

ERIC Educational Resources Information Center

Klein, Alyson

2010-01-01

In an election year dominated by the pitched battle for Congress and major governors' races, state ballot measures involving education are largely tied to a similar theme: the burden of funding K-12 programs when state finances are shaky. In some cases, initiatives, constitutional amendments, and other ballot measures seek to tap new sources of…

Educational Challenges of Internal Migrant Girls: A Case Study among Primary School Children in Turkey

ERIC Educational Resources Information Center

Altinyelken, Hulya Kosar

2009-01-01

This article seeks to investigate education-related challenges encountered by internal migrant girls studying at primary schools in Turkey. From the perspectives of participants, the emerging themes included adaptation, language, low socio-economic status, peer relations, discrimination and bullying. These challenges seem to have direct or…

Positing Living to Remember God: An Autoethnography

ERIC Educational Resources Information Center

Badger, Mariza A.

2015-01-01

This dissertation is a qualitative study in which I, the researcher and public school teacher, seek through writing the self in a narrative and evocative autoethnography to explore three emergent themes: My family's six year and six month circumnavigation, spirituality, and important literature that I have shared with other readers that direct our…

Resourcing Change in Small Schools

ERIC Educational Resources Information Center

Anderson, Michelle; White, Simone

2011-01-01

The theme of this article is the challenge that school leaders face in creating the conditions for learning in small schools. We draw on the concepts of "social capital" and "social entrepreneurship" to identify tensions and possibilities for school leaders in a case study of a small rural school as they seek to find resources…

Recognising Change and Seeking Affirmation: Themes for Embedding Indigenous Knowledges on Teaching Practicum

ERIC Educational Resources Information Center

McLaughlin, Juliana M.; Whatman, Susan L.

2015-01-01

The imperative for Indigenous education in Australia is influenced by national political, social and economic discourses as Australian education systems continue to grapple with an agreed aspiration of full participation for Aboriginal and Torres Strait Islander students. Innovations within and policies guiding our education systems are often…

Highlights in the History of the Education of Women.

ERIC Educational Resources Information Center

Zuelow, Margo J.

The history of the education of women from prehistory through the 1960s reveals constant themes. In every period, obstacles reflecting the prevalent social attitudes were placed in the paths of women seeking education. Economic conditions directly affected the status and scope of women's education, although certain disciplines such as religion and…

Alaska Wildlife Week, Junior/Senior High School Teacher's Guide. Unit 4. We All Need Each Other--The Web of Life. April 20-26, l986.

ERIC Educational Resources Information Center

Quinlan, Susan E.

The ecological theme of "We all need each other--the web of life" serves as the focus of Alaska's fourth annual wildlife week and as the emphasis for the activities in this guide for junior/senior high school teachers. The packet of materials contains: (1) an introduction (explaining the theme); (2) table of contents (indicating each…

FY16 Strategic Themes White Paper.

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

Leland, Robert W.

The Science and Technology (S&T) Division 1000 Strategic Plan includes the Themes, Goals, and Actions for FY16. S&T will continue to support the Labs Strategic plan, Mission Areas and Program Management Units by focusing on four strategic themes that align with the targeted needs of the Labs. The themes presented in this plan are Mission Engagement, Bold Outcomes, Collaborative Environment, and the Safety Imperative. Collectively they emphasize diverse, collaborative teams and a self-reliant culture of safety that will deliver on our promise of exceptional service in the national interest like never before. Mission Engagement focuses on increasing collaboration at allmore » levels but with emphasis at the strategic level with mission efforts across the labs. Bold Outcomes seeks to increase the ability to take thoughtful risks with the goal of achieving transformative breakthroughs more frequently. Collaborative environment strives for a self-aware, collaborative working environment that bridges the many cultures of Sandia. Finally, Safety Imperative aims to minimize the risk of serious injury and to continuously strengthen the safety culture. Each of these themes is accompanied by a brief vision statement, several goals, and planned actions to support those goals throughout FY16 and leading into FY17.« less

Religion and the Psychotherapeutic Relationship: Transferential and Countertransferential Dimensions

PubMed Central

Abernethy, Alexis D.; Lancia, Joseph J.

1998-01-01

The salience of religion in society and health care has received increased attention. Recent developments in psychiatry reflect a broader view of religion that includes an appreciation of its adaptive and maladaptive dimensions. An examination of religious counter- transferential and transferential reactions provides a framework for examining religious themes. Case examples illustrate the following critical factors that increase therapists' skill in working with religious themes: 1) monitoring the therapist's own attitude toward religious content, 2) attending to religious content, 3) seeking consultation, and 4) using religious content in interpretations. (The Journal of Psychotherapy Practice and Research 1998; 7:281–289) PMID:9752639

Rural gay men in northern New England: life experiences and coping styles.

PubMed

Cody, P J; Welch, P L

1997-01-01

This study describes thematically the life experiences of 20 gay men in the rural setting of northern New England and examines what coping skills they have evolved. A qualitative study was undertaken, so that the researchers could learn of rural gay men in their own words, particularly in terms of how they understood their life experiences. This material was analyzed and 9 common themes were discovered. In descending order of frequency of occurrence in subjects' narratives, the themes are: early awareness of difference, internalized homophobia, positive aspects of rural living, negative aspects of rural living, positive family of choice, compulsory heterosexuality, isolation, current life partner, and family censorship.

Patients' perceptions and attitudes on recurrent prostate cancer and hormone therapy: Qualitative comparison between decision-aid and control groups.

PubMed

Gorawara-Bhat, Rita; O'Muircheartaigh, Siobhan; Mohile, Supriya; Dale, William

2017-09-01

To compare patients' attitudes towards recurrent prostate cancer (PCa) and starting hormone therapy (HT) treatment in two groups-Decision-Aid (DA) (intervention) and Standard-of-care (SoC) (Control). The present research was conducted at three academic clinics-two in the Midwest and one in the Northeast U.S. Patients with biochemical recurrence of PCa (n=26) and follow-up oncology visits meeting inclusion criteria were randomized to either the SoC or DA intervention group prior to their consultation. Analysts were blinded to group assignment. Semi-structured phone interviews with patients were conducted 1-week post consultation. Interviews were audio-taped and transcribed. Qualitative analytic techniques were used to extract salient themes and conduct a comparative analysis of the two groups. Four salient themes emerged-1) knowledge acquisition, 2) decision-making style, 3) decision-making about timing of HT, and 4) anxiety-coping mechanisms. A comparative analysis showed that patients receiving the DA intervention had a better comprehension of Prostate-specific antigen (PSA), an improved understanding of HT treatment implications, an external locus-of-control, participation in shared decision-making and, support-seeking for anxiety reduction. In contrast, SoC patients displayed worse comprehension of PSA testing and HT treatment implications, internal locus-of-control, unilateral involvement in knowledge-seeking and decision-making, and no support-seeking for anxiety-coping. The DA was more effective than the SoC group in helping PCa patients understand the full implications of PSA testing and treatment; motivating shared decision-making, and support-seeking for anxiety relief. DA DVD interventions can be a useful patient education tool for bringing higher quality decision-making to prostate cancer care. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceived Barriers and Enablers of Help-Seeking for Substance Use Problems During Adolescence.

PubMed

Berridge, Bonita J; McCann, Terence V; Cheetham, Ali; Lubman, Dan I

2018-01-01

Receiving professional help early can reduce long-term harms associated with substance use. However, little is known about the factors that influence help-seeking for substance use problems during early-mid adolescence, prior to the emergence of disorder. Given that beliefs regarding help-seeking are likely to develop early, understanding adolescent views of help-seeking during this period is likely to provide important information for prevention and intervention efforts. The current study identifies perceptions that would facilitate or prevent adolescents from seeking support for substance use problems from formal and informal help sources. Thirty-four 12- to 16-year-olds from two schools in Melbourne, Victoria, Australia, were recruited. A qualitative interpretative design was used, incorporating semistructured, audio-recorded interviews. Three overlapping themes that reflected barriers or enablers to help-seeking were identified: approachability, confidentiality and trustworthiness, and expertise. Help-seeking was facilitated when adolescents believed that the help source would be supportive and understanding, would keep information confidential, and had expertise in the alcohol and drug field. Conversely, adolescents were reluctant to seek help from sources they believed would be judgmental, lacked expertise, or would inform their parents. These findings highlight perceptions that may influence help-seeking for alcohol and drug problems during adolescence. Further research is needed to determine if help-seeking can be facilitated by improving parents' and peers' knowledge and promoting health professionals' expertise in working with young people's alcohol and drug issues.

Over-reassurance and undersupport after a 'false alarm': a systematic review of the impact on subsequent cancer symptom attribution and help seeking.

PubMed

Renzi, Cristina; Whitaker, Katriina L; Wardle, Jane

2015-02-04

This literature review examined research into the impact of a previous 'all-clear' or non-cancer diagnosis following symptomatic presentation ('false alarm') on symptom attribution and delays in help seeking for subsequent possible cancer symptoms. The comprehensive literature review included original research based on quantitative, qualitative and mixed data collection methods. We used a combination of search strategies, including in-depth searches of electronic databases (PubMed, EMBASE, PsychInfo), searching key authors and articles listed as 'related' in PubMed, and reference lists. We performed a narrative synthesis of key themes shared across studies. The review included studies published after 1990 and before February 2014 reporting information on adult patients having experienced a false alarm following symptomatic presentation. We excluded false alarms in the context of screening. We evaluated the effect of a 'false alarm' on symptom attribution and help seeking for new or recurrent possible cancer symptoms. Overall, 1442 papers were screened and 121 retrieved for full-text evaluation. Among them, 19 reported on false alarms and subsequent symptom attribution or help seeking. They used qualitative (n=14), quantitative (n=3) and mixed methods (n=2). Breast (n=7), gynaecological (n=3), colorectal (n=2), testicular (n=2), and head and neck cancers (n=2) were the most studied. Two broad themes emerged underlying delays in help seeking: (1) over-reassurance from the previous 'all-clear' diagnosis leading to subsequent symptoms being interpreted as benign, and (2) unsupportive healthcare experiences in which symptoms were dismissed, leaving patients concerned about appearing hypochondriacal or uncertain about the appropriate next actions. The evidence suggested that the effect of a false alarm can persist for months and even years. In conclusion, over-reassurance and undersupport of patients after a false alarm can undermine help seeking in the case of new or recurrent potential cancer symptoms, highlighting the need for appropriate patient information when investigations rule out cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Online information seeking practices of biology teachers and the perceived influences on instructional planning

NASA Astrophysics Data System (ADS)

Perrault, Anne Marie

The purpose of this study was to examine biology teachers' perceptions of how their online information seeking practices influence their instructional planning. When teachers engage in activities to locate, evaluate, and use online information and resources, a myriad of inter-related and often inseparable consequences follows. These influences may be any combination of direct/indirect, desirable/undesirable, or anticipated/unanticipated (Rogers, 2003). This exploratory study collected baseline data regarding teachers' online practices and its influence on their practice. There were two phases of data collection in this study. Phase I was an online survey of more than seventy New York State biology teachers. The survey was intended to capture (1) a snapshot of the biology teachers' online information seeking practices during the summer and fall 2004, and (2) their perceptions regarding how their online practices influenced their instructional planning. In Phase II, ten study participants were interviewed in order to explore in greater detail the consequences of their online information seeking practices on their instructional planning. Four themes reflecting the consequences of teachers' information seeking practices emerged from the data analysis: Currency of Information; Sparking of Ideas and Gaining Personal Knowledge; Resource Management and the Role of Time; and Webs of Sharing. Each theme encompassed both the purposeful and the indirect actions by teachers to access knowledge and resources to refine and improve their instructional planning. This study's findings show that teachers are using a greater number and wider range of current and multi-modal resources than pre-Internet and they perceive this as an advantage in creating authentic, inquiry-based learning experiences. A notable discovery was of the under-use by teachers of educational online resources specifically designed to support teaching and learning activities (e.g., digital libraries, online databases, and listservs). This study's findings point to a recursive process in which teachers are engaged in ongoing online information seeking practices; continually learning and fostering new knowledge; integrating the learning into their instructional planning practices; changing their teaching strategies; and going back online to search for information and resources and begin the cycle again.

Parental Perspectives of Communication at the End of Life at a Pediatric Oncology Institution.

PubMed

Snaman, Jennifer M; Torres, Carlos; Duffy, Brian; Levine, Deena R; Gibson, Deborah V; Baker, Justin N

2016-03-01

The interaction of health care providers and hospital staff with patients and families at the end of life affects the parental grief experience. Both verbal and nonverbal communication are key components of this interaction. The study objective was to explore the communication between hospital staff members and patients and families at the time of patients' health decline near the end of life. Twelve bereaved parents participated in a focus group. Semantic content analysis was used to analyze the transcript. Parents' responses to the prompt about typical ways the medical team communicated yielded 109 codes, which were grouped into 12 themes. The most common themes were "patient inclusion" and "explanation of medical plan," both used in 17% of responses. Responses to the prompt about positive and negative aspects of communication generated 208 codes, yielding 15 different themes. The most common theme about positive communication was the "strong relationship between family and staff." The theme "variations in care with a negative impact" was used most frequently in describing negative communication. This study helps to identify techniques that should be used by clinicians as they work with children with cancer and their families, particularly including patients in treatment decisions, ongoing relationship building, communicating with caring and empathy, using an interdisciplinary team for additional support, and pairing bad news with a plan of action.

Ethical frameworks for surrogates’ end-of-life planning experiences: A qualitative systematic review

PubMed Central

Kim, Hyejin; Deatrick, Janet A; Ulrich, Connie M

2016-01-01

Despite the growing body of knowledge about surrogate decision making, we know very little about the use of ethical frameworks including ethical theories, principles, and concepts to understand surrogates’ day-to-day experiences in end-of-life care planning for incapacitated adults. This systematic review of 30 qualitative research papers was conducted to identify the types of ethical frameworks used to address surrogates’ experiences in end-of-life care planning for incapacitated adults as well as the most common themes or patterns found in surrogate decision making research.. Seven papers explicitly identified ethical theories, principles, or concepts for their studies, such as autonomy, substituted judgment, and best interests. Themes identified about surrogate decision making included: responsibilities and goals, factors affecting surrogates’ decision making, and outcomes for surrogates. In fact, an overarching theme of “wanting to do the right thing” for incapacitated adults and/or themselves was prominent. Understanding the complexity of surrogates’ experiences of end-of-life care planning is beyond the scope of conventional ethical frameworks. Ethical frameworks that address individuality and contextual variations related to decision making may more appropriately guide surrogate decision making research that explores surrogates’ end-of-life care planning experiences. PMID:27005954

Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles

PubMed Central

Muse, Kate; McManus, Freda; Hackmann, Ann; Williams, Matthew; Williams, Mark

2010-01-01

Increased understanding of the nature and role of intrusive imagery has contributed to the development of effective treatment protocols for some anxiety disorders. However, intrusive imagery in severe health anxiety (hypochondriasis) has been comparatively neglected. Hence, the current study investigates the prevalence, nature and content of intrusive imagery in 55 patients who met DSM-IV-TR (APA, 2000) criteria for the diagnosis of hypochondriasis. A semi-structured interview was used to assess the prevalence, nature and possible role of intrusive imagery in this disorder. Over 78% of participants reported experiencing recurrent, distressing intrusive images, the majority (72%) of which either were a memory of an earlier event or were strongly associated with a memory. The images tended to be future orientated, and were reliably categorised into four themes: i) being told ‘the bad news’ that you have a serious/life threatening-illness (6.9%), ii) suffering from a serious or life-threatening illness (34.5%), iii) death and dying due to illness (22.4%) and iv) impact of own death or serious illness on loved ones (36.2%). Participants reported responding to experiencing intrusive images by engaging in avoidance, checking, reassurance seeking, distraction and rumination. Potential treatment implications and links to maintenance cycles are considered. PMID:20627270

[Emotion and soma (dis)connected in magazine pages: the thematic categories of the prescriptive discourse on phenomena of life and illness].

PubMed

Alves, Vera Lucia Pereira; Lima, Daniela Dantas; Rivorêdo, Carlos Roberto Soares Freire de; Turato, Egberto Ribeiro

2013-02-01

Magazines sold on newsstands have become self-help texts, and the study of the topics covered makes it possible to understand how the discourses are constructed, how they become repositories used to give meaning to life. In the case of magazines that deal with the sphere of health, prescribing methods of treatment, prevention and even healthy lifestyles, the studies allow us to understand the meanings of discourses about body and health. In some articles, the emphasis that sometimes highlights the physical aspect is accompanied by the inclusion of mental aspects. This fact gave rise to this study, which seeks to clarify how this mind-body connection is conceptualized and prescribed in these pages. Six articles of a Brazilian health magazine published between August 2005 and February 2006 were analyzed regarding the content of the texts as well as graphic and textual features. The way this media format operates was considered significant, and when associated with the themes: self-diagnosis, the place of emotion, the prescriptions and causality reinforce healthy lifestyles. Readers must learn to self-diagnose and control their emotions, considered to be juxtaposed to the physical emotions. The articles outline a field of health in which the mind-body split deepens and extends, establishing the medicalization of society.

Career Development through Life-Centered Education.

ERIC Educational Resources Information Center

Wernick, Walter

Schooling can be a terrible social disease, if it generates grasping, self-centered individuals seeking freedom from responsibility rather than life-centered human beings seeking freedom for responsibility. Career education can focus on individuals, but help them see themselves as characters in a larger play on the world's stage. Others may have…

International Students' Proactive Behaviors in the United States: Effects of Information-Seeking Behaviors on School Life

ERIC Educational Resources Information Center

Cho, Jaehee; Lee, Seungjo

2016-01-01

Considering the continuous increase of international students, the main goal of this study was to examine how international students' proactive behaviors, particularly information seeking behaviors, would impact key emotional outcomes including communication satisfaction with instructors and school-life satisfaction. For this investigation, we…

The faces of breastfeeding support: Experiences of mothers seeking breastfeeding support online.

PubMed

Bridges, Nicole

2016-03-01

The aim of this study was to advance understanding of the experiences of mothers using closed Facebook groups attached to the Australian Breastfeeding Association (ABA) and how these mothers find and share breastfeeding support and information using this forum. The study involved members of three closed Facebook groups that were chosen as interesting cases for study, based on the volume and nature of their posts. Members of these three groups then participated in online depth interviews and online semi-structured focus groups. The overarching theme identified was support, with four sub-themes that describe the nature of online breastfeeding support within the Facebook environment. These sub-themes are: community, complementary, immediate and information. It was found that social networking sites (SNSs) provide support from the trusted community. It is immediate, it complements existing support or services that ABA provides and also provides practical and valuable information for its users.

Designing a leadership development program for surgeons.

PubMed

Jaffe, Gregory A; Pradarelli, Jason C; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B

2016-01-01

Although numerous leadership development programs (LDPs) exist in health care, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons' motivations and desired goals for leadership training to design an evidence-based LDP in surgery. At a large academic health center, we conducted semistructured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding to extract major themes regarding surgeons' motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Three major themes emerged regarding surgeons' motivations for seeking leadership training: (1) Recognizing key gaps in their formal preparation for leadership roles; (2) Exhibiting an appetite for personal self-improvement; and (3) Seeking leadership guidance for career advancement. Participants' interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a LDP: (1) leadership and communication; (2) team building; (3) business acumen/finance; and (4) greater understanding of the health care context. Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A LDP that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. Copyright © 2016 Elsevier Inc. All rights reserved.

Insomnia patients' help-seeking experiences.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Glozier, Nicholas; Saini, Bandana

2014-03-04

Timely access to appropriate treatment is important for optimizing insomnia management. To date, little is known about insomnia patients' treatment experiences or how they access and engage with the available health care resources. This study sought to capture the help-seeking experiences and behavioral patterns of patients with insomnia who are seeking or receiving specialist care. A purposive sample of 26 insomnia patients from specialist sleep and mental health clinics located in metropolitan New South Wales, Australia was recruited. Participants completed a brief questionnaire, followed by an in-depth, semi-structured interview. Interviews were digitally recorded, transcribed verbatim, and analyzed using framework analysis. Three key themes emerged from the data: patients' sleep beliefs, treatment beliefs, and accessing specialized care. The findings show that daytime symptoms arising from insomnia serve as important illness cues for patients to seek medical help. In addition, participants' treatment pathways highlight factors that prevent the widespread use of cognitive behavioral therapy for insomnia (CBT-I), including limited awareness about CBT-I, tentative referral mechanisms, limited service providers, and the high cost of CBT-I.

Transitions Regarding Palliative and End-of-Life Care in Severe Chronic Obstructive Pulmonary Disease or Advanced Cancer: Themes Identified by Patients, Families, and Clinicians

PubMed Central

REINKE, LYNN F.; ENGELBERG, RUTH A.; SHANNON, SARAH E.; WENRICH, MARJORIE D.; VIG, ELIZABETH K.; BACK, ANTHONY L.; CURTIS, J. RANDALL

2015-01-01

Background Classic trajectories of illness at end of life (EOL) suggest different care needs for patients with cancer versus chronic obstructive pulmonary disease (COPD) and may lead to different experiences of transitions over the course of a life-limiting illness. Patients may experience transitions in different ways than clinicians. No prior studies have examined this issue from patients’, families’, and clinicians’ perspectives. Objectives We sought to explore transitions, defined as experiences that patients and family members viewed as milestones in the evolution of their illnesses and therapies, and compare these perceptions with the perspectives of the patient’s physician and nurse to provide insights about communication concerning EOL care. Methods We conducted a qualitative study using grounded theory to examine participants’ perspectives on the experiences of key transitions in the context of living with advanced COPD or cancer. In-depth interviews with patients, family members, nurses, and physicians were conducted by experienced interviewers. Results Six themes were identified regarding participants’ experiences with transitions. Themes that defined transitions among both patients with COPD and those with cancer included: new or different treatments and no more treatments available. Themes unique to patients with COPD were activity limitations due to functional decline and initiation of oxygen therapy. One theme unique to clinicians was acute exacerbation of illness or hospitalization. Conclusions This study identified differences in the meaning of transitions for patients versus clinicians and for patients with COPD versus those with cancer. These findings may offer clinicians the opportunity to provide a more patient-centered approach to communication about end-of-life care by acknowledging and addressing transitions in palliative care from the perspective of the patient and family. PMID:18454613

Improving University Principal Preparation Programs: Five Themes from the Field

ERIC Educational Resources Information Center

Mendels, Pamela, Ed.

2016-01-01

What is the state of university-based principal preparation programs? How are these essential training grounds of future school leaders viewed--by themselves as well as by the school districts that hire their graduates? Do the programs need to improve? If so, by what means? This publication seeks to help answer those questions by bringing together…

Ohio Geographers: Recent Research Themes. Volume Number 2: 1974.

ERIC Educational Resources Information Center

Roder, Wolf, Ed.; Shelton, Marlyn L., Ed.

Ten professional geography research papers presented at the Geography Section of the 1974 annual meeting of the Ohio Academy of Science are provided. Six of the papers may be considered to fall under the broad classification of human geography, two others are about physical geography, while the remaining two seek to improve the craft of modern…

Faculty Best Practices to Support Students in the "Virtual Doctoral Land"

ERIC Educational Resources Information Center

Deshpande, Anant

2017-01-01

Online students face numerous challenges in successfully completing doctoral programmes. The aim of this article is to explore the best practices that can be employed by faculty to support students in achieving this. It also seeks to categorize and identify the best practices emerging from literature into themes. An exploratory research method was…

Exemplar: A Model for Social Studies Curriculum Development in Delaware, K-12.

ERIC Educational Resources Information Center

Delaware State Dept. of Public Instruction, Dover.

GRADES OR AGES: Grades K-12. SUBJECT MATTER: Social studies. ORGANIZATION AND PHYSICAL APPEARANCE: The subject matter is divided into the following five themes: 1) Man develops within his physical and cultural environment. 2) Man functions within an interdependent society. 3) Man seeks justice and order. 4) Man experiences conflict and change. 5)…

Using Fiction to Teach American History in Middle School: Affects on Student Engagement

ERIC Educational Resources Information Center

Elias, Anjuli Rose

2010-01-01

This research highlights the effects of using literature and relevant curriculum to teach history in grade levels 6 through 8, and analyzes how students respond when learning complicated themes and events through the medium of historic fiction. Specifically, my research seeks to inform secondary educators concerning the use of the narrative and…

At This Time and in This Place: Vocation and Higher Education

ERIC Educational Resources Information Center

Cunningham, David S., Ed.

2015-01-01

Seeking to deepen current scholarly engagement with vocational exploration in both theory and practice, "At This Time and In This Place" champions the themes of calling and vocation as key elements of effective undergraduate education. Growing out of a year-long seminar sponsored by the Council of Independent Colleges and its Network for…

Great Valley Riparian Habitats and the National Registry of Natural Landmarks

Treesearch

Robert F. Holland; Cynthia L. Roye

1989-01-01

The National Registry of Natural Landmarks is a program established by the National Park Service that seeks to recognize nationally significant examples of the Nation's natural history. Nearly 100 Great Valley riparian sites were evaluated using Park Service criteria. Three sites illustrative of the range of this biotic theme were recommended to the National Park...

Valuing autonomy, struggling for an identity and a collective voice, and seeking role recognition: community mental health nurses' perceptions of their roles.

PubMed

White, Jane H; Kudless, Mary

2008-10-01

Leaders in this community mental health system approached the problem of job frustration, morale issues, and turnover concerns of their Community Mental Health Nurses (CMHNs) by designing a qualitative study using Participant Action Research (PAR) methodology based on the philosophy of Habermas. Six focus groups were conducted to address the nurses' concerns. The themes of Valuing Autonomy, Struggling for an Identity and Collective Voice, and Seeking Role Recognition best explained the participants' concerns. The study concluded with an action plan, the implementation of the plan, and a discussion of the plan's final outcomes.

Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: a multi-site focus group study.

PubMed

Palepu, Anita; Hubley, Anita M; Russell, Lara B; Gadermann, Anne M; Chinni, Mary

2012-08-15

The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

Workforce Issues of the 21st Century: The People CMM to the Rescue

DTIC Science & Technology

2008-07-01

skilled, and adaptable workforce United States, European Union, Mexico, South Africa, China… Work - life balance United States, European Union, China...direction Seek work / life balance Generation Y 1980 - 2000 Prefer informality Learn quickly Embrace diversity Requires supervision Indirect...communication: email & texting Seek “demand” work / life balance Source: Hammill 2005 Traditionalist 1928-1945 Hard worker Respects authority Work is an

Intrinsic factors influencing help-seeking behaviour in an acute stroke situation.

PubMed

Zock, Elles; Kerkhoff, Henk; Kleyweg, Ruud Peter; van de Beek, Diederik

2016-09-01

The proportion of stroke patients eligible for intravenous or intra-arterial treatment is still limited because many patients do not seek medical help immediately after stroke onset. The aim of our study was to explore which intrinsic factors and considerations influence help-seeking behaviour of relatively healthy participants, confronted with stroke situations. Semi-structured interviews were conducted with 25 non-stroke participants aged 50 years or older. We presented 5 clinical stroke situations as if experienced by the participants themselves. Recognition and interpretation of symptoms were evaluated and various factors influencing help-seeking behaviour were explored in-depth. We used the thematic synthesis method for data analysis. Five themes influencing help-seeking behaviour in a stroke situation were identified: influence of knowledge, views about seriousness, ideas about illness and health, attitudes towards others and beliefs about the emergency medical system. A correct recognition of stroke symptoms or a correct interpretation of the stroke situations did not automatically result in seeking medical help. Interestingly, similar factors could lead to different types of actions between participants. Many intrinsic, as well as social and environmental factors are of influence on help-seeking behaviour in an acute stroke situation. All these factors seem to play a complex role in help-seeking behaviour with considerable inter-individual variations. Accomplishing more patients eligible for acute stroke treatment, future research should focus on better understanding of all factors at various levels grounded in a theory of help-seeking behaviour.

Social Inequality, Life Course Transitions, and Adolescent Development: Introduction to the Special Issue.

PubMed

Buchmann, Marlis; Steinhoff, Annekatrin

2017-10-01

Conceptualizing adolescent development within a life course framework that links the perspectives on social inequality and early life course transitions has largely been absent from previous research. Such a conceptual model is needed, however, in order to understand how the individual development of agentic capacities and the opportunities and constraints inherent in the social contexts of growing up interact and jointly affect young people's trajectories across the adolescent life stage. We present the corner stones of the conceptual "trident" of social inequality, life course transitions, and adolescent development and identify three major themes the eleven contributions to this special issue address within this conceptual framework: social and individual prerequisites and consequences of coping with life course transitions; intergenerational transmission belts of social inequality; socialization of agency in and outside the family home. These three themes exemplify the great analytical potential inherent in this framework.

Experiences of experts about the instances of plagiarism.

PubMed

Keyvanara, Mahmod; Ojaghi, Rezvan; Sohrabi, Mozafar Cheshmeh; Papi, Ahmad

2013-01-01

Plagiarism is defined as intentional deceiving or lack of honesty, which deprives others from both material and spiritual possessions. Ethics is considered as one of the most important aspects of evaluating the quality of higher education. Moreover, scientific ethics should be reflected from university values, as a specialized institution, rather than being a reflection of the others cares. Therefore, the main aim of the present study is explore of expert experiences about plagiarism in Isfahan University of Medical Sciences. This study employed qualitative method with using in-deep interview. The research participants consisted of 21, who tend to this work. Semi structure interview were conducted and recorded. The method of analyzing data was 'thematic analysis'. The data were transcribed and saved on computer after each interview. Themes and sub-themes were extracted. Finally, relevant sub-themes were arranged in a category and suggested were presented. Analyzing data showed 600 primary codes, 40 sub-themes and 6 themes. The main themes included repeated works, non-normative adoption, non-normative adaptation, shares distribution, forging, and profit-seeking, each of which consisted of one or several subgroups. The findings of this study show that since, there are numerous ways of cheating, the universities' research committees must create institutions in order to educate the individuals how to avoid plagiarism. In addition, providing information about different types of scientific violations, as well as their following punishments might lead to the decrease of such misbehaviors.

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

PubMed

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

2016-06-01

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

Exploring end-of-life care for South Asian kidney patients: interviewer reflections.

PubMed

Wilkinson, Emma; Waqar, Muhammad; Gill, Balbir; Hoque, Pina; Jetha, Champa; Bola, Kulwinder Kaur; Mahmood, Riffat; Mahmood, Sultan; Saujani, Rita; Randhawa, Gurch

2017-03-16

The reduction of inequalities in access to quality care has been a central tenet of UK health policy. Ethnic minorities may experience additional inequalities because of language and other cultural barriers. This article reports interviewer reflections of conducting interviews with South Asian kidney patients about their experiences of end-of-life care. It explores themes which emerged from the analysis of a focus group held with eight bilingual research interviewers. The relevance of these themes to understanding inequalities and access to end-of-life care is discussed; together with the potential for the research process to contribute to service improvement.

Silence of male child sexual abuse in India: Qualitative analysis of barriers for seeking psychiatric help in a multidisciplinary unit in a general hospital

PubMed Central

Subramaniyan, Vyjayanthi Kanugodu Srinivasa; Reddy, Praveen; Chandra, Girish; Rao, Chandrika; Rao, T. S. Sathyanarayana

2017-01-01

Introduction: In 2007, Ministry of Women and Child Welfare, supported by United Nations Children's Fund, save the children and Prayas conducted a study to understand the magnitude of child abuse in India, they found that 53.22% children faced one or more forms of sexual abuse; among them, the number of boys abused was 52.94%. Aim: The aim of this study was to explore the barriers for seeking psychiatric help by qualitative analysis of stake holders of male victims of child abuse. Materials and Methods: All the statements made by the stakeholders regarding psychiatric assessment and treatment were recorded in each referral made to the psychiatrist. Semistructured interviews and in-depth interviews were conducted to explore the topic of understanding the need for psychiatric treatment to the victims. Results: Collaborative child response unit, a multidisciplinary team, to tackle child sexual abuse in a general hospital received three referrals of male child abuse among the 27 referrals in 20 months. The main theme of the barrier that was generated by interviewing the stakeholders of male child victims of abuse was the misconception of superiority of a male victim due to gender (patriarchy) an expectation that he will outgrow the experience. In-depth interviews of three cases of homosexual abuse explored the theme. Conclusion: Patriarchy is oppressing male children and acts as a barrier to seek psychiatric help in collaborative child response unit. PMID:28827868

Theme Courses for Community Colleges.

ERIC Educational Resources Information Center

Conway, Diana

1986-01-01

Discusses organization of community college Spanish courses around themes, such as geography, life sciences, arts, holidays, in conjunction with techniques such as the Natural Approach and Total Physical Response. The discussion includes examples of class activities, suggestions for materials, and notes on accommodating different levels. (SED)

Postpartum depression among African-American women.

PubMed

Amankwaa, Linda Clark

2003-01-01

The purpose of this qualitative study was to describe the nature of postpartum depression (PPD) among African-American women. Twelve women, who had experienced PPD within the last three years, were interviewed for approximately one hour at two intervals. Nudist-4 software and the constant comparative method were used to analyze the data. Five themes "Stressing Out," "Feeling Down," "Losing It," "Seeking Help," and "Feeling Better" represented aspects of PPD as experienced by the participants. The last theme, "Dealing with It," represented the cultural ways in which African-American mothers managed their depression. These included Keeping the Faith, Trying to Be a Strong Black Woman, Living with Myths, and Keeping Secrets. Suggestions for future directions in nursing research are included.

Acceptance of spousal death: the factor of time in bereaved older adults' search for meaning.

PubMed

Chan, Wallace Chi Ho; Chan, Cecilia L W

2011-02-01

Response to the death of a spouse was examined by focusing on acceptance, which was conceptualized as both a process and an outcome. Grounded theory was applied to analyze the experience of 15 bereaved Hong Kong Chinese older adults. The main theme that emerged was time. Acceptance of spousal death was found to be related to the search for meaning in 2 time-related themes: timing of spousal death and paradoxical time perception. For paradoxical time perception, 2 subthemes were identified: truncation and daily isolation in time. For bereaved older adults, time-related meaning seeking may be best fostered by self-transcendence, (e.g., participation in volunteer work and social activities).

Coping strategies used by poorly adherent patients for self-managing bipolar disorder

PubMed Central

Blixen, Carol; Levin, Jennifer B; Cassidy, Kristin A; Perzynski, Adam T; Sajatovic, Martha

2016-01-01

Background Bipolar disorder (BD) is a chronic mental illness associated with reduced quality of life, high rates of suicide, and high financial costs. Evidence indicates that psychosocial stress might play an important role in the onset and course of BD. Objective The objective of this study was to address the gap between coping theory and the clinical use of coping strategies used to self-manage BD. Methods In-depth interviews were conducted with a sample of 21 poorly adherent patients with BD. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis with an emphasis on dominant themes. Results Transcript-based analysis generated two major domains of coping strategies used to self-manage BD: 1) problem focused (altering eating habits, managing mood-stabilizing medications, keeping psychiatric appointments, seeking knowledge, self-monitoring, and socializing) and 2) emotion focused (distracting activities, denial, isolation, modifying/avoiding, helping others, and seeking social support). Participants used both types of coping strategies to deal with stressful situations brought about by the internal and external demands associated with self-management of BD. Conclusion This qualitative study provided a first step in evaluating coping strategies as a possible mediator in the self-management of BD and has implications for health care providers. Being able to characterize an individual’s coping behaviors can help patients modify or replace more maladaptive coping with better coping strategies in the self-management of this chronic mental illness. PMID:27524888

Haematopoietic stem cell transplantation survivorship and quality of life: is it a small world after all?

PubMed

Brice, Lisa; Gilroy, Nicole; Dyer, Gemma; Kabir, Masura; Greenwood, Matt; Larsen, Stephen; Moore, John; Kwan, John; Hertzberg, Mark; Brown, Louisa; Hogg, Megan; Huang, Gillian; Tan, Jeff; Ward, Christopher; Gottlieb, David; Kerridge, Ian

2017-02-01

The aim of this qualitative study was to gain a rich understanding of the impact that haematopoietic stem cell transplantation (HSCT) has on long-term survivor's quality of life (QoL). Participants included 441 survivors who had undergone HSCT for a malignant or non-malignant disease. Data were obtained by a questionnaire positing a single open-ended question asking respondents to list the three issues of greatest importance to their QoL in survivorship. Responses were analysed and organised into QoL themes and subthemes. Major themes identified included the following: the failing body and diminished physical effectiveness, the changed mind, the loss of social connectedness, the loss of the functional self and the patient for life. Each of these themes manifests different ways in which HSCT survivor's world and opportunities had diminished compared to the unhindered and expansive life that they enjoyed prior to the onset of disease and subsequent HSCT. HSCT has a profound and pervasive impact on the life of survivors-reducing their horizons and shrinking various parts of their worlds. While HSCT survivors can describe the ways in which their life has changed, many of their fears, anxieties, regrets and concerns are existential in nature and are ill-defined-making it exceeding unlikely that they would be adequately captured by standard psychometric measures of QoL post HSCT.

The top eight issues Queensland Australia's aged-care nurses and assistants-in-nursing worried about outside their workplace: a qualitative snapshot.

PubMed

Tuckett, Anthony; Hegney, Desley; Parker, Deborah; Eley, Robert M; Dickie, Robyn

2011-10-01

The attainment of a work-life balance is an important issue for recruitment, retention and workforce planning. This paper aims to report on the free text data provided by the aged-care sector nurses around perceptions of important work-life issues. Data were written responses of aged-care nurses to the open-ended request at the end of a survey, which asked them to list up to five political/social/environmental issues concerning them outside of their work. For aged-care nurses, when asked to list political/social/environmental issues they were concerned about outside of work in late 2007, there emerged considered issues around work and life. Among the top eight themes there is an intriguing balance between the themes work, industrial relations, aged care/elder care and health-care services compared with the themes environment, water, societal values and housing. Qualitative insights into the political/social/environmental issues aged-care nurses are concerned about outside of your work suggest their desire for a labour/life or work/life harmony. Aged-care nurses place an equal importance on the nature of labour and the basics of life. The findings provide information for aged-care sector managers and workforce planners on areas in need of consideration to recruit and retain a workforce within aged care. © 2011 Blackwell Publishing Asia Pty Ltd.

Moving backwards, moving forward: the experiences of older Filipino migrants adjusting to life in New Zealand.

PubMed

Montayre, Jed; Neville, Stephen; Holroyd, Eleanor

2017-12-01

To explore the experiences of older Filipino migrants adjusting to living permanently in New Zealand. The qualitative descriptive approach taken in this study involved 17 individual face-to-face interviews of older Filipino migrants in New Zealand. Three main themes emerged from the data. The first theme was "moving backwards and moving forward", which described how these older Filipino migrants adjusted to challenges they experienced with migration. The second theme was "engaging with health services" and presented challenges relating to the New Zealand healthcare system, including a lack of knowledge of the nature of health services, language barriers, and differences in cultural views. The third theme, "new-found home", highlighted establishing a Filipino identity in New Zealand and adjusting to the challenges of relocation. Adjustment to life in New Zealand for these older Filipino migrants meant starting over again by building new values through learning the basics and then moving forward from there.

Moving backwards, moving forward: the experiences of older Filipino migrants adjusting to life in New Zealand

PubMed Central

Montayre, Jed; Neville, Stephen; Holroyd, Eleanor

2017-01-01

ABSTRACT Purpose: To explore the experiences of older Filipino migrants adjusting to living permanently in New Zealand. Method: The qualitative descriptive approach taken in this study involved 17 individual face-to-face interviews of older Filipino migrants in New Zealand. Results: Three main themes emerged from the data. The first theme was “moving backwards and moving forward”, which described how these older Filipino migrants adjusted to challenges they experienced with migration. The second theme was “engaging with health services” and presented challenges relating to the New Zealand healthcare system, including a lack of knowledge of the nature of health services, language barriers, and differences in cultural views. The third theme, “new-found home”, highlighted establishing a Filipino identity in New Zealand and adjusting to the challenges of relocation. Conclusion: Adjustment to life in New Zealand for these older Filipino migrants meant starting over again by building new values through learning the basics and then moving forward from there. PMID:28705087

Using Virtual Environments as Professional Development Tools for Pre-Service Teachers Seeking ESOL Endorsement

ERIC Educational Resources Information Center

Blankenship, Rebecca J.

2010-01-01

The purpose of this study was to investigate the potential use of Second Life (Linden Labs, 2004) and Skype (Skype Limited, 2009) as simulated virtual professional development tools for pre-service teachers seeking endorsement in teaching English as a Second Official Language (ESOL). Second Life is an avatar-based Internet program that allows…

Use of qualitative methods to explore the quality-of-life construct from a consumer perspective.

PubMed

Corring, Deborah J; Cook, Joanne V

2007-02-01

This study explored the construct of quality of life from the perspective of adults diagnosed as having severe and persistent mental illness, such as schizophrenia. Qualitative research strategies, specifically in-depth interviews (N=18) and focus groups (N=35), were used to collect data. Interviews and focus groups took place in hospitals, community clinics, community agencies, and clients' homes. A convenience, snowball sampling strategy was utilized. Analysis using the constant comparative method resulted in the identification of two dominant themes. These themes permeated the results, crossed all domains, influenced the linkages between domains, and clearly influenced how individuals frame their expectations regarding quality of life. The first theme was the presence of stigma and its effects on everyday life and future planning, and the second was the pervasive fear of the return of major positive symptoms of psychosis, such as hallucinations, delusions, and general loss of contact with reality. In addition, four quality-of-life domains were identified-the experience of illness, relationships, occupation, and sense of self. Many persons with mental illness simply wish for the basics in life-mental and physical health, supportive relationships, meaningful occupations, and a positive sense of self-believing that acquisition of these basics will lead to a more satisfactory quality of life. Ensuring that they are able to obtain the basics requires action on their part, by those who support them, by service providers that interact with them, and by a more accepting society.

Re-conceptualizing the origins of life

NASA Astrophysics Data System (ADS)

Walker, Sara I.; Packard, N.; Cody, G. D.

2017-11-01

Over the last several hundred years of scientific progress, we have arrived at a deep understanding of the non-living world. We have not yet achieved an analogous, deep understanding of the living world. The origins of life is our best chance at discovering scientific laws governing life, because it marks the point of departure from the predictable physical and chemical world to the novel, history-dependent living world. This theme issue aims to explore ways to build a deeper understanding of the nature of biology, by modelling the origins of life on a sufficiently abstract level, starting from prebiotic conditions on Earth and possibly on other planets and bridging quantitative frameworks approaching universal aspects of life. The aim of the editors is to stimulate new directions for solving the origins of life. The present introduction represents the point of view of the editors on some of the most promising future directions. This article is part of the themed issue 'Reconceptualizing the origins of life'.

Understanding the relationship transitions and associated end of life clinical needs of young adults with life-limiting illnesses: A triangulated longitudinal qualitative study

PubMed Central

Johnston, Bridget; Jindal-Snape, Divya; Pringle, Jan; Gold, Libby; Grant, Jayne; Dempsey, Raymond; Scott, Ros; Carragher, Pat

2016-01-01

Background: Care of young adults with life-limiting illnesses can often be complex due to the fact that they are growing and developing within the continuing presence of their illness. There is little research conducted nationally and internationally, which has examined the life issues of young adults or taken a longitudinal approach to understand such issues over a period of time. Aim: To gain clear understanding of one particular and pertinent life issue—relationship transition—occurring in the context of being a young adult with a life-limiting illness and the clinical needs arising from this. Design: This was a triangulated, longitudinal, qualitative study involving young adults with life-limiting illnesses and their significant others, namely, family members and healthcare professionals. Semi-structured interviews were conducted with participants and analysed using thematic analysis. Clinical case note reviews were also carried out. Setting/participants: A total of 12 young adults (aged between 17 and 23 years) from 2 hospices and 22 nominated significant others participated in a total of 58 interviews. Results: Thematic analysis revealed 4 main themes and 11 subthemes. The main themes were ‘Dependence dichotomy’, ‘In it together’, ‘Biographical uncertainty’, and ‘Conserving integrity’. These themes helped to establish the nature of relationship transitions that the young adult participants from the study experienced and additionally allowed insight into their possible needs at their end of life. Conclusion: This study has identified the nature of relationship transitions pertinent to young adults and has highlighted associated end of life clinical needs. This study can influence further research into the transitions and end of life needs of this particular patient group receiving palliative care, while informing the lacking evidence base which exists internationally. PMID:27781097

Life Cycle. K-6 Science Curriculum.

ERIC Educational Resources Information Center

Blueford, J. R.; And Others

Life Cycle is one of the units of a K-6 unified science curriculum program. The unit consists of four organizing sub-themes: (1) past life (focusing on dinosaurs and fossil formation, types, and importance); (2) animal life (examining groups of invertebrates and vertebrates, cells, reproduction, and classification systems); (3) plant life…

Seeking life balance: the perceptions of health of Cambodian women in resettlement.

PubMed

Catolico, Olivia

2013-07-01

This grounded theory study in California, United States was an inquiry into the perceptions of health of Cambodian women in resettlement. The sequelae of significant life trauma on the health of women who escaped political conflict have received little attention in the nursing literature. Thirty-nine Cambodian women were recruited through a social service organization and verbal referrals. Open-ended questions and a conversational approach to dialogue and data gathering facilitated the interview process. Women were interviewed at home or the local temple. Seeking life balance emerged as the core perspective of this study. The relationships between thematic categories of seeking life balance, patterns of knowing, and caring for self were salient. Outcomes of these interrelationships further moved women's health toward disharmony or harmony. The findings of this study are limited by sampling participants in a tightly networked community and may serve as a pilot for future research.

Marilou Awiakta: Reweaving the Future.

ERIC Educational Resources Information Center

Crowe, Thomas Rain, Ed.

1990-01-01

Taped interview in which Appalachian Indian poet Marilou Awiakta examines her own life and work. Discusses effects of rural upbringing, Cherokee culture, modern science, and life abroad on writing. Examines themes of feminism and technology in life and work. Includes six poems. (TES)

Men's reflections on participating in cancer rehabilitation: a systematic review of qualitative studies 2000-2013.

PubMed

Handberg, C; Nielsen, C V; Lomborg, K

2014-03-01

This paper aims to report on a systematic review of qualitative studies on men's reflections on participating in cancer rehabilitation. Nine databases were systematically searched to identify qualitative papers published between 2000 and 2013. Papers were selected by pre-defined inclusion criteria and subsequently critically appraised. Key themes were extracted and synthesised. Fifteen papers were selected and represented. Four central themes were identified in the analytical process: 'changed life perspective', 'the masculinity factor', 'a desire to get back to normal' and 'the meaning of work'. Six peripheral themes were identified: 'the meaning of context', 'music', 'physical training', 'religion', 'humour' and 'the unmentionable'. The themes were synthesised into an integrative model representing men's reflections on participating in cancer rehabilitation. We conclude that existing qualitative literature offers insight into men's reflections on cancer rehabilitation and highlights the interrelationship between men's reflections on their changed life perspective, masculinity, orientation towards a normal life and getting back to work. Further research-based knowledge is needed to explore (1) the underlying causes and patterns of the men's needs, preferences and choices in rehabilitation; and (2) the health professional perspective on male cancer rehabilitation. © 2013 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

Film in the College Classroom: Using "Twilight" to Examine Adolescent Development

ERIC Educational Resources Information Center

Tagsold, Jennifer T.; Decuir-Gunby, Jessica

2012-01-01

The hit movie saga "Twilight" has made an impact on viewers of all ages. This article seeks to explore the uses of film in psychology classes with a focus on ways in which instructors may find scenes from the "Twilight" series helpful and engaging for students. The authors describe scenes and themes from the first three movies…

Defining Fun and Seeking Flow in English Language Arts

ERIC Educational Resources Information Center

Romano, Tom

2009-01-01

Students have fun with Facebook, MySpace, YouTube, and video games. They have fun text messaging, talking on cell phones, listening to iPods. They have fun at theme parks and hanging out with friends. As their teacher the author wants to introduce students to another kind of fun. This fun can be time consuming, rigorous, and fulfilling. It's the…

Australia seeks free science debate

NASA Astrophysics Data System (ADS)

Pockley, Peter

2008-04-01

A major theme of the Australian election last November was the conflicting views of the competing parties on climate change. The former Conservative government under Prime Minister John Howard stuck to its refusal, alone with US President George Bush, to ratify the Kyoto accord. However, it was heavily criticized for suppressing the evidence for global warming from scientists who were dependent on government support.

Next Generation Communications: Making IT Work. Pacific Telecommunications Council Annual Conference Proceedings (24th, Honolulu, Hawaii, January 13-17, 2002).

ERIC Educational Resources Information Center

Pacific Telecommunications Council, Honolulu, HI.

This proceedings includes the papers presented at the 2002 conference of the Pacific Telecommunications Council (PTC), with its theme "Next Generation Communications: Making IT Work." The PTC2002 annual conference seeks to focus on harnessing the complexities of the broadest range of communications technologies and services for the user.…

Invited Review: Challenges of Residential and Community Care--"The Times They Are a-Changin"

ERIC Educational Resources Information Center

Jackson, R.

2011-01-01

This paper seeks to examine a number of issues which relate to the provision of appropriate and high-quality residential and community care for people with an intellectual disability. A number of key themes emerging from this Special Issue of the "Journal of Intellectual Disability Research" are identified and explored: (1) normalisation; (2)…

Stress Management among Parents of Neonates Hospitalized in NICU: A Qualitative Study.

PubMed

Heidari, Haydeh; Hasanpour, Marzieh; Fooladi, Marjan

2017-03-01

Introduction: Infant hospitalization is stressful event for parent in NICU. Parents think that they have lost control because of unfamiliar environment. Therefore, stress management is very important in this period. The family as the main factor of strength and protection for infant is required as the bases of standard care in NICU. Therefore the aim of this study was to investigate stress management in Iranian NICU Parents. Methods: Using qualitative content analysis approach helped to collect and analysis data for open coding, classification, and theme abstraction. Twenty one parents with hospitalized neonates, physicians and nurses in the city of Isfahan were purposely recruited and selected for in-depth interviews. Results: The analyzed content revealed unique stress management approaches among the parents. The main themes were: 1) spirituality, 2) seeking information, 3) Seeking hope, 4) maintaining calm, 5) attachment to infant, and 6) communicating with the medical team Conclusion: Findings of this study highlights the importance of medical team's attention to stressed parents who are trying to make adjustment or adapt to the hospitalization of their infant. A revised management approach to address the emotional needs of parents of neonates in Iran seems essential for improving communication with physicians and nurses.

Autism Narratives in Media Coverage of the MMR Vaccine-Autism Controversy under a Crip Futurism Framework.

PubMed

Mann, Benjamin W

2018-03-09

While previous studies in health communication have examined online news media regarding autism, there is a lack of research that critically examines how such media representations may stigmatize autism and seeks to eliminate the condition, particularly in the context of the resurging measles, mumps, and rubella (MMR) vaccine-autism controversy. To address this gap in the literature, this study analyzes 153 articles that engage the MMR vaccine-autism controversy from the top 10 online news sources in the U.S. from September 2015 through July 2017. It draws from Kafer's (2013) work in Feminist, Crip, Queer, using a lens of crip futurism to interpret three major narrative themes: a death and survival narrative that purports autism as a worst-case scenario, a societal problem narrative, and a preventative narrative that seeks to eliminate the condition. These themes suggest that online news media narratives about autism surrounding the autism-MMR controversy play into stereotypes about autism, including stigmatization and prioritization of preventive behaviors and cures over supporting the lived experiences of autistic individuals. Continued research on the impact of online media portrayals of autism specifically, and disability in health contexts generally, is called for.

Stress Management among Parents of Neonates Hospitalized in NICU: A Qualitative Study

PubMed Central

Heidari, Haydeh; Hasanpour, Marzieh; Fooladi, Marjan

2017-01-01

Introduction: Infant hospitalization is stressful event for parent in NICU. Parents think that they have lost control because of unfamiliar environment. Therefore, stress management is very important in this period. The family as the main factor of strength and protection for infant is required as the bases of standard care in NICU. Therefore the aim of this study was to investigate stress management in Iranian NICU Parents. Methods: Using qualitative content analysis approach helped to collect and analysis data for open coding, classification, and theme abstraction. Twenty one parents with hospitalized neonates, physicians and nurses in the city of Isfahan were purposely recruited and selected for in-depth interviews. Results: The analyzed content revealed unique stress management approaches among the parents. The main themes were: 1) spirituality, 2) seeking information, 3) Seeking hope, 4) maintaining calm, 5) attachment to infant, and 6) communicating with the medical team Conclusion: Findings of this study highlights the importance of medical team’s attention to stressed parents who are trying to make adjustment or adapt to the hospitalization of their infant. A revised management approach to address the emotional needs of parents of neonates in Iran seems essential for improving communication with physicians and nurses. PMID:28299295

Why people seek advice from community pharmacies about skin problems.

PubMed

Tucker, Rod; Stewart, Derek

2015-04-01

The objective of this study was to explore the reasons why patients with undiagnosed skin problems seek advice at pharmacies. Semi-structured telephone interviews were conducted with patients presenting at pharmacies requesting advice for their own (or their child's) undiagnosed skin problem. Twenty-five patients were interviewed. Key themes around choice of pharmacy were convenience of professional advice, triage to general practitioner (GP) care if warranted, inaccessibility of GP care and perceived non-serious nature of the condition. Interviewees also described high levels of trust in their pharmacists. Few concerns were noted, but those that were centred on lack of privacy and the potential for misdiagnosis. Almost all participants felt positive about their pharmacy care and would re-visit for future skin problems. Patients with undiagnosed skin problems seek advice from pharmacies for reasons of professional advice, accessibility, familiarity and trust and because they perceive their conditions as non-serious. © 2014 Royal Pharmaceutical Society.

Foucault on targets.

PubMed

Lynch, John

2004-01-01

This paper seeks to gain an insight into the behavior of a large NHS trust, in its attempt to meet a 90 percent patient access target, in a week long national audit in March 2003. Why did individuals act in dramatically different ways to their norm over this period. The work of Michel Foucault is used to explore these issues. The discourses of power, knowledge, discipline and governmentality are identified as key foucaudian themes that offer an alternative interpretation of how individuals behave in their place of work. The importance of the historical context of discourse within the NHS cannot be underestimated in shaping the behavior of individuals and groups today. Power and knowledge permeate NHS organizations through disciplinary practices and dressage. Governmentality seeks to maintain the status quo through disciplinary processes such as national healthcare targets. The natural response of NHS organizations is therefore, to seek order and conformity rather than disorder and conflict.

Medical Anthropology in Africa: The Trouble with a Single Story.

PubMed

Mkhwanazi, Nolwazi

2016-01-01

In the growing number of publications in medical anthropology about sub-Saharan Africa, there is a tendency to tell a single story of medicine, health, and health-seeking behavior. The heavy reliance on telling this singular story means that there is very little exposure to other stories. In this article, I draw on five books published in the past five years to illustrate the various components that make up this dominant narrative. I then provide examples of two accounts about medicine, health, and health-seeking behavior in Africa that deviate from this dominant narrative, in order to show the themes that alternative accounts have foregrounded. Ultimately, I make a plea to medical anthropologists to be mindful of the existence of this singular story and to resist the tendency to use its components as scaffolding in their accounts of medicine, health, and health-seeking behavior in Africa.

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking.

PubMed

Hill, Erin M

2016-07-01

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.

Linkages between mental health need and help-seeking behavior among adolescents: Moderating role of ethnicity and cultural values

PubMed Central

Guo, Sisi; Nguyen, Hannah; Weiss, Bahr; Ngo, Victoria; Lau, Anna S.

2015-01-01

Risk of developing of emotional and behavioral mental health problems increases markedly during adolescence. Despite this increasing need, most adolescents, particularly ethnic minority youth, do not seek professional help. Informed by conceptual models of health behavior, the current study examined how cultural values are related to help-seeking among adolescents from two distinct racial/ethnic groups. In a prospective survey design, 169 10th and 11th grade Vietnamese American and European American youth reported on their mental health need, as measured by emotional/behavioral mental health symptoms and stressful life events, with participants reporting on their help-seeking behavior at 6-month follow-up assessments. Multinomial logistic regression analyses indicated that mental health need interacted with cultural values and ethnicity to predict help-seeking behavior. Specifically, associations between symptoms and stressful life events, and help-seeking behavior were smaller among Vietnamese American adolescents, and among adolescents with strong family obligation values. These results underscore the complex sociocultural factors influencing adolescents’ help-seeking behavior, which have important implications for engaging youth in needed mental health care. PMID:26376178

Psychometric evaluation of the Korean Version of the Self-Efficacy for Exercise Scale for older adults.

PubMed

Choi, Mona; Ahn, Sangwoo; Jung, Dukyoo

2015-01-01

We evaluated the psychometric properties of the Korean version of the Self-Efficacy for Exercise Scale (SEE-K). The SEE-K consists of nine items and was translated into Korean using the forward-backward translation method. We administered it to 212 community-dwelling older adults along with measures of outcome expectation for exercise, quality of life, and physical activity. The validity was determined using confirmatory factor analysis and Rasch analysis with INFIT and OUTFIT statistics, which showed acceptable model fit. The concurrent validity was confirmed according to positive correlations between the SEE-K, outcome expectation for exercise, and quality of life. Furthermore, the high physical activity group had higher SEE-K scores. Finally, the reliability of the SEE-K was deemed acceptable based on Cronbach's alpha, coefficients of determination, and person and item separation indices with reliability. Thus, the SEE-K appears to have satisfactory validity and reliability among older adults in South Korea. Copyright © 2015 Elsevier Inc. All rights reserved.

Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

PubMed Central

2012-01-01

Background The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study. PMID:22894551

Quantitative and Qualitative Evaluations of the Enhanced Logo-autobiography Program for Korean-American Women.

PubMed

Sung, Kyung Mi; Bernstein, Kunsook

2017-12-01

This study extends Bernstein et al.'s (2016) investigation of the effects of the Enhanced Logo-autobiography Program on Korean-American women's depressive symptoms, coping strategies, purpose in life, and posttraumatic growth by analyzing quantitative and qualitative data. This study's participants significantly improved on quantitative measures of depression, coping strategies, purpose in life, and post-traumatic growth at eight weeks post-intervention and follow-up. The qualitative content analysis revealed 17 themes with five essential themes. The program's activity to promote purpose in life through posttraumatic growth facilitated participants' recovery from traumatic experiences. Standardized guidelines are needed to conduct this program in Korean community centers.

Work and Life Balance: Community College Occupational Deans

ERIC Educational Resources Information Center

Bailey, Jean M.

2008-01-01

This article focuses on work and life balance from a community college occupational dean perspective. It addresses definitions and concepts of work life and the nature of the role of occupational dean. The themes from this study include the use of time both at work and away from work, work/life crossover, perception of work/life, and work/life…

Overactive bladder symptom severity, bother, help-seeking behavior, and quality of life in patients with type 2 diabetes: a path analysis.

PubMed

Xu, Dongjuan; Zhao, Meng; Huang, Liqun; Wang, Kefang

2018-01-02

This study aimed to investigate the relationships among overactive bladder (OAB) symptom severity, bother, help-seeking behavior, and quality of life (QOL) in patients with type 2 diabetes. A total of 127 diabetic patients, aged at least 18 years, with overactive bladder from a hospital in Shandong Province, China, were recruited for this study. Symptom severity, bother, and quality of life were assessed using the Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and Overactive Bladder Questionnaire Short Form (OAB-q SF), respectively. Help-seeking behavior was assessed by asking patients whether they consulted health care professionals or received treatment for their bladder problems. A two-step path analysis was performed to analyze the data. OAB symptom severity was directly associated with lower levels of QOL, and the strength of this association was no longer significant when taking bother and help-seeking behavior into account. Bother increased with OAB symptom severity, and patients with bothersome OAB tended to have lower levels of QOL. Moreover, bother increased help-seeking behavior; however, patients who sought help tended to have lower levels of QOL. Our findings highlight the role of bother and help-seeking behavior in the relationship between OAB symptom severity and QOL. To improve a patient's QOL, health care providers should focus not only on symptom bother but also on dysfunctional help-seeking patterns.

Lived experience of epilepsy from the perspective of children in Taiwan.

PubMed

Chen, Hsiu-Jung; Chen, Yueh-Chih; Yang, Hui-Chuan; Chi, Ching-Shiang

2010-05-01

The purpose of this study was to explore the lived experiences of school-aged children with epilepsy in Taiwan. Epilepsy affects many people worldwide, especially school-aged children, but few studies have examined children's viewpoints of their experiences with epilepsy. An exploratory, phenomenological interview design was used. Children (ages 7-12 years) with well-controlled epilepsy and no developmental delay were recruited from a hospital in central Taiwan. Data were collected from 15 children using a semi-structured interview guide. Interviews were tape-recorded with permission from parents and children. Verbatim transcripts were analysed using Colazzi's phenomenological method. Two themes emerged from the analysis. The first theme, 'living with epilepsy', had two subthemes: disease-related experiences and school-related issues. The second theme, 'coping with epilepsy', had two subthemes: developing strategies to manage or reduce seizures and seeking support from family members. Taiwanese children with epilepsy had similar lived experiences as their counterparts in Western culture, e.g. unpleasant somatic symptoms, difficulty learning and troubled peer relationships. Taiwanese children also coped similarly with epilepsy by taking medications to control seizures, but they differed from their Western counterparts in trying to self-manage seizures and seeking support from family members. Public health and school nurses can apply our findings to educate school teachers and parents about epilepsy and encourage activities that allow children with and without epilepsy to interact, thus improving peer relationships and reducing stigmatisation. Children with and without epilepsy would also benefit from an age-appropriate education manual that includes causes of epilepsy, treatment, dealing with seizures and psychological and social adaptation.

Designing a Leadership Development Program for Surgeons

PubMed Central

Jaffe, Gregory A.; Pradarelli, Jason C.; Lemak, Christy Harris; Mulholland, Michael W.; Dimick, Justin B.

2015-01-01

Background Although numerous leadership development programs exist in healthcare, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons’ motivations and desired goals for leadership training in order to design an evidence-based Leadership Development Program (LDP) in surgery. Materials and Methods At a large academic health center, we conducted semi-structured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding in order to extract major themes regarding surgeons’ motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Results Three major themes emerged regarding surgeons’ motivations for seeking leadership training: 1) Recognizing key gaps in their formal preparation for leadership roles; 2) Exhibiting an appetite for personal self-improvement; and 3) Seeking leadership guidance for career advancement. Participants’ interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a leadership development program: 1) leadership and communication; 2) team building; 3) business acumen/finance; and 4) greater understanding of the healthcare context. Conclusions Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A Leadership Development Program that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. PMID:26323368

Compensatory help-seeking in young and older adults: does seeking help, help?

PubMed

Alea, Nicole; Cunningham, Walter R

2003-01-01

Asking other people for help is a compensatory behavior that may be useful across the life span to enhance functioning. Seventy-two older and younger men and women were either allowed to ask for help or were not allowed to ask for help while solving reasoning problems. Although the older adults answered fewer problems correctly, they did not seek additional help to compensate for their lower levels of performance. Younger adults sought more help. There were no age differences, however, in the types of help sought: indirect help (e.g., hints) was sought more often than direct help (e.g., asking for the answer). Exploratory analyses revealed that one's ability level was a better indicator than age of the utility of help-seeking. Findings are interpreted in the context of social and task-related influences on the use of help-seeking as a compensatory behavior across the life span.

Impulsivity as a Moderator and Mediator between Life Stress and Pathological Gambling among Chinese Treatment-Seeking Gamblers

ERIC Educational Resources Information Center

Tang, Catherine So-kum; Wu, Anise M. S.

2012-01-01

This study examined the role of impulsivity and its interplay with gambling correlates in influencing the severity of pathological gambling in Chinese societies. It also investigated the extent to which impulsivity would moderate and/or mediate the relationship between life stress and pathological gambling in 94 Chinese treatment-seeking gamblers.…

Living with the health and social inequities of a disability: a critical feminist study.

PubMed

Bethune-Davies, Patricia; McWilliam, Carol L; Berman, Helene

2006-03-01

Clients living at home with chronic disabling conditions together with their caregivers, service providers, and policymakers face major challenges in optimizing health care. In this critical feminist interpretive study we examined the experiences of women receiving home care for chronic disabling conditions. Five themes emerged: struggling with the embodied limitations of disabling chronic conditions; actively seeking health; struggling with service limitations; seeking ways to manage; and living with isolation and marginalization. Having done this study, we learned that home care services do not always contribute sufficiently to the overall health and well-being of women living with chronic disabling conditions and, in fact, may negatively impact upon their health.

Comparing Help-Seeking Behavior of Male and Female Survivors of Sexual Assault: A Content Analysis of a Hotline.

PubMed

Young, Stephen M; Pruett, Jana A; Colvin, Marianna L

2018-06-01

This content analysis examines written documentation of telephone calls to a regional sexual assault hotline over a 5-year period. All male callers identified as primary victims were selected for analysis ( n = 58) and a corresponding sample of female primary victims ( n = 58) were randomly selected for comparison to better understand the help-seeking behavior of sexual assault survivors and inform services accordingly. A summative content analysis revealed significant contrasting themes between male and female victims, including females significantly receiving more referrals and males accessing the hotline to tell their experience of being sexually assaulted due to perceived limited support. Implications for training, practice, and future research are discussed.

Celebrating Geography: Geography in Everyday Life.

ERIC Educational Resources Information Center

Fitzhugh, William P.

The paper suggests that the five fundamental themes of geography can serve as a good starting point for understanding how geography affects lives everyday in every way. Geography serves to remind people how interwoven geographic concepts are in individuals' lives. Ten activities are suggested to incorporate the five fundamental themes into a…

Mathematics and Science across the Curriculum.

ERIC Educational Resources Information Center

Thorson, Annette, Ed.

2002-01-01

This issue, intended for classroom teachers, provides a collection of essays organized around the theme of mathematics and science across the curriculum as well as a guide to instructional materials related to the theme. Topics addressed in the essays include experiencing mathematics through nature; connecting science, fiction, and real life;…

Collage as a Mirror of Society

ERIC Educational Resources Information Center

Bae, Jaehan

2009-01-01

A thematic approach toward teaching art is integral because it serves as art for life's sake. Ecology of place, which is a main theme, defines relationships between plants, animals, people, and their environment. Sub-themes include recycling, pollution, acid rain, and global warming. As collage is an excellent artistic avenue for visual…

Quality of life in late-life disability: "I don't feel bitter because I am in a wheelchair".

PubMed

King, Jennifer; Yourman, Lindsey; Ahalt, Cyrus; Eng, Catherine; Knight, Sara J; Pérez-Stable, Eliseo J; Smith, Alexander K

2012-03-01

To determine perceived quality of life in a diverse population of elderly adults with late-life disability. Qualitative cross-sectional study. Community-dwelling participants were recruited from San Francisco's On Lok Lifeways program, the first Program of All-inclusive Care for the Elderly. On Lok enrollees meet Medicaid criteria for nursing home placement. Sixty-two elderly adults with a mean age of 78 and a mean 2.4 activity of daily living dependencies and 6.6 instrumental activity of daily living dependencies were interviewed. Respondents were 63% female, 24% white, 19% black, 18% Latino, 32% Chinese American, and 6% other race. Elderly adults who scored higher than 17 points on the Mini-Mental State Examination were interviewed. Interviews were conducted in English, Spanish, and Cantonese. Respondents were asked to rate their overall quality of life on a 5-point scale. Open-ended questions explored positive and negative aspects of participants' daily experiences. Interviews were analyzed using modified grounded theory and digital coding software. Eighty-seven percent of respondents rated their quality of life in the middle range of the quality-of-life spectrum (fair to very good). Themes were similar across ethnic groups. Most themes could be grouped into four domains that dependent elderly adults considered important to their quality of life: physical (e.g., pain), psychological (e.g., depression), spiritual or religious (e.g., religious coping), and social (e.g., life-space). Dignity and a sense of control were identified as themes that are the most closely tied to overall quality of life. Factors that influence quality of life in late-life disability were similar across ethnic groups. As the number of elderly adults from diverse backgrounds with late life disability increases in the United States, interventions should be targeted to maximize daily sense of control and dignity. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Experiences of experts about the instances of plagiarism

PubMed Central

Keyvanara, Mahmod; Ojaghi, Rezvan; Sohrabi, Mozafar Cheshmeh; Papi, Ahmad

2013-01-01

Introduction: Plagiarism is defined as intentional deceiving or lack of honesty, which deprives others from both material and spiritual possessions. Ethics is considered as one of the most important aspects of evaluating the quality of higher education. Moreover, scientific ethics should be reflected from university values, as a specialized institution, rather than being a reflection of the others cares. Therefore, the main aim of the present study is explore of expert experiences about plagiarism in Isfahan University of Medical Sciences. Materials and Methods: This study employed qualitative method with using in-deep interview. The research participants consisted of 21, who tend to this work. Semi structure interview were conducted and recorded. The method of analyzing data was ‘thematic analysis’. The data were transcribed and saved on computer after each interview. Themes and sub-themes were extracted. Finally, relevant sub-themes were arranged in a category and suggested were presented. Result: Analyzing data showed 600 primary codes, 40 sub-themes and 6 themes. The main themes included repeated works, non-normative adoption, non-normative adaptation, shares distribution, forging, and profit-seeking, each of which consisted of one or several subgroups. Conclusion: The findings of this study show that since, there are numerous ways of cheating, the universities’ research committees must create institutions in order to educate the individuals how to avoid plagiarism. In addition, providing information about different types of scientific violations, as well as their following punishments might lead to the decrease of such misbehaviors. PMID:24083282

What's eating the internet? Content and perceived harm of pro-eating disorder websites.

PubMed

Steakley-Freeman, Diana M; Jarvis-Creasey, Zachary L; Wesselmann, Eric D

2015-12-01

The internet is a popular tool for information dissemination and community building, serving many purposes from social networking to support seeking. However, there may be a downside to using some online support communities. For individuals with eating disorders (EDs), it is possible that certain online communities may reinforce the negative social aspects that encourage these disorders, rather than positive aspects that would facilitate treatment and recovery. Previous research identified several linguistic themes present on pro-eating disorder websites in an attempt to better understand the web-based conversation in the pro-eating disorder movement. We hypothesized that differences in theme presentation may predict changes in perceived harm. The present study sought to understand the perceived harm, and presentation patterns of pro-eating disorder (Pro-ED) website content. We replicated and extended previous research by having laypersons code these websites' content using previously identified linguistic themes and rate perceived harm. Our data replicate and extend the previous research by finding the same associations between co-occurring themes, and investigating associated perceived harm. We found that themes of Sacrifice, Control, Deceit, and Solidarity were associated with the highest perceived harm scores. In addition, we suggest an initial conceptualization of the "Eating Disorder Lifestyle", and its associations with the themes of Isolation, Success, and Solidarity. This research may provide clinicians with information to better understand the potential influence these sites have on eating disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Quality of life and functional vision concerns of children with cataracts and their parents.

PubMed

Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

2016-09-01

PurposeTo identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves.MethodsIndividual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5-17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme.ResultsRegarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%).ConclusionsA wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts.

Quality of life and functional vision concerns of children with cataracts and their parents

PubMed Central

Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

2016-01-01

Purpose To identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves. Methods Individual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5–17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme. Results Regarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%). Conclusions A wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts. PMID:27391939

YY v TURKEY: INFERTILITY AS A PRE-CONDITION FOR GENDER CONFIRMATION SURGERY.

PubMed

Dunne, Peter

2015-01-01

In YY v Turkey, the Second Chamber of the European Court of Human Rights (ECtHR) held that Turkey's refusal, over a period of many years, to authorise gender confirmation surgery because the applicant remained capable of procreating was a violation of the right to private life under Art. 8 of the European Convention on Human Rights. The Second Chamber's judgment acknowledges, and gives practical effect to, the 'physical and moral security' of transgender persons. YY has the potential to revolutionise gender confirming health care in Europe and will hopefully ensure that, where individuals do seek to medically transition, they need only access to treatments that are both necessary and desired. The ECtHR's decision may also impact upon the legal recognition of transgender identities. While not the direct focus of the Second Chamber's assessment, legal gender recognition is a constant theme throughout the judgment, and many of the Court's arguments are equally applicable to legal schemes for acknowledging preferred gender. © The Author 2015. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Impact of Respite Programming on Caregiver Resilience in Dementia Care: A Qualitative Examination of Family Caregiver Perspectives

PubMed Central

Roberts, Emily; Struckmeyer, Kristopher M.

2018-01-01

Family members with a relative with dementia often experience what has been called the “unexpected career of caregiver” and face multifaceted, complex, and stressful life situations that can have important consequences. This exploratory study was designed to address this major public health challenge through the lens of caregiver resilience and caregiver respite programming. While many caregivers report that they derive significant emotional and spiritual rewards from their caregiving role, many also experience physical and emotional problems directly related to the stress and demands of daily care. One way to alleviate these demands is the growing respite care field, providing services in a variety of settings for caregiver. Through qualitative analysis from face-to-face interviews with 33 family caregivers of individuals with dementia, several themes emerged describing the path to caregiver resilience which include family dynamics, isolation, financial struggles, seeking respite, and acceptance. While much research focuses on a caregiving burden perspective, the innovation of the present study is applying the resilience framework to outcomes from respite programming. PMID:29424252

Looking at the Camp: Paleolithic Depiction of a Hunter-Gatherer Campsite.

PubMed

García-Diez, Marcos; Vaquero, Manuel

2015-01-01

Landscapes and features of the everyday world were scarcely represented in Paleolithic art, especially those features associated with the human landscape (huts and campsites). On the contrary, other figurative motifs (especially animals) and signs, traditionally linked to the magic or religious conceptions of these hunter-gatherer societies, are the predominant themes of Upper Paleolithic art. This paper seeks to present an engraved schist slab recently found in the Molí del Salt site (North-eastern Iberia) and dated at the end of the Upper Paleolithic, ca. 13,800 years ago. This slab displays seven semicircular motifs that may be interpreted as the representation of dome-shaped huts. The analysis of individual motifs and the composition, as well as the ethnographic and archeological contextualization, suggests that this engraving is a naturalistic depiction of a hunter-gatherer campsite. Campsites can be considered the first human landscape, the first area of land whose visible features were entirely constructed by humans. Given the social meaning of campsites in hunter-gatherer life-styles, this engraving may be considered one of the first representations of the domestic and social space of a human group.

'Depression is not an illness. It's up to you to make yourself happy': Perceptions of Chinese health professionals and community workers about older Chinese immigrants' experiences of depression and anxiety.

PubMed

Haralambous, Betty; Dow, Briony; Goh, Anita; Pachana, Nancy A; Bryant, Christina; LoGiudice, Dina; Lin, Xiaoping

2016-12-01

The aim of this study was to improve our understanding of depression and anxiety among older immigrant Chinese Australians. The study was based on the National Ageing Research Institute's Cultural Exchange Model, an iterative process of exchange between researchers and stakeholders. The project involved a range of components including consultations with health professionals and community workers about perceptions of depression and anxiety within the Chinese community. This paper reports on these consultation findings. Thematic analysis generated five main categories to explain participants' perceptions of depression and anxiety within the Chinese community. Themes included: lack of knowledge; personal weakness rather than illness; stigma; somatisation; and experience of migration in later life. Responses to questions about education and information dissemination were collated separately and reported. Views of depression and anxiety among older Chinese people suggest that educating the community may be an important way to improve mental health literacy and help-seeking behaviour. © 2016 AJA Inc.

[Social actors in HIV/AIDS prevention: opposition and interests in educational policy in Mexico, 1994-2000].

PubMed

Granados-Cosme, José Arturo; Nasaiya, Kittipong; Brambila, Alberto Torres

2007-03-01

Studies and recommendations by health agencies have emphasized the importance of education in HIV-AIDS prevention. Mexico has included topics on sexuality and HIV-AIDS in school programs, triggering resistance by some social actors. The current study seeks to clarify the various positions and interests and their influence on the textbook content. A literature search was conducted on the period during which the last educational reform was implemented in Mexico. The discourse analysis focused on the ethnography of communication, which identified: the various actors' positions, arguments, actions, economic and political power, and relations to others. The results show that those who oppose the inclusion of these themes in the school curriculum base their position on tradition, contrary to modernization and secularization of social life, and that their positions range from refusal to raising conditions. Networks have been formed that provide such groups with significant economic and political power. Government has given in to some demands by partially modifying the textbook contents. The current analysis proposes to reflect on the potential repercussions of such actions on the control of the epidemic.

"Is it realistic?" the portrayal of pregnancy and childbirth in the media.

PubMed

Luce, Ann; Cash, Marilyn; Hundley, Vanora; Cheyne, Helen; van Teijlingen, Edwin; Angell, Catherine

2016-02-29

Considerable debate surrounds the influence media have on first-time pregnant women. Much of the academic literature discusses the influence of (reality) television, which often portrays birth as risky, dramatic and painful and there is evidence that this has a negative effect on childbirth in society, through the increasing anticipation of negative outcomes. It is suggested that women seek out such programmes to help understand what could happen during the birth because there is a cultural void. However the impact that has on normal birth has not been explored. A scoping review relating to the representation of childbirth in the mass media, particularly on television. Three key themes emerged: (a) medicalisation of childbirth; (b) women using media to learn about childbirth; and (c) birth as a missing everyday life event. Media appear to influence how women engage with childbirth. The dramatic television portrayal of birth may perpetuate the medicalisation of childbirth, and last, but not least, portrayals of normal birth are often missing in the popular media. Hence midwives need to engage with television producers to improve the representation of midwifery and maternity in the media.

[Surviving the initial phase: subjective theories of illness in patients suffering from acute leukaemia at the end of initial inpatient treatment].

PubMed

Koehler, Katharina; Dogan, Elif; Koehler, Michael; Heine, Viktoria; Frommer, Jörg

2011-01-01

Studies concentrating on the temporal dependence of subjective concepts during oncological treatment are underrepresented. Subjective interpretation contexts develop in the course of illness. The study focuses on the ideal-typical gestalt of these contents. In a follow-up study on coping, 12 patients with acute leukaemia (AL) were interviewed using a semistructured interview at the end of initial inpatient treatment. Using qualitative methodology, we inductively developed categories and assigned them to formal main categories. The following categories were developed: causal uncertainty as burden; discrepancy between subjective and objective assessment of degree of threat; knowledge of disease: conflict between information-seeking and information-avoiding behavior; dominance of medical approach to treatment; pursuit of normality; defense of emotions; orientation to workflows on the ward; adjustment as a coping strategy; positive attitude as a resource; life between hope and fear; limited future; latent fear of death. Themes of coping with the disease become visible. Some of these contents are tacit and latent, although of high subjective relevance to the patient. Their consideration could improve the patient-physician relationship.

[The use of metaphors to express toothache: a study in the field of the anthropology of health].

PubMed

Lucas, Simone Dutra; Mattos, Flávio de Freitas; Melo, João Augusto do Carmo; Vasconcelos, Mara; Abreu, Mauro Henrique Nogueira Guimaraes de; Ferreira, Natália Enes

2014-06-01

This research was conducted with patients who sought emergency care at a Comprehensive Primary Care Clinic (CIAP IV) at the Dental School of Minas Gerais Federal University and at the Dental Center of a medium-sized city in the state of Minas Gerais. The scope of this article is to identify how the social representations of this issue are generated through the metaphors used by patients to express toothache. A total of 35 individuals of both genders who sought emergency care for toothache participated in the study. Content theme analysis was used. Social representations of toothache are generated as people resort to their life experiences to find words to express the problem. Prior sensations and feelings, and even imaginary situations, generate metaphors to attempt to explain the suffering. Toothache is often compared with the worst feelings ever experienced by individuals. Toothache represents great suffering for people seeking emergency dental care. This fact may help to develop further public oral health policies, bearing in mind that a socially deprived population is more often afflicted by toothache.

Perceptions of family caregivers of cancer patients about the challenges of caregiving: a qualitative study.

PubMed

Nemati, Shahnaz; Rassouli, Maryam; Ilkhani, Mahnaz; Baghestani, Ahmad Reza

2018-03-01

The experience of caring for a family member with cancer is associated with several care-related problems and challenges for the caregiver. The comprehensive and in-depth understanding of the trials and tribulations of caregiving can be a step towards resolving the problems faced by family caregivers of these patients. The present study aimed to explore challenges faced by Iranian family caregivers of cancer patients. The present qualitative study was conducted through in-depth semi-structured interviews held with 21 family caregivers of cancer patients selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analysed through conventional content analysis. The codes extracted from interviews produced four main themes, including 'confusion', 'uncertainty', 'disintegration' and 'setback', which collectively caused suffering for family caregivers. Care provided in an atmosphere of suffering and discontent diminishes caregiver's quality of life and quality of patient care. Health planners should therefore consider the challenges and sufferings faced by family caregivers and should seek to obviate them through appropriate plans. © 2017 Nordic College of Caring Science.

Overcoming challenges: life with an ostomy.

PubMed

Popek, Sarah; Grant, Marcia; Gemmill, Robin; Wendel, Christopher S; Mohler, M Jane; Rawl, Susan M; Baldwin, Carol M; Ko, Clifford Y; Schmidt, C Max; Krouse, Robert S

2010-11-01

Studies have demonstrated decreased health-related quality of life in patients with stomas. Using US Department of Veterans Affairs electronic medical records, veterans with stomas were surveyed using the City of Hope Quality of Life-Ostomy questionnaire. Focus groups were conducted segregated by type of stoma (ileostomy vs colostomy) and quality-of-life score (high vs low). Qualitative analysis was performed on the basis of the City of Hope Quality of Life for Ostomates format of health-related quality of life (physical, psychological, social, and spiritual). The findings of the colostomy focus groups are reported. Two new domains emerged: colostomy specific and health care specific. The most common domains discussed were colostomy specific, psychological, and social. The most frequently discussed colostomy-specific theme was effective and ineffective solutions to colostomy care. Family and spousal relationships were the main theme from the psychological category. The predominant social issue was sexual relationships. Awareness of patients' social, psychological, and medical status allows surgeons to identify those likely to have problems and devote resources to those veterans. Published by Elsevier Inc.

Sociostructural factors influencing health behaviors of urban African-American men.

PubMed

Plowden, Keith O; Young, Anthony E

2003-06-01

African-American men are suffering disproportionately from most illnesses. Seemingly, action is needed if health disparities that disproportionately affect African-American men as compared to their White and female counterparts are to be reduced or eliminated. An important step in decreasing common health disparities evidenced among African-American men is to understand social factors that act as motivators and barriers to seeking care for most of this vulnerable population. Following a constructionist epistemology, this study used ethnography to explore social structure factors that motivate urban African-American men to seek care. Leininger's Culture Care Diversity and Universality Theory guided this study. Qualitative interviews were conducted with urban African-American men and other individuals in the community to explore understanding, attitudes, and beliefs about health. Critical issues examined included social factors associated with health seeking behaviors. Themes that emerged from these data indicated that critical social factors include: 1) Kinship/significant others; 2) accessibility of resources; 3) ethnohealth belief; and 4) accepting caring environment. The data also indicated a relationship between these social factors and health seeking behaviors of urban African-American men.

Parental professional help-seeking for infant sleep.

PubMed

Hsu, Pei-Wen; Wu, Wei-Wen; Tung, Yi-Ching; Thomas, Karen A; Tsai, Shao-Yu

2017-12-01

To explore the perceptions and experiences of parental professional help-seeking for infant sleep and sleep-related concerns. Infant sleep is a frequent concern for parents. However, very little is known about the reasons parents seek, do not seek or delay seeking professional attention about their concerns related to infant sleep. A qualitative study design was used. Twenty audio-taped interviews with parents of healthy 12-month-old infants were conducted at a university-affiliated hospital or parents' homes depending on where parents felt more comfortable discussing their personal views and medical help-seeking experiences. Thematic content analysis was performed to determine specific patterns and similarities within and between interview data. Three main themes developed from the interviews were as follows: (i) uncertainty about infant sleep; (ii) I can handle infant sleep; and (iii) I am not satisfied with the professional services provided for infant sleep. Overall, parents knew little about or misunderstood infant sleep behaviours. Lack of proper information and knowledge about infant sleep influenced parents' motivation for professional help-seeking and help-receiving. Parents who have consulted a healthcare professional but received unsatisfactory responses, such as an ambivalent attitude or insufficient assessment, reported being less motivated or unwilling to seek medical help again. Our study demonstrates the complexity of parental professional help-seeking and receiving for infant sleep. Findings suggest that parents perceive a wide range of barriers that influence the likelihood that they will seek professional advice for infant sleep. Reducing knowledge barriers and providing adequate attention at all well-infant visits would facilitate parental use of healthcare services to manage problematic infant sleep behaviours. © 2017 John Wiley & Sons Ltd.

The Information Seeking and Use Behaviors of Retired Investors

ERIC Educational Resources Information Center

O'Connor, Lisa G.

2013-01-01

This exploratory study examines the information seeking and use behaviors of a group of US retired or near-retirement investors from everyday life information seeking and serious leisure perspectives. Although primarily qualitative, it also collects and analyzes quantitative data to describe retired investors' information preferences and use.…

User Experience and Care Integration in Transitional Care for Older People From Hospital to Home: A Meta-Synthesis.

PubMed

Allen, Jacqueline; Hutchinson, Alison M; Brown, Rhonda; Livingston, Patricia M

2017-01-01

This meta-synthesis aimed to improve understanding of user experience of older people, carers, and health providers; and care integration in the care of older people transitioning from hospital to home. Following our systematic search, we identified and synthesized 20 studies, and constructed a comprehensive framework. We derived four themes: (1) 'Who is taking care of what? Trying to work together"; (2) 'Falling short of the mark'; (3) 'A proper discharge'; and (4) 'You adjust somehow.' The themes that emerged from the studies reflected users' experience of discharge and transitional care as a social process of 'negotiation and navigation of independence (older people/carers), or dependence (health providers).' Users engaged in negotiation and navigation through the interrogative strategies of questioning, discussion, information provision, information seeking, assessment, and translation. The derived themes reflected care integration that facilitated, or a lack of care integration that constrained, users' experiences of negotiation and navigation of independence/dependence. © The Author(s) 2016.

Object relations perspectives on "Phantom of the Opera" and its demon lover theme: the modern film.

PubMed

Kavaler-Adler, Susan

2009-06-01

This study of the modern film version of "Phantom of the Opera" employs a mythic theme to illustrate how women can involve themselves with charismatic and eroticized narcissistic men, who are unavailable for true relationship within the conscious world of societal connection. How can the healthy-heroic woman extricate herself from the seductive web of such men, men who seek to own the women--not through sexual relations--but through ownership and control of the women's creative talents? What are the developmental, internal world, dynamics that spell out the muse turned demon/lover theme in British and American Object Relations terms? Similar to the mythic vampire who entrances women to suck their blood, the male muse haunts the female artist to possess her talents. The "demon lover" creates himself to woo the unsuspecting female with potential but yet unrealized creative talents. He woos through entrancement, like so many psychologically wounded narcissistic characters who require mirroring to have any sense of existence!

Exploring awareness and help-seeking intentions for testicular symptoms among heterosexual, gay, and bisexual men in Ireland: A qualitative descriptive study.

PubMed

Saab, Mohamad M; Landers, Margaret; Hegarty, Josephine

2017-02-01

The incidence of malignant and benign testicular disorders among young men is on the rise. Evidence from three reviews suggest that men's knowledge of these disorders is lacking and their help-seeking intention for testicular symptoms is suboptimal. Qualitative studies have addressed men's awareness of testicular cancer, with none exploring their awareness of non-malignant diseases such as epididymitis, testicular torsion, and varicocele and none including sexual minorities. To explore, in-depth, heterosexual, gay, and bisexual men's awareness of testicular disorders and their help-seeking intentions for testicular symptoms in the Irish context. This study used a qualitative descriptive approach. Data were collected via face-to-face individual interviews and focus groups. Participation was sought from a number of community and youth organisations and one university in Southern Ireland. Maximum variation and snowball sampling were used to recruit a heterogeneous sample. A total of 29 men partook in this study. Participants were men, aged between 18 and 50 years, and residents of the Republic of Ireland. All interviews were audio-recorded and transcribed verbatim. Reflective field notes were taken following each interview. A summary of the interview was shared with selected participants for member-check. Data were analysed and validated by three researchers. Inductive qualitative analysis of manifest content was used. Latent content was captured in the field notes. Data analysis yielded two key themes. The themes that emerged from the interviews were: Awareness of testicular disorders and their screening, and help-seeking intentions for testicular symptoms. Although most participants heard of testicular cancer, most did not know the different aspects of this malignancy including its risk factors, symptoms, treatments, and screening. Several men had a number of misconceptions around testicular disorders which negatively impacted their intentions to seek prompt help. Intentions to delay help-seeking for testicular symptoms were often linked to a number of emotional factors including fear and embarrassment, and social normative factors such as machoism and stoicism. In this study, culture was perceived by some participants as a barrier to awareness and help-seeking. In contrast, many believed that young men, especially those who self-identify as gay, are becoming increasingly interested in their own health. Findings suggest the need to educate young men about testicular disorders and symptoms. This could be achieved through conducting health promotion campaigns that appeal to younger men, drafting national men's health policies, and normalising open discussions about testicular health at a young age. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nurses' attitudes to assisted suicide: sociodemographic factors.

PubMed

Evans, Luke

This literature review seeks to explore the factors that influence nurses' attitudes towards assisted suicide. A poll conducted by the Royal College of Nursing (RCN) showed that 49% of nurses supported assisted suicide while 40% were opposed to it. A literature review resulted in 16 articles being identified for data synthesis using a recognised critiquing framework. The articles revealed four key themes: nursing specialty, level of education, geographical location and religion. It was concluded that these four themes are key to understanding a nurse's attitude towards assisted suicide. Nursing staff need to be aware of their own influences on this topic, since they will inevitably be involved in the process in some way or another, in countries where assisted suicide has been legalised.

[Mercosur's regional health agenda: architecture and themes].

PubMed

Queiroz, Luisa Guimaraes; Giovanella, Ligia

2011-08-01

This article describes the shaping of institutional health spaces in the Mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. We discuss the organization, operation, focus topics, and results achieved in specific health forums (Meeting of Ministers of Health and Sub-Working Group 11), seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the European experience. The aim of this reflection is to identify how the work done by Mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.

Everyday Life with ALS: A Practical Guide

MedlinePlus

... best possible quality of life. A major theme running through this guide is the importance of planning ... glass when drinking. This knife has a curved blade and an enlarged handle. You can cut food ...

Decision making processes in people with symptoms of acute myocardial infarction: qualitative study

PubMed Central

Pattenden, Jill; Watt, Ian; Lewin, Robert J P; Stanford, Neil

2002-01-01

Objective To identify the themes that influence decision making processes used by patients with symptoms of acute myocardial infarction. Design Qualitative study using semistructured interviews. Setting Two district hospitals in North Yorkshire. Participants 22 patients admitted to hospital with confirmed second, third, or fourth acute myocardial infarction. Main outcome measure Patients' perceptions of their experience between the onset of symptoms and the decision to seek medical help. Results Six main themes that influence the decision making process were identified: appraisal of symptoms, perceived risk, previous experience, psychological and emotional factors, use of the NHS, and context of the event. Conclusions Knowledge of symptoms may not be enough to promote prompt action in the event of an acute myocardial infarction. Cognitive and emotional processes, individual beliefs and values, and the influence of the context of the event should also be considered in individual interventions designed to reduce delay in the event of symptoms of acute myocardial infarction. What is already known on this topicIndividual sociodemographic and clinical characteristics affect the time to seeking medical care in patients with symptoms of acute myocardial infarctionAppraisal of symptoms is difficult; people with classic and severe symptoms are more likely to take prompt actionWhat this study addsThe decision to seek medical help in patients who have had one or more previous myocardial infarctions is a complex processSimply providing patients with information on symptoms of acute myocardial infarction, and what to do in the event of these symptoms, may not be sufficient to promote prompt action PMID:11976241

Living with sensor-augmented pump therapy in type 1 diabetes: adolescents' and parents' search for harmony.

PubMed

Rashotte, Judy; Tousignant, Kelley; Richardson, Christine; Fothergill-Bourbonnais, Frances; Nakhla, Meranda M; Olivier, Patricia; Lawson, Margaret L

2014-08-01

Adolescents have difficulty successfully sustaining use of continuous glucose monitoring even when it is introduced to experienced pump users. However, little is known about how adolescents and parents perceive and manage sensor-augmented pump therapy (SAPT) in daily life. The purpose of this study was to explore adolescents' and parents' daily experience of living with SAPT. We used an interpretive phenomenological study design. We conducted in-depth, digitally recorded interviews with 7 adolescents and 9 parents recruited through 1 Canadian pediatric diabetes program. Adolescents who participated were 13 to 17 years of age with type 1 diabetes mellitus and had experience (current or past) living with SAPT. Transcripts of the interviews were subjected to a thematic analysis guided by the procedure outlined by Colaizzi. The overarching theme, seeking harmony, reflected adolescents' and parents' daily struggles with balancing multiple tensions that arose from managing SAPT and harmonizing seemingly opposing choices that were brought to the fore, while also struggling to live with both wellness and chronic illness. Four themes constituted the struggle to find harmony living with diabetes managed with SAPT: struggling with hopes and expectations for SAPT, being ready for SAPT, living the burdens of continuous glucose monitoring and creating partnerships. Healthcare providers can facilitate adolescent and parental decision-making about the optimal timing for SAPT introduction. Success with SAPT requires exploration of adolescent and parental expectations for SAPT as well as the degree to which parents have previously fostered their adolescent's involvement in and responsibility for diabetes management. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

The Emerging Diabetes Online Community

PubMed Central

Hilliard, Marisa E.; Sparling, Kerri M.; Hitchcock, Jeff; Oser, Tamara K.; Hood, Korey K.

2015-01-01

Abstract: Background Diabetes self-management is complex and demanding, and isolation and burnout are common experiences. The Internet provides opportunities for people with diabetes to connect with one another to address these challenges. The aims of this paper are to introduce readers to the platforms on which Diabetes Online Community (DOC) participants interact, to discuss reasons for and risks associated with diabetes-related online activity, and to review research related to the potential impact of DOC participation on diabetes outcomes. Methods Research and online content related to diabetes online activity is reviewed, and DOC writing excerpts are used to illustrate key themes. Guidelines for meaningful participation in DOC activities for people with diabetes, families, health care providers, and industry are provided. Results Common themes around DOC participation include peer support, advocacy, self-expression, seeking and sharing diabetes information, improving approaches to diabetes data management, and humor. Potential risks include access to misinformation and threats to individuals’ privacy, though there are limited data on negative outcomes resulting from such activities. Likewise, few data are available regarding the impact of DOC involvement on glycemic outcomes, but initial research suggests a positive impact on emotional experiences, attitudes toward diabetes, and engagement in diabetes management behaviors. Conclusion The range of DOC participants, activities, and platforms is growing rapidly. The Internet provides opportunities to strengthen communication and support among individuals with diabetes, their families, health care providers, the health care industry, policy makers, and the general public. Research is needed to investigate the impact of DOC participation on self-management, quality of life, and glycemic control, and to design and evaluate strategies to maximize its positive impact. PMID:25901500

The emerging diabetes online community.

PubMed

Hilliard, Marisa E; Sparling, Kerri M; Hitchcock, Jeff; Oser, Tamara K; Hood, Korey K

2015-01-01

Diabetes self-management is complex and demanding, and isolation and burnout are common experiences. The Internet provides opportunities for people with diabetes to connect with one another to address these challenges. The aims of this paper are to introduce readers to the platforms on which Diabetes Online Community (DOC) participants interact, to discuss reasons for and risks associated with diabetes-related online activity, and to review research related to the potential impact of DOC participation on diabetes outcomes. Research and online content related to diabetes online activity is reviewed, and DOC writing excerpts are used to illustrate key themes. Guidelines for meaningful participation in DOC activities for people with diabetes, families, health care providers, and industry are provided. Common themes around DOC participation include peer support, advocacy, self-expression, seeking and sharing diabetes information, improving approaches to diabetes data management, and humor. Potential risks include access to misinformation and threats to individuals' privacy, though there are limited data on negative outcomes resulting from such activities. Likewise, few data are available regarding the impact of DOC involvement on glycemic outcomes, but initial research suggests a positive impact on emotional experiences, attitudes toward diabetes, and engagement in diabetes management behaviors. The range of DOC participants, activities, and platforms is growing rapidly. The Internet provides opportunities to strengthen communication and support among individuals with diabetes, their families, health care providers, the health care industry, policy makers, and the general public. Research is needed to investigate the impact of DOC participation on self-management, quality of life, and glycemic control, and to design and evaluate strategies to maximize its positive impact.

Distancing at Close Range: Making Strange Devices in Dorothy Heathcote's Process Drama "Teaching Political Awareness through Drama"

ERIC Educational Resources Information Center

Eriksson, Stig A.

2011-01-01

By refocusing traditions preoccupied with stimulating critical reflection, the article seeks to contribute to a rekindling of a socially oriented drama teaching and to add to the reservoir of teacher reflection in the field. A passage of a drama by Dorothy Heathcote is analysed, in which the theme of pollution is the concrete starting point,…

Children's experiences of managing Type 1 diabetes in everyday life: a thematic synthesis of qualitative studies.

PubMed

Rankin, D; Harden, J; Jepson, R; Lawton, J

2017-08-01

To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices. Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis. Eighteen studies from five countries were included in the review. Synthesis of studies' findings resulted in the identification of three overarching analytical themes. The first theme, 'Understandings of diabetes and involvement in self-management', outlines ways in which children understand diabetes and develop self-management responsibilities. The second theme, 'Disruption to life and getting on with it', reports children's frustrations at disruptions to everyday life when managing diabetes, and how attempts to appear normal to family and friends affect self-management practices. The third theme, 'Friends' support', describes how friends' reactions and responses to diabetes affect children's ability to appear normal and willingness to disclose information about diabetes, and support provided by 'informed friends', or peers with diabetes. Although the synthesis has identified how children's everyday life experiences inform ways in which they undertake diabetes self-management, it was not possible to determine new ways to provide support. To help children optimise their glycaemic control, further work should be undertaken to identify their need for support and which takes into account the potential ways in which parents, friends and peers can offer assistance. © 2017 Diabetes UK.

Variation in narrative identity is associated with trajectories of mental health over several years.

PubMed

Adler, Jonathan M; Turner, Ariana F; Brookshier, Kathryn M; Monahan, Casey; Walder-Biesanz, Ilana; Harmeling, Luke H; Albaugh, Michelle; McAdams, Dan P; Oltmanns, Thomas F

2015-03-01

This article presents 2 longitudinal studies designed to assess the relationship between variability in narrative identity and trajectories of mental health over several years. In Study 1, core scenes from 89 late-mid-life adults' life stories were assessed for several narrative themes. Participants' mental health and physical health were assessed concurrently with the narratives and annually for the subsequent 4 years. Concurrent analyses indicated that the themes of agency, redemption, and contamination were significantly associated with mental health. Longitudinal analyses indicated that these same 3 themes were significantly associated with participants' trajectories of mental health over the course of 4 years. Exploratory analyses indicated that narratives of challenging experiences may be central to this pattern of results. In Study 2, similar longitudinal analyses were conducted on a sample of 27 late-mid-life adults who received a major physical illness diagnosis between the baseline assessment and 6 months later and a matched sample of 27 control participants who remained healthy throughout the study. Participants' mental health and physical health were assessed every 6 months for 2 years. In this study, the themes of agency, communion, redemption, and contamination in participants' life narratives collected at baseline (before any participant became sick) were significantly associated with mental health in the group of participants who went on to receive a medical diagnosis, but not in the control group. Taken together, the results of these 2 studies indicate that the way an individual constructs personal narratives may impact his or her trajectory of mental health over time. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Variation in Narrative Identity is Associated with Trajectories of Mental Health over Several Years

PubMed Central

Adler, Jonathan M.; Turner, Ariana F.; Brookshier, Kathryn M.; Monahan, Casey; Walder-Biesanz, Ilana; Harmeling, Luke H.; Albaugh, Michelle; McAdams, Dan P.; Oltmanns, Thomas F.

2015-01-01

This paper presents two longitudinal studies designed to assess the relationship between variability in narrative identity and trajectories of mental health over several years. In Study 1, core scenes from 89 late-mid-life adults’ life stories were assessed for several narrative themes. Participants’ mental health and physical health were assessed concurrently with the narratives and once a year for the subsequent four years. Concurrent analyses indicated that the themes of agency, redemption, and contamination were significantly associated with mental (but not physical) health. Longitudinal analyses indicated that these same three themes were significantly associated with participants’ trajectories of mental health over the course of four years. Exploratory analyses indicated that narratives of challenging experiences may be central to this pattern of results. In Study 2, similar longitudinal analyses were conducted on a sample of 27 late-mid-life adults who received a major physical illness diagnosis between the baseline assessment and six months later and a matched sample of 27 control participants who remained healthy throughout the study. Participants’ mental health and physical health were assessed every six months for two years. In this tightly controlled study, the themes of agency, communion, redemption, and contamination in participants’ life narratives collected at Baseline (before any participant got sick) were significantly positively associated with mental health in the group of participants who went on to receive a medical diagnosis, but not in the control group. Taken together, the results of these two studies indicate that the way an individual constructs personal narratives may impact his or her trajectory of mental health over time. PMID:25751718

Living with Diabetes: Experiences of Inner and Outer Sources of Beliefs in Women with Low Socioeconomic Status

PubMed Central

Boonsatean, Wimonrut; Carlsson, Anna; Östman, Margareta; Rosner, Irena Dychawy

2016-01-01

The purpose of this study was to examine the life experiences of nineteen Thai women of low socioeconomic status who were living with type 2 diabetes. A qualitative research design was conducted, and the women were identified by the snowball technique. Data was collected through semi-structured interviews, and processes of induction and abstraction were used for data analysis. The theme “keeping equilibrium of one’s mind” involved two sub-themes: experiencing an unpredictable future and being empowered by emerged beliefs. The first sub-theme encompassed worries concerning health and fears of being a burden to one’s family. The second sub-theme comprised the experiences of continuing life without being conquered by the disease and believing in the natural law described in Buddhist teachings. These findings revealed that participants could maintain a balance among their concerns through empowerment by inner and outer sources of beliefs, particularly in Buddhist teachings. Despite the vulnerable situations caused by diabetes and low socioeconomic status, the women remained calm, with a consciousness to continue their lives with the disease. The Buddhist views on life, specifically natural law, assisted them to consider life with diabetes as simply a natural course. Buddhism served as a spiritual refuge and helped the women to cope with their psychological burden from diabetes. These findings may reflect the need for health care professionals to provide more holistic care that would assist patients to live with their disease. Buddhist beliefs can be used as a tool to assist Thai patients to empower themselves successfully. PMID:27045410

"A steep learning curve": junior doctor perspectives on the transition from medical student to the health-care workplace.

PubMed

Sturman, Nancy; Tan, Zachary; Turner, Jane

2017-05-26

The transition from medical student to hospital-based first year junior doctor (termed "intern" in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition. Final-year University of Queensland medical students recruited junior doctors working in diverse hospital settings, and videorecorded individual semi-structured interviews about their transition from medical student to working as a junior doctor. Two clinical academics (NS and JT) and an intern (ZT) independently conducted a descriptive analysis of interview transcripts, and identified preliminary emerging concepts and themes, before reaching agreement by consensus on the major overarching themes. Three key themes emerged from the analysis of 15 interviews: internship as a "steep learning curve"; relationships and team; and seeking help. Participants described the intern transition as physically, mentally and emotionally exhausting. They learned to manage long days, administrative and clinical tasks, frequent interruptions and time pressures; identify priorities; deal with criticism without compromising key relationships; communicate succinctly; understand team roles (including their own status within hospital hierarchies); and negotiate conflict. Participants reported a drop in self-confidence, and difficulty maintaining self-care and social relationships. Although participants emphasised the importance of escalating concerns and seeking help to manage patients, they appeared more reluctant to seek help for personal issues and reported a number of barriers to doing so. Findings may assist educators in refining their intern preparation and intern training curricula, and ensuring that medical school and intern preparation priorities are not seen as competing. Insights from non-medical disciplines into the organisational and relational challenges facing junior doctors and their health-care teams may enhance inter-professional learning opportunities. Workplace support and teaching, especially from junior colleagues, is highly valued during the demanding intern transition.

How people interpret healthy eating: contributions of qualitative research.

PubMed

Bisogni, Carole A; Jastran, Margaret; Seligson, Marc; Thompson, Alyssa

2012-01-01

To identify how qualitative research has contributed to understanding the ways people in developed countries interpret healthy eating. Bibliographic database searches identified reports of qualitative, empirical studies published in English, peer-reviewed journals since 1995. Authors coded, discussed, recoded, and analyzed papers reporting qualitative research studies related to participants' interpretations of healthy eating. Studies emphasized a social constructionist approach, and most used focus groups and/or individual, in-depth interviews to collect data. Study participants explained healthy eating in terms of food, food components, food production methods, physical outcomes, psychosocial outcomes, standards, personal goals, and as requiring restriction. Researchers described meanings as specific to life stages and different life experiences, such as parenting and disease onset. Identity (self-concept), social settings, resources, food availability, and conflicting considerations were themes in participants' explanations for not eating according to their ideals for healthy eating. People interpret healthy eating in complex and diverse ways that reflect their personal, social, and cultural experiences, as well as their environments. Their meanings include but are broader than the food composition and health outcomes considered by scientists. The rich descriptions and concepts generated by qualitative research can help practitioners and researchers think beyond their own experiences and be open to audience members' perspectives as they seek to promote healthy ways of eating. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

OAST Space Theme Workshop. Volume 1: Summary report. 1: Introduction. 2: General observations and some key findings. 3: Follow-on activity. Quick-look comments and working papers

NASA Technical Reports Server (NTRS)

1976-01-01

The Outlook for Space Study, consideration of National needs and OAST technology goals were factors in the selection of the following themes for candidate technical initiative and supporting program plans: space power station; search for extraterrestrial life; industrialization of space; global service station; exploration of the solar system; and advanced space transportation system. An overview is presented of the Space Theme Workshop activities in developing technology needs, program requirements, and proposed plans in support of each theme. The unedited working papers used by team members are included.

Information sought, information shared: exploring performance and image enhancing drug user-facilitated harm reduction information in online forums.

PubMed

Tighe, Boden; Dunn, Matthew; McKay, Fiona H; Piatkowski, Timothy

2017-07-21

There is good evidence to suggest that performance and image enhancing drug (PIED) use is increasing in Australia and that there is an increase in those using PIEDs who have never used another illicit substance. Peers have always been an important source of information in this group, though the rise of the Internet, and the increased use of Internet forums amongst substance consumers to share harm reduction information, means that PIED users may have access to a large array of views and opinions. The aim of this study was to explore the type of information that PIED users seek and share on these forums. An online search was conducted to identify online forums that discussed PIED use. Three discussion forums were included in this study: aussiegymjunkies.com, bodybuildingforums.com.au, and brotherhoodofpain.com. The primary source of data for this study was the 'threads' from the online forums. Threads were thematically analysed for overall content, leading to the identification of themes. One hundred thirty-four threads and 1716 individual posts from 450 unique avatars were included in this analysis. Two themes were identified: (1) personal experiences and advice and (2) referral to services and referral to the scientific literature. Internet forums are an accessible way for members of the PIED community to seek and share information to reduce the harms associated with PIED use. Forum members show concern for both their own and others' use and, where they lack information, will recommend seeking information from medical professionals. Anecdotal evidence is given high credence though the findings from the scientific literature are used to support opinions. The engagement of health professionals within forums could prove a useful strategy for engaging with this population to provide harm reduction interventions, particularly as forum members are clearly seeking further reliable information, and peers may act as a conduit between users and the health and medical profession.

Four aspects of self-image close to death at home.

PubMed

Carlander, Ida; Ternestedt, Britt-Marie; Sahlberg-Blom, Eva; Hellström, Ingrid; Sandberg, Jonas

2011-04-21

Living close to death means an inevitable confrontation with one's own existential limitation. In this article, we argue that everyday life close to death embodies an identity work in progress. We used a narrative approach and a holistic-content reading to analyze 12 interviews conducted with three persons close to death. By illuminating the unique stories and identifying patterns among the participants' narratives, we found four themes exemplifying important aspects of the identity work related to everyday life close to death. Two of the themes, named "Inside and outside of me" and "Searching for togetherness," represented the core of the self-image and were framed by the other themes, "My place in space" and "My death and my time." Our findings elucidate the way the individual stories moved between the past, the present, and the future. This study challenges the idea that everyday life close to impending death primarily means limitations. The findings show that the search for meaning, new knowledge, and community can form a part of a conscious and ongoing identity work close to death.

Four aspects of self-image close to death at home

PubMed Central

Carlander, Ida; Ternestedt, Britt-Marie; Sahlberg-Blom, Eva; Hellström, Ingrid; Sandberg, Jonas

2011-01-01

Living close to death means an inevitable confrontation with one's own existential limitation. In this article, we argue that everyday life close to death embodies an identity work in progress. We used a narrative approach and a holistic-content reading to analyze 12 interviews conducted with three persons close to death. By illuminating the unique stories and identifying patterns among the participants’ narratives, we found four themes exemplifying important aspects of the identity work related to everyday life close to death. Two of the themes, named “Inside and outside of me” and “Searching for togetherness,” represented the core of the self-image and were framed by the other themes, “My place in space” and “My death and my time.” Our findings elucidate the way the individual stories moved between the past, the present, and the future. This study challenges the idea that everyday life close to impending death primarily means limitations. The findings show that the search for meaning, new knowledge, and community can form a part of a conscious and ongoing identity work close to death. PMID:21526139

Factors associated with the quality of life of family carers of people with dementia: A systematic review.

PubMed

Farina, Nicolas; Page, Thomas E; Daley, Stephanie; Brown, Anna; Bowling, Ann; Basset, Thurstine; Livingston, Gill; Knapp, Martin; Murray, Joanna; Banerjee, Sube

2017-05-01

Family carers of people with dementia are their most important support in practical, personal, and economic terms. Carers are vital to maintaining the quality of life (QOL) of people with dementia. This review aims to identify factors related to the QOL of family carers of people with dementia. Searches on terms including "carers," "dementia," "family," and "quality of life" in research databases. Findings were synthesized inductively, grouping factors associated with carer QOL into themes. A total of 909 abstracts were identified. Following screening, lateral searches, and quality appraisal, 41 studies (n = 5539) were included for synthesis. A total of 10 themes were identified: demographics; carer-patient relationship; dementia characteristics; demands of caring; carer health; carer emotional well-being; support received; carer independence; carer self-efficacy; and future. The quality and level of evidence supporting each theme varied. We need further research on what factors predict carer QOL in dementia and how to measure it. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Negotiation, Mediation and Communication between Cultures: End-of-Life Care for South Asian Immigrants in Canada from the Perspective of Family Caregivers.

PubMed

Weerasinghe, Swarna; Maddalena, Victor

2016-01-01

In the present study, we explored family caregivers' experiences in providing end-of-life care for terminally ill South Asian immigrants. We employed qualitative methods and. in-depth interviews were conducted with seven family caregivers living in Nova Scotia, Canada. Interview data were validated, coded and organized for themes. Three major themes identified in the data illustrated (a) how South Asian caregivers experienced clashes between biomedical and ethno-cultural realms of care that led to cultural insensitivity, (b) how family members acted as mediators, and (c) how communication issues that challenged cultural sensitivity were handled. Findings provide directions for culturally sensitive end-of-life care planning.

Claremont Reading Conference. Thirty-Fourth Yearbook.

ERIC Educational Resources Information Center

Douglass, Malcolm P., Ed.

This collection of 19 articles included in the 34th Yearbook of the Claremont Reading Conference focuses on the theme "Reading and School Life," with specific emphasis on how the quality of school experiences affects the reader and the development of the reading process. The permanent conference theme is "Reading is the Process of Making…

Envisioning the Possible: Building a Critical Literacy Curriculum.

ERIC Educational Resources Information Center

Flint, Amy Seely

2000-01-01

Notes that connecting the teachers' stories and experiences presented in this themed issue are such themes as using real life issues as the curriculum, risk taking, student ownership, and community building. Discusses how these teachers believe in the importance of making curriculum relevant and meaningful to the lives of the children by…

'Once I had money in my pocket, I was every colour under the sun': using 'appearance biographies' to explore the meanings of appearance for people with dementia.

PubMed

Ward, Richard; Campbell, Sarah; Keady, John

2014-08-01

Appearance and the work invested in it by and for people with dementia are a neglected issue within dementia studies. In policy and practice there exists an assumption that the role of supporting a person to manage their appearance is easily assumed by another within caring encounters, only to be subsumed within the daily task-oriented provision of care. This paper reports on interviews conducted as part of the Hair and Care project, which explored questions of appearance and the meanings it holds with people with dementia. The research used 'appearance biographies', a method which allows for a range of topics to be considered about appearance throughout the life course, acting as a conduit for reminiscence and life story work. The paper reports on the key themes and findings from these interviews, discussing them in the context of a wider debate on dementia, self-expression and agency. A key question posed by the authors is whether appearance and the work invested in it are legitimate considerations for dementia care policy and practice. And if so, how should we make sense of this work and what significance should we attach to it? In seeking to answer these questions the authors position the perspectives and experiences of people with dementia as central to their analysis. A narrative framework is suggested as a useful basis on which to understand the work of managing appearance over the life course. The implications for policy and practice are outlined. Copyright © 2014 Elsevier Inc. All rights reserved.

Communication During Palliative Care and End of Life: Perceptions of Experienced Pediatric Oncology Nurses.

PubMed

Montgomery, Kathleen E; Sawin, Kathleen J; Hendricks-Ferguson, Verna

Communication between patients, families, and healthcare providers is a central component of end-of-life care. Nurse communication during palliative care (PC) and end of life (EOL) is a phenomenon with limited research. It is unclear how the level of nursing experience influences the perspectives of nurses communicating during EOL. The aim of this study is to describe the commonalities of experienced nurses' perceptions of communicating during PC and EOL and perceptions of barriers and facilitators to effective communication. This study was part of a larger multisite study that used a qualitative, empirical phenomenology design and represents focus group data gathered from pediatric oncology nurses with more than 5 years of experience or who were advanced practice nurses not involved in the direct evaluation of other nurses. Five core themes with corresponding themes and subthemes were identified. The core themes included (a) Evolution of PC/EOL, (b) Skill of Knowing, (c) Expanded Essence of Caring, (d) Experienced Nurse as Committed Advocate, and (e) Valuing Individual Response to Grief. Findings reflect how the concept of experience transcended the 5 core themes and captured how experience provided nurses the know-how to fulfill the roles of communication, caring, and advocacy for children and families. Enhancing nurse communication skills during EOL requires opportunities to gain experience coupled with clinical strategies, such as standardized curricula, simulation, competency-based orientation programs, mentorship, and peer support.

Looking beyond the Internet: examining socioeconomic inequalities in cancer information seeking among cancer patients.

PubMed

Lee, Chul-Joo; Ramírez, A Susana; Lewis, Nehama; Gray, Stacy W; Hornik, Robert C

2012-01-01

The gap in cancer information seeking between high-socioeconomic-status (high-SES) cancer patients and low-SES cancer patients deserves serious attention, considering the importance of information and knowledge in cancer control. We thus explored the association of SES, as measured by education, with cancer patients' overall cancer information seeking, and with seeking from each source (i.e., the Internet, mass media, medical sources, and nonmedical interpersonal sources) and across two topic categories (i.e., treatment, quality of life). We then asked whether the effect of education on treatment information seeking is reduced among those who are particularly motivated to control treatment choices. We conducted a survey with breast, prostate, and colon cancer patients diagnosed in 2005 (n = 2,013), who were randomly drawn from the Pennsylvania Cancer Registry in the fall of 2006. We found that education was more strongly associated with Internet use than with the use of other sources regardless of topics. Also, when information was sought from mass media, education had a greater association with treatment information seeking than with quality-of-life information seeking. Preference for active participation in treatment decision making, however, did not moderate the effect of education on treatment information seeking. The implications of these findings for public health research and cancer patient education were discussed.

Looking beyond the Internet: Examining Socioeconomic Inequalities in Cancer Information Seeking among Cancer Patients

PubMed Central

Lee, Chul-joo; Ramirez, Susana; Lewis, Nehama; Gray, Stacy W.; Hornik, Robert C.

2014-01-01

The gap in cancer information seeking between high-socioeconomic status (SES) cancer patients and low-SES cancer patients deserves serious attention considering the importance of information and knowledge in cancer control. We thus explored the association of SES, as measured by education, with cancer patients’ overall cancer information seeking, and with seeking from each source (i.e., the Internet, mass media, medical sources, and non-medical interpersonal sources) and across two topic categories (i.e., treatment, quality of life). We then asked whether the effect of education on treatment information seeking is reduced among those who are particularly motivated to control treatment choices. We conducted a survey with breast, prostate, and colon cancer patients diagnosed in 2005 (N = 2,013), who were randomly drawn from the Pennsylvania Cancer Registry in the fall of 2006. We found that education was more strongly associated with Internet use than with the use of other sources regardless of topics. Also, when information was sought from mass media, education had a greater association with treatment information seeking than with quality-of-life information seeking. Preference for active participation in treatment decision making, however, did not moderate the effect of education on treatment information seeking. The implications of these findings for public health research and cancer patient education were discussed. PMID:22356137

Spotlight on equality of employment opportunities: A qualitative study of job seeking experiences of graduating nurses and physiotherapists from black and minority ethnic backgrounds.

PubMed

Hammond, John; Marshall-Lucette, Sylvie; Davies, Nigel; Ross, Fiona; Harris, Ruth

2017-09-01

There is growing attention in the UK and internationally to the representation of black and minority ethnic groups in healthcare education and the workplace. Although the NHS workforce is very diverse, ethnic minorities are unevenly spread across occupations, and considerably underrepresented in senior positions. Previous research has highlighted that this inequality also exists at junior levels with newly qualified nurses from non-White/British ethnic groups being less likely to get a job at graduation than their White/British colleagues. Although there is better national data on the scale of inequalities in the healthcare workforce, there is a gap in our understanding about the experience of job seeking, and the factors that influence disadvantage in nursing and other professions such as physiotherapy. This qualitative study seeks to fill that gap and explores the experience of student nurses (n=12) and physiotherapists (n=6) throughout their education and during the first 6-months post qualification to identify key experiences and milestones relating to successful employment particularly focusing on the perspectives from different ethnic groups. Participants were purposively sampled from one university to ensure diversity in ethnic group, age and gender. Using a phenomenological approach, in-depth semi-structured interviews were conducted at course completion and 6 months later. Two main themes were identified. The 'proactive self' ('It's up to me') theme included perceptions of employment success being due to student proactivity and resilience; qualities valued by employers. The second theme described the need to 'fit in' with organisational culture. Graduates described accommodating strategies where they modified aspects of their identity (clothing, cultural markers) to fit in. At one extreme, rather than fitting in, participants from minority ethnic backgrounds avoided applying to certain hospitals due to perceptions of discriminatory cultures, 'I wouldn't apply there 'cos you know, it's not really an ethnic hospital'. In contrast, some participants recognised that other graduates (usually white) did not need to change and aspects of their identity brought unsolicited rewards 'if your face fits then the barriers are reduced'. The findings indicate that success in getting work is perceived as determined by individual factors, and fitting in is enabled by strategies adopted by the individual rather than the workplace. Demands for change are more acute for graduates from black and minority ethnic backgrounds. This is an issue for healthcare organisations seeking to be inclusive and challenges employers and educators to acknowledge inequalities and take action to address them. Copyright © 2017 Elsevier Ltd. All rights reserved.

Life and Self Meaning: The Process of Their Creation.

ERIC Educational Resources Information Center

Weenolsen, Patricia

Research has not addressed issues of life meaning in a life-span developmental framework. The Loss and Transcendence paradigm was developed as a humanistic-existential approach to life-span development which has as its central theme the concept that individuals are in a continuous process of creating their lives and their selves. To explore loss…

"Why doesn't she seek help for partner abuse?" An exploratory study with South Asian immigrant women.

PubMed

Ahmad, Farah; Driver, Natasha; McNally, Mary Jane; Stewart, Donna E

2009-08-01

This study explores why South Asian immigrant women with experiences of partner abuse delay seeking help from professionals. Three focus groups were conducted in Hindi language with South Asian immigrant women in Toronto. Twenty-two women participated with a mean age of 46 years (range 29-68 years). Thematic analysis was conducted on the transcribed data using constant comparison techniques within and across the groups. We found that three major themes emerged from the discussions: reasons for delayed help-seeking, turning points and talking to professionals. Women expressed delaying help-seeking to the point when "Pani sar se guzar jata he" (water crosses over your head). Their dominant reasons for delayed help-seeking were social stigma, rigid gender roles, marriage obligations, expected silence, loss of social support after migration and limited knowledge about available resources and myths about partner abuse. Women usually turned for help only after experiencing pronounced mental and physical health problems. The findings are interpreted in light of participants' immigration context and the socio-cultural norms of patriarchy, collectivism and familism. Prevention approaches to address partner abuse and delayed help-seeking among South Asian immigrant women should include tailored community education, social services to reduce vulnerability, and cultural competency of professionals. Further research and program evaluation is needed to advance the field.

The 'global interconnectedness' of dentist migration: a qualitative study of the life-stories of international dental graduates in Australia.

PubMed

Balasubramanian, Madhan; Brennan, David S; Spencer, A John; Short, Stephanie D

2015-05-01

The migration of dentists is a major challenge contributing to the oral health system crisis in many countries. This paper explores the origins of the dentist migration problem through a study on international dental graduates, who had migrated to Australia. Life-stories of 49 international dental graduates from 22 countries were analysed in order to discern significant themes and patterns. We focused on their home country experience, including stories on early life and career choice; dental student life; professional life; social and political life; travels; and coming to Australia. Our participants exhibited a commitment to excellence in earlier stages of life and had cultivated a desire to learn more and be involved with the latest technology. Dentists from low- and middle-income countries were also disappointed by the lack of opportunity and were unhappy with the local ethos. Some pointed towards political unrest. Interestingly, participants also carried prior travel learnings and unforgettable memories contributing to their migration. Family members and peers had also influenced participants. These considerations were brought together in four themes explaining the desire to migrate: 'Being good at something', 'Feelings of being let down', 'A novel experience' and 'Influenced by someone'. Even if one of these four themes dominated the narrative, we found that more than one theme, however, coexisted for most participants. We refer to this worldview as 'Global interconnectedness', and identify the development of migration desire as a historical process, stimulated by a priori knowledge (and interactions) of people, place and things. This qualitative study has enriched our understanding on the complexity of the dental migration experience. It supports efforts to achieve greater technical co-operation in issues such as dental education, workforce surveillance and oral health service planning within the context of ongoing global efforts on health professional migration by the World Health Organization and member states. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Advance care planning: a qualitative study of dialysis patients and families.

PubMed

Goff, Sarah L; Eneanya, Nwamaka D; Feinberg, Rebecca; Germain, Michael J; Marr, Lisa; Berzoff, Joan; Cohen, Lewis M; Unruh, Mark

2015-03-06

More than 90,000 patients with ESRD die annually in the United States, yet advance care planning (ACP) is underutilized. Understanding patients' and families' diverse needs can strengthen systematic efforts to improve ACP. In-depth interviews were conducted with a purposive sample of patients and family/friends from dialysis units at two study sites. Applying grounded theory, interviews were audiotaped, professionally transcribed, and analyzed in an iterative process. Emergent themes were identified, discussed, and organized into major themes and subthemes. Thirteen patients and nine family/friends participated in interviews. The mean patient age was 63 years (SD 14) and five patients were women. Participants identified as black (n=1), Hispanic (n=4), Native American (n=4), Pacific Islander (n=1), white (n=11), and mixed (n=1). Three major themes with associated subthemes were identified. The first theme, "Prior experiences with ACP," revealed that these discussions rarely occur, yet most patients desire them. A potential role for the primary care physician was broached. The second theme, "Factors that may affect perspectives on ACP," included a desire for more of a connection with the nephrologist, positive and negative experiences with the dialysis team, disenfranchisement, life experiences, personality traits, patient-family/friend relationships, and power differentials. The third theme, "Recommendations for discussing ACP," included thoughts on who should lead discussions, where and when discussions should take place, what should be discussed and how. Many participants desired better communication with their nephrologist and/or their dialysis team. A number expressed feelings of disenfranchisement that could negatively impact ACP discussions through diminished trust. Life experiences, personality traits, and relationships with family and friends may affect patient perspectives regarding ACP. This study's findings may inform clinical practice and will be useful in designing prospective intervention studies to improve patient and family experiences at the end of life. Copyright © 2015 by the American Society of Nephrology.

Constructing Narratives in Later Life: Autoethnography beyond the Academy

ERIC Educational Resources Information Center

Golding, Barry; Foley, Annette

2017-01-01

Learning through life experiences as distinct from learning through the academy and courses have become increasingly important themes in later life adult education research and practice. Whilst the dominant discourse for most younger people is still about education and training for students in standardised and accredited courses, there is…

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

PubMed Central

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

2014-01-01

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

Touch, the essence of caring for people with end-stage dementia: a mental health perspective in Namaste Care.

PubMed

Nicholls, Daniel; Chang, Esther; Johnson, Amanda; Edenborough, Michel

2013-01-01

This article presents the mental health aspects of 'touch' associated with a funded research project: Avoiding 'high tech' through 'high touch' in end-stage dementia: Protocol for care at the end-of-life. These mental health aspects highlight the human need for touch that continues up until and inclusive of the final stages of life. This study was informed by Simard's (2007) 'high touch' protocol based on the End-of-Life Namaste Care programme for people with dementia. The article is situated in relation to the research project which used a three-phase mixed methods approach. Data explored in this article are derived from focus groups conducted at three residential aged care facilities located in metropolitan and regional areas of NSW, Australia. The exploration of touch vis-a-vis mental health fell under two broad themes: touch by others and touch by the person. Sub-elements of these themes comprised touch towards a physical objective, touch towards an emotional objective, touch of objects and touch of others. The overarching outcome of interconnectedness embraced environmental awareness and human and life awareness. These two broad themes, with their accompanying elements, express the essential nature of mental health as a reciprocal connectedness, with reciprocal impacts on both those people with advanced dementia and their carers.

The Intergenerational Circumstances of Household Food Insecurity and Adversity.

PubMed

Chilton, Mariana; Knowles, Molly; Bloom, Sandra L

2017-04-03

Household food insecurity is linked with exposure to violence and adversity throughout the life course, suggesting its transfer across generations. Using grounded theory, we analyzed semistructured interviews with 31 mothers reporting household food insecurity where participants described major life events and social relationships. Through the lens of multigenerational interactions, 4 themes emerged: (1) hunger and violence across the generations, (2) disclosure to family and friends, (3) depression and problems with emotional management, and (4) breaking out of intergenerational patterns. After describing these themes and how they relate to reports of food insecurity, we identify opportunities for social services and policy intervention.

Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints.

PubMed

Rotenberg Shpigelman, Shlomit; Sternberg, Shelley; Maeir, Adina

2017-08-29

Preliminary evidence suggests that older people who seek medical help for subjective memory complaints (SMC) may be at risk for depression, poor quality of life (QoL), and functional limitations. This study aims to: (1) further investigate bio-psycho-social characteristics, participation in personally meaningful activities and QoL of help-seekers; and (2) examine the relationship of these characteristics to QoL, and explore the unique contribution of participation to QoL. Cognitive, meta-cognitive, emotional, social, participation, and QoL measures were used to compare 51 help-seekers referred from geriatric clinics to 40 age-matched controls who did not seek help for memory problems. Help-seekers exhibited lower participation and QoL, had lower mean cognitive scores, reported more memory mistakes and negative memory-beliefs, more depression, worse self-efficacy, and less positive social interaction than non-help-seekers. Quality of life in help-seekers was significantly correlated with most variables. Participation contributed to the explained variance of QoL in help-seekers, beyond that accounted for by cognition and emotional status. Help-seekers with SMC exhibited a complex health condition that includes not only SMC, but also objective memory impairment, depression, functional restrictions, negative memory beliefs, low perception of memory abilities, reduced self-efficacy and insufficient social interactions, all associated with lower QoL. This multi-faceted condition should be considered in the treatment of help-seekers. Implications for Rehabilitation Older people who seek help for subjective memory complaints may be facing a larger problem involving bio-psycho-social factors, affecting participation in meaningful activities and quality of life. Quality of life may be improved via treatment of depression, functional restrictions, memory beliefs, self-efficacy, and positive social interactions. Participation in meaningful activities is an especially important target for improving health and quality of life in this population. Interventions for older adults seeking help for subjective memory complaints will benefit from adopting a bio-psycho-social rehabilitation perspective.

Complexity of Work-Life Identities and Policy Development: Implications for Work-Life in Higher Education

ERIC Educational Resources Information Center

Lester, Jaime

2016-01-01

This chapter describes the themes that emerged in this volume with attention to important policy implications on the federal, state, and institutional levels. Recommendations for future research are provided.

Extinction and Reinstatement of Cocaine-seeking in Self-administering Mice is Associated with Bidirectional AMPAR-mediated Plasticity in the Nucleus Accumbens Shell.

PubMed

Ebner, Stephanie R; Larson, Erin B; Hearing, Matthew C; Ingebretson, Anna E; Thomas, Mark J

2018-06-07

Experience-dependent synaptic plasticity is an important component of both learning and motivational disturbances found in addicted individuals. Here, we investigated the role of cocaine experience-dependent plasticity at excitatory synapses in the nucleus accumbens shell (NAcSh) in relapse-related behavior in mice with a history of volitional cocaine self-administration. Using an extinction/reinstatement paradigm of cocaine-seeking behavior, we demonstrate that cocaine-experienced mice with extinguished cocaine-seeking behavior show potentiation of synaptic strength at excitatory inputs onto NAcSh medium spiny neurons (MSNs). Conversely, we found that exposure to various distinct types of reinstating stimuli (cocaine, cocaine-associated cues, yohimbine "stress") after extinction can produce a relative depotentiation of NAcSh synapses that is strongly associated with the magnitude of cocaine-seeking behavior exhibited in response to these challenges. Furthermore, we show that these effects are due to α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR)-specific mechanisms that differ depending on the nature and context of the reinstatement-inducing stimuli. Together, our findings identify common themes as well as differential mechanisms that are likely important for the ability of diverse environmental stimuli to drive relapse to addictive-like cocaine-seeking behavior. Copyright © 2018. Published by Elsevier Ltd.

Healthcare-seeking behaviour in relation to sexual and reproductive health among Thai-born women in Sweden: a qualitative study.

PubMed

Åkerman, Eva; Essén, Birgitta; Westerling, Ragnar; Larsson, Elin

2017-02-01

Thailand is one of the most common countries of origin among immigrants in Sweden and Thai immigrants comprise the immigrant group most frequently diagnosed with HIV. Little is known about their healthcare-seeking behaviour and views on HIV prevention. This study explored Thai women's healthcare-seeking behaviour in relation to sexual and reproductive health and their views on HIV prevention. Nineteen in-depth interviews were conducted with Thai-born women in the Stockholm area. Three themes were identified: (1) poor access to healthcare in Sweden, preferring to seek care in Thailand; (2) partners playing a key role in women's access to healthcare; (3) no perceived risk of HIV, but a positive attitude towards prevention. Despite expressing sexual and reproductive healthcare needs, most women had not sought this type of care, except for the cervical cancer screening programme to which they had been invited. Identified barriers for poor access to healthcare were lack of knowledge about the healthcare system and language difficulties. To achieve 'healthcare on equal terms', programmes and interventions must meet Thai women's healthcare needs and consider what factors influence their care-seeking behaviour. Integrating HIV prevention and contraceptive counselling into the cervical screening programme might be one way to improve access.

A qualitative study of determinants of PTSD treatment initiation in veterans.

PubMed

Sayer, Nina A; Friedemann-Sanchez, Greta; Spoont, Michele; Murdoch, Maureen; Parker, Louise E; Chiros, Christine; Rosenheck, Robert

2009-01-01

Although there are effective treatments for Posttraumatic Stress Disorder (PTSD), many PTSD sufferers wait years to decades before seeking professional help, if they seek it at all. An understanding of factors affecting treatment initiation for PTSD can inform strategies to promote help-seeking. We conducted a qualitative study to identify determinants of PTSD treatment initiation among 44 U.S. military veterans from the Vietnam and Afghanistan/Iraq wars; half were and half were not receiving treatment. Participants described barriers to and facilitators of treatment initiation within themselves, the post-trauma socio-cultural environment, the health care and disability systems, and their social networks. Lack of knowledge about PTSD was a barrier that occurred at both the societal and individual levels. Another important barrier theme was the enduring effect of experiencing an invalidating socio-cultural environment following trauma exposure. In some cases, system and social network facilitation led to treatment initiation despite individual-level barriers, such as beliefs and values that conflicted with help-seeking. Our findings expand the dominant model of service utilization by explicit incorporation of factors outside the individual into a conceptual framework of PTSD treatment initiation. Finally, we offer suggestions regarding the direction of future research and the development of interventions to promote timely help-seeking for PTSD.

Patients’ Experiences of Being a Burden on Family in Terminal Illness

PubMed Central

Johnson, Julia Overturf; Sulmasy, Daniel P.; Nolan, Marie T.

2009-01-01

Studies of persons with chronic and life-threatening illness have revealed a fear of being a burden on family. The purpose of this case study was to explore that concern in-depth in three persons with different terminal illnesses. Participants were part of a larger study of end-of-life decision making and were selected for this study because their illnesses are characterized by a steady decline in health (amyotrophic lateral sclerosis), a rapid decline (stage IV lung cancer), or an uncertain trajectory of decline (advanced heart failure). Content analysis of their interviews resulted in four themes: managing the burden, spirituality, supportive relationships, and planning for the future. Themes contained specific categories of thoughts, feelings, and actions related to fear of being a burden. These themes should be explored in greater depth in future larger studies of persons with terminal illness. PMID:19183701

How do older people discuss their own sexuality? A systematic review of qualitative research studies.

PubMed

Gewirtz-Meydan, Ateret; Hafford-Letchfield, Trish; Ayalon, Liat; Benyamini, Yael; Biermann, Violetta; Coffey, Alice; Jackson, Jeanne; Phelan, Amanda; Voß, Peggy; Geiger Zeman, Marija; Zeman, Zdenko

2018-06-04

This study captured older people's attitudes and concerns about sex and sexuality in later life by synthesising qualitative research published on this issue. The systematic review was conducted between November 2015 and June 2016 based on a pre-determined protocol. Key words were used to ensure a precise search strategy. Empirically based, qualitative literature from 18 databases was found. Twenty studies met the inclusion criteria. Thomas and Harden's thematic synthesis was used to generate 'analytical themes' which summarise this body of literature. Three main themes were identified: (a) social legitimacy for sexuality in later life; (b) health, not age, is what truly impacts sexuality, and (c) the hegemony of penetrative sex. The themes illustrate the complex and delicate relation between ageing and sexuality. Older adults facing health issues that affect sexual function adopt broader definitions of sexuality and sexual activity.

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2011-01-01

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

Online women-seeking-women personal ads and the deployment of "tomboy" identities.

PubMed

Farr, Daniel

2011-01-01

This article examines online women-seeking-women (WSW) personal ads that engage with tomboy identities and ideologies. This research demonstrates the importance of body and physicality among lesbian personal ads and the diversity of women using online personal ads. The meaning of "tomboy" in the language of WSW personal ads suggests major themes of use including: as an intermediate identity distinct within a butch/femme dichotomy, as a tempering agent for traditional femininity, as a fluid construct of personality, physicality, and body, as an understood descriptor of a particular aesthetic or physicality, and as synonymous with butch. To be a tomboy is to be simultaneously understood as a social stereotype, but also as complex, fluid, and of multiple meanings.

Influences to ADHD Problem Recognition: Mixed-Method Investigation and Recommendations to Reduce Disparities for Latino Youth.

PubMed

Haack, Lauren M; Meza, Jocelyn; Jiang, Yuanyuan; Araujo, Eva Jimenez; Pfiffner, Linda

2018-05-16

ADHD problem recognition serves as the first step of help seeking for ethnic minority families, such as Latinos, who underutilize ADHD services. The current mixed-method study explores underlying factors influencing recognition of ADHD problems in a sample of 159 school-aged youth. Parent-teacher informant discrepancy results suggest that parent ethnicity, problem domain, and child age influence ADHD problem recognition. Emerging themes from semi-structured qualitative interviews/focus groups conducted with eighteen Spanish-speaking Latino parents receiving school-based services for attention and behavior concerns support a range of recognized ADHD problems, beliefs about causes, and reactions to ADHD identification. Findings provide recommendations for reducing disparities in ADHD problem recognition and subsequent help seeking.

The experience of stigma among Black mental health consumers.

PubMed

Alvidrez, Jennifer; Snowden, Lonnie R; Kaiser, Dawn M

2008-08-01

Little is known about how stigma affects Black people receiving mental health treatment. For a project to develop a consumer-based stigma intervention, qualitative interviews were conducted with public-sector Black mental health consumers (N=34). Primary themes from the interviews regarding stigma concerns, experiences, and coping strategies were examined. Concerns about stigma prompted most consumers initially to avoid or delay treatment; once in treatment, consumers commonly faced stigmatizing reactions from others. Consumers identified numerous strategies to deal with stigma, including seeking support from accepting members of their existing social networks, and viewing their own health as more important than the reaction of others. These consumer perspectives may be valuable to Black individuals who are contemplating seeking mental health treatment.

Cascading effects of attention disengagement and sensory seeking on social symptoms in a community sample of infants at-risk for a future diagnosis of autism spectrum disorder.

PubMed

Baranek, Grace T; Woynaroski, Tiffany G; Nowell, Sallie; Turner-Brown, Lauren; DuBay, Michaela; Crais, Elizabeth R; Watson, Linda R

2018-01-01

Recent work suggests sensory seeking predicts later social symptomatology through reduced social orienting in infants who are at high-risk for autism spectrum disorder (ASD) based on their status as younger siblings of children diagnosed with ASD. We drew on extant longitudinal data from a community sample of at-risk infants who were identified at 12 months using the First Year Inventory, and followed to 3-5 years. We replicate findings of Damiano et al. (in this issue) that a) high-risk infants who go on to be diagnosed with ASD show heightened sensory seeking in the second year of life relative to those who do not receive a diagnosis, and b) increased sensory seeking indirectly relates to later social symptomatology via reduced social orienting. We extend previous findings to show that sensory seeking has more clinical utility later in the second year of life (20-24 months) than earlier (13-15 months). Further, this study suggests that diminished attention disengagement at 12-15 months may precede and predict increased sensory seeking at 20-24 months. Findings add support for the notion that sensory features produce cascading effects on social development in infants at risk for ASD, and suggest that reduced attention disengagement early in life may set off this cascade. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Perceived reasons for, opinions about, and suggestions for elders considering suicide: elderly outpatients' perspectives.

PubMed

Chen, Ying-Jen; Tsai, Yun-Fang; Ku, Yan-Chiou; Lee, Shwu-Hua; Lee, Hsiu-Lan

2014-07-01

The purposes of this study were to explore elderly outpatients' perceived reasons for, opinions of, and suggestions for elderly people considering suicide in Taiwan. Elderly outpatients (N = 83) were recruited in 2011-2012 by convenience sampling from three randomly selected medical centers in Taiwan. Data were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Findings revealed that most participants had heard of elderly suicide, with television news as the main source for their information. Their opinions about elderly suicide reflected judgmental attitudes, negative emotional reactions, expectations of social welfare, and could happen after losing one's meaning in life. Their suggestions for elderly people considering suicide fell into four major themes: give up suicidal ideas, seek help, enhance social welfare, and attend religious activities. Since television news was the main source for participants' information about elderly suicide, this mass medium should be used in suicide prevention to disseminate suicide knowledge, increase access to help, and strengthen suicide-protective factors among the elderly. Furthermore, no participants mentioned depression as a reason for attempted or completed suicide among older people despite depression being a well-known suicide-risk factor. Future suicide-prevention programs should emphasize the role of depression in suicide among older people. Participants also did not suggest that older people considering suicide seek help from the health system. Thus, older people should be educated about the role of the health system in suicide prevention and trained as gatekeepers to recognize signs of suicide ideation and respond appropriately.

Abortion restrictions in the U.S. military: voices from women deployed overseas.

PubMed

Grindlay, Kate; Yanow, Susan; Jelinska, Kinga; Gomperts, Rebecca; Grossman, Daniel

2011-01-01

U.S. military women and dependents have few options for abortion when facing an unintended pregnancy overseas. Federal law prohibits the use of Department of Defense facilities and funds for abortion except when the woman's life is at risk, and privately funded abortions are permitted at military facilities only if a pregnancy is the result of rape or incest. The purpose of this study was to explore military women's experiences seeking abortion care during overseas deployment. We reviewed routine consultation data and user queries from an online service providing information about medication abortion. Information received between September 2005 and December 2009 from U.S. military women and dependents overseas was included. All women gave consent for anonymous use of their data, which were analyzed qualitatively for themes related to experiences seeking abortion. Data were analyzed for 130 women, including 128 women in the U.S. military and 2 military dependents. Women reported facing numerous challenges accessing abortion overseas, including legal and logistical barriers to care in-country, and real or perceived difficulties accessing abortion elsewhere owing to confidentiality concerns, fear of military reprimand for the pregnancy, and the narrow timeframe for early abortion. With no perceived alternatives, some women considered unsafe methods to terminate the pregnancy themselves. U.S. servicewomen overseas lack access to safe abortion services, which may place their health and careers in jeopardy. These women should have the same rights to abortion care as women living in the United States. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Experiencing Support During Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3-7Years).

PubMed

Karlsson, Katarina; Dalheim Englund, Ann-Charlotte; Enskär, Karin; Nyström, Maria; Rydström, Ingela

Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures. This study aims to explain and understand the meaning of the research phenomenon: support during NRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children. The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7years of age who have experienced NRMPs. The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources. The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive. Copyright © 2016 Elsevier Inc. All rights reserved.

Responsible gambling among older adults: a qualitative exploration.

PubMed

Subramaniam, Mythily; Satghare, Pratika; Vaingankar, Janhavi A; Picco, Louisa; Browning, Colette J; Chong, Siow Ann; Thomas, Shane A

2017-04-04

Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important.

Celebrate Your Freedom--Assuring Equal Justice for All. Law Day 2002 Planning Guide.

ERIC Educational Resources Information Center

White, Charles, Ed.

The theme for Law Day 2002 was set long before the tragic events of September 11, 2001, and its aftermath. The vision of Law Day planners was to plan programs on how the courts and legal system seek to assure equal access to justice for all people. This guide gives planners the tools for programs and discussions on legal aid, the "pro bono…

Materials Development in Three Italian CALL Projects: Seeking an Optimal Mix between In-Class and Out-of-Class Learning

ERIC Educational Resources Information Center

Levy, Mike; Kennedy, Claire

2010-01-01

This paper considers the design and development of CALL materials with the aim of achieving an optimal mix between in-class and out-of-class learning in the context of teaching Italian at an Australian university. The authors discuss three projects in relation to the following themes: (a) conceptions of the in-class/out-of-class relationship, (b)…

20 Years of EUROCALL: Learning from the Past, Looking to the Future. Proceedings [of the] 2013 EUROCALL Conference (Évora, Portugal, September 11-14, 2013)

ERIC Educational Resources Information Center

Bradley, Linda, Ed.; Thouësny, Sylvie, Ed.

2013-01-01

EUROCALL 2013's theme was "20 Years of EUROCALL: Learning from the Past, Looking to the Future." The conference seeked to establish an overview of EUROCALL's twentieth anniversary. As a professional organization, EUROCALL has been aiming, along its 20 years of existence, to promote innovative research, development and practice in the…

The Gaze or the Groove? Emerging Themes from the "New Meanings and Pathways: Community Dance and Dance Education Symposium" in Beijing

ERIC Educational Resources Information Center

Rowe, Nicholas; Buck, Ralph; Martin, Rosemary

2015-01-01

Established in 1954 and drawing heavily on dance conservatory models from Russia, the Beijing Dance Academy (BDA) has become a predominant influence on dance education in East Asia. As it addresses the artistic, cultural and educational needs of China into the twenty-first century, the BDA is now negotiating a new terrain and seeking new…

A Thousand Writers Writing: Seeking Change through the Radical Practice of Writing as a Way of Being

ERIC Educational Resources Information Center

Yagelski, Robert P.

2009-01-01

In this frankly utopian essay, Robert Yagelski's theme is the transformative power of writing as an act in and of itself. He makes us reevaluate our motivation and point for teaching writing in schools and asks us to consider an agenda that will quite frankly scare teachers as he explains why we need an ontology of writing. (Contains 6 notes.)

Reclaiming the everyday world: how long-term ventilated patients in critical care seek to gain aspects of power and control over their environment.

PubMed

Johnson, Patricia

2004-08-01

Critical care nurses are increasingly seeking to base patient care on evidence derived from research studies. The purpose of this study was to explore the meanings former patients attributed to being on long-term mechanical ventilation in a critical care unit (CCU) in Australia. Using Heideggerian phenomenology, unstructured interviews were undertaken with nine participants. Data were analysed thematically using the method developed by van Manen. Thematic analysis revealed four major themes. This article presents the findings from the theme titled: Reclaiming the everyday world, which describes how the study participants gained comfort from the presence of nurses and their families, sought control over their treatments, and questioned and interpreted the environment, in order to reclaim self. The study highlighted the central role of nurses in patient care, and served as a basis for a number of recommendations, which include recognising the significant role of nurses and family in patient care, and being aware that patients may want more control over their environment and instigate ways to facilitate this. Further research is warranted to examine CCU patients' perceived level of control and power, and to investigate the extent and type of involvement CCU patients would like to have in their care.

Uncovering the unknown: A grounded theory study exploring the impact of self-awareness on the culture of feedback in residency education.

PubMed

Ramani, Subha; Könings, Karen; Mann, Karen V; van der Vleuten, Cees

2017-10-01

Self-assessment and reflection are essential for meaningful feedback. We aimed to explore whether the well-known Johari window model of self-awareness could guide feedback conversations between faculty and residents and enhance the institutional feedback culture. We had previously explored perceptions of residents and faculty regarding sociocultural factors impacting feedback. We re-analyzed data targeting themes related to self-assessment, reflection, feedback seeking and acceptance, aiming to generate individual and institutional feedback strategies applicable to each quadrant of the window. We identified the following themes for each quadrant: (1) Behaviors known to self and others - Validating the known; (2) Behaviors unknown to self but known to others - Accepting the blind; (3) Behaviors known to self and unknown to others - Disclosure of hidden; and (4) Behaviors unknown to self and others - Uncovering the unknown. Normalizing self-disclosure of limitations, encouraging feedback seeking, training in nonjudgmental feedback and providing opportunities for longitudinal relationships could promote self-awareness, ultimately expanding the "open" quadrant of the Johari window. The Johari window, a model of self-awareness in interpersonal communications, could provide a robust framework for individuals to improve their feedback conversations and institutions to design feedback initiatives that enhance its quality and impact.

A Qualitative Study of Young Adult Experiences in the Bariatric Healthcare System: Psychosocial Challenges and Developmental Difficulties.

PubMed

Taube-Schiff, Marlene; Yufe, Shira; Kastanias, Patti; Weiland, Mary; Sockalingam, Sanjeev

2017-08-01

Bariatric surgery is an evidence-based treatment for severe obesity; however, the unique developmental and psychosocial needs of young adults often complicate care and, as yet, are not well understood. We sought to identify themes in young adult patients undergoing bariatric surgery regarding: 1) the psychosocial experiences of obese young adults (18 to 24) seeking bariatric surgery; 2) the experiences during the preoperative bariatric surgery process and 3) the postoperative experiences of young adult patients. In-depth, semistructured individual interviews were conducted with 13 young adult bariatric patients who were seeking or had undergone bariatric surgery within the past 5 years. Interviews were analyzed using a qualitative methodology. We found the following themes in our analyses: 1) the impact of relationships (with families and healthcare providers) on the bariatric healthcare experience; 2) preoperative experiences by young adults prior to undergoing surgery and 3) postoperative reflections and challenges experienced by young adult patients. Results revealed that patients' experiences appear to encompass impact on familial relationships, needs sought to be fulfilled by healthcare providers, and various preoperative and postoperative psychosocial concerns. By understanding the experiences of young adults, healthcare providers might be able to provide better care for these patients. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Magnificent Mum Education Program Featuring the Mum Kids (Grades 4-5).

ERIC Educational Resources Information Center

Kelleher, Christine, Ed.

Magnificent Mum Education Program is a theme-based program developed around the garden mum. With its bright colors, various flower forms, perennial life cycle, and easy propagation, the garden mum is ideal for classroom use and community planting programs. The mum-theme lessons can be integrated into all subject areas including science, math,…

Magnificent Mum Education Program Featuring the Mum Kids (Grades 2-3).

ERIC Educational Resources Information Center

Kelleher, Christine, Ed.

The Magnificent Mum Education Program is a theme-based program developed around the garden mum. With its bright colors, various flower forms, perennial life cycle, and easy propagation, the garden mum is ideal for classroom use and community planting programs. The mum-theme lessons can be integrated into all subject areas including science, math,…

Foster Youth Who Have Succeeded in Higher Education: Common Themes. Information Brief. Volume 7, Issue 1

ERIC Educational Resources Information Center

Lovitt, Thomas; Emerson, John

2008-01-01

The publication is based on interviews conducted by Casey Family Programs with eight foster youth who graduated from college to learn their perspectives on going to college and obtaining a degree despite numerous barriers. This report presents fifteen major themes concerning college success and their general outlook on life. Their accomplishments…

Middle Childhood Support-Seeking Behavior during Stress: Links with Self-Reported Attachment and Future Depressive Symptoms

ERIC Educational Resources Information Center

Dujardin, Adinda; Santens, Tara; Braet, Caroline; De Raedt, Rudi; Vos, Pieter; Maes, Bea; Bosmans, Guy

2016-01-01

This study tested whether children's more anxious and avoidant attachment is linked to decreased support-seeking behavior toward their mother during stress in middle childhood, and whether children's decreased support-seeking behavior enhances the impact of experiencing life events on the increase of depressive symptoms 18 months later.…

Matters of spirituality at the end of life in the pediatric intensive care unit.

PubMed

Robinson, Mary R; Thiel, Mary Martha; Backus, Meghan M; Meyer, Elaine C

2006-09-01

Our objective with this study was to identify the nature and the role of spirituality from the parents' perspective at the end of life in the PICU and to discern clinical implications. A qualitative study based on parental responses to open-ended questions on anonymous, self-administered questionnaires was conducted at 3 PICUs in Boston, Massachusetts. Fifty-six parents whose children had died in PICUs after the withdrawal of life-sustaining therapies participated. Overall, spiritual/religious themes were included in the responses of 73% (41 of 56) of parents to questions about what had been most helpful to them and what advice they would offer to others at the end of life. Four explicitly spiritual/religious themes emerged: prayer, faith, access to and care from clergy, and belief in the transcendent quality of the parent-child relationship that endures beyond death. Parents also identified several implicitly spiritual/religious themes, including insight and wisdom; reliance on values; and virtues such as hope, trust, and love. Many parents drew on and relied on their spirituality to guide them in end-of-life decision-making, to make meaning of the loss, and to sustain them emotionally. Despite the dominance of technology and medical discourse in the ICU, many parents experienced their child's end of life as a spiritual journey. Staff members, hospital chaplains, and community clergy are encouraged to be explicit in their hospitality to parents' spirituality and religious faith, to foster a culture of acceptance and integration of spiritual perspectives, and to work collaboratively to deliver spiritual care.

"You cannot perform music without taking care of your body": a qualitative study on musicians' representation of body and health.

PubMed

Schoeb, Veronika; Zosso, Amélie

2012-09-01

To identify professional musicians' representation of health and illness and to identify its perceived impact on musical performance. A total of 11 professional musicians participated in this phenomenological study. Five of the musicians were healthy, and the others suffered debilitating physical health problems caused by playing their instruments. Semi-structured interviews were conducted, transcribed verbatim and analysed. Thematic analysis, including a six-step coding process, was performed (ATLAS-ti 6). Three major themes emerged from the data: music as art, the health of musicians, and learning through experience. The first theme, music as art, was discussed by both groups; they talked about such things as passion, joy, sense of identity, sensitivity, and a musician's hard life. Discussions of the second theme, the health of musicians, revealed a complex link between health and performance, including the dramatic impact of potential or actual health problems on musical careers. Not surprisingly, musicians with health problems were more concerned with dysfunctional body parts (mostly the hand), whereas healthy musicians focused on maintaining the health of the entire person. The third theme, learning through experience, focused on the dynamic nature of health and included the life-long learning approach, not only in terms of using the body in musical performance but also in daily life. The centre of a musician's life is making music in which the body plays an important part. Participants in this study evidenced a complex link between health and musical performance, and maintaining health was perceived by these musicians as a dynamic balance. Our results suggest that learning through experience might help musicians adapt to changes related to their bodies.

Life impact of ankle fractures: qualitative analysis of patient and clinician experiences.

PubMed

McPhail, Steven M; Dunstan, Joel; Canning, Julie; Haines, Terry P

2012-11-21

Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

Theme: Balancing Your Professional and Personal Life.

ERIC Educational Resources Information Center

Bowen, Blannie E.; And Others

1987-01-01

Consists of six articles dealing with the need to have both a personal and a professional life and ways to do so. Topics include burnout, overcoming workaholism, ways to balance roles, the administrator's view, and the two-career family. (CH)

A structured review and theme analysis of papers published on 'quality of life' in head and neck cancer: 2000-2005.

PubMed

Rogers, S N; Ahad, S A; Murphy, A P

2007-10-01

Over the past 10 years, quality of life (QOL) has been increasingly recognised as an important outcome parameter in head and neck cancer. Validated questionnaires have emerged and there has been an increase in the number of papers published each year. The aim of this article is to review the literature over the past five years (2000-2005 inclusive), to identify papers reporting outcomes using patient self-competed questionnaires and group these into themes. The tabulated summary allows for the areas of health related quality of life research to be identified and to explore issues that are perhaps deficit in the literature. The three authors independently searched the literature published in the English language using the ISI search engine with cross-reference using Pub Med and Ovid. The search terms were; quality of life, questionnaire, and head and neck cancer. Studies were placed in to one of five themes. There were 165 studies identified. The numbers in each theme were predictors of QOL [Hassanein KA, Musgrove BT, Bradbury E. Functional status of patients with oral cancer and its relation to style of coping, social support and psychological status. Br J Oral Maxillofac Surg 2001;39:340-5.], functional outcome [Klug C, Neuburg J, Glaser C, Schwarz B, Kermer C, Millesi W. Quality of life 2-10 years after combined treatment for advanced oral and oropharyngeal cancer. Int J Oral Maxillofac Surg 2002;31:664-9.], questionnaire development [Hanna E, Sherman A, Cash D, Adams D, Vural E, Fan CY, et al. Quality of life for patients following total laryngectomy vs chemoradiation for laryngeal preservation. Arch Otolaryngol Head Neck Surg 2004;130:875-9.], randomised clinical trials [Kanatas AN, Rogers SN. A national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll Surg Engl 2004;86:6-10.], and reviews [Kanatas AN, Rogers SN. A national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll Surg Engl 2004;86:6-10.]. Although many facets of HRQOL following head and neck cancer have been explored over the last five years the paper identifies issues where research is still lacking.

A Qualitative Exploration of the Lived Experiences of Patients Before and After Ileostomy Creation as a Result of Surgical Management for Crohn's Disease.

PubMed

Morris, Andrew; Leach, Bethan

2017-01-01

Patient experiences pre- and post-ileostomy creation as a result of severe Crohn's Disease are underresearched. A qualitative phenomenological design involving a purposeful sampling approach was used to capture the lived physical and psychosocial transition of patients with Crohn's Disease before and after ileostomy formation. Patients were recruited from the membership of the United Kingdom Ileostomy Association; inclusion criteria stipulated participants must speak English and have a diagnosis of Crohn's Disease and subsequent stoma formation. Ten (10) patients (6 women, 4 men, ranging in age from 34 to 83 years with Crohn's Disease and an ileostomy [mean time with stoma 18.3 years, range 3-36 years]) participated in indepth, semistructured interviews with questions on sociodemographic characteristics along with questions informed by the relevant literature regarding life before and after the ileostomy. All interviews were audiorecorded and transcribed verbatim. Interpretative phenomenological analysis was used to examine the data and identify and interpret themes. Participants were asked to comment on these themes to ensure they were a realistic interpretation of their experiences. Two (2) major themes emerged that embodied ileostomy formation: being controlled by Crohn's and transition to a new life with an ileostomy. Crohn's symptoms controlled daily activities such as work and socializing due, in part, to the need to be in close proximity to toilet facilities. The ileostomy facilitated a transition to a new life that allowed patients to re-engage with work and social activities. One minor theme emerged: memories of Crohn's. Participants said their memories of Crohn's affected life with an ileostomy. Where Crohn's controlled every aspect of people's lives pre-ileostomy formation, the creation of the ileostomy was a positive experience because it helped manage Crohn's symptoms. Memories of life pre-ileostomy may affect individuals' behavior post-ileostomy formation. In order to offer appropriate support, health professionals may need to be more aware that having Crohn's may affect patient behavior post-ileostomy.

Teaching Life: Re-Creating and Re-Teaching Literature: Conception to Instruction.

ERIC Educational Resources Information Center

Kerner, Howard A.

Suggesting that instructors approach literature from a multidisciplinary life-based stance, this paper presents syllabi, pedagogical techniques, and a student essay which illustrates a life-based approach to literary themes. The first section of the paper deals with creative curricular re-packaging of great literature in which traditional course…

Special Issue: "Getting of Wisdom", Learning in Later Life

ERIC Educational Resources Information Center

Krašovec, Sabina Jelenc; Golding, Barry; Findsen, Brian; Schmidt-Hertha, Bernhard

2017-01-01

This specially themed ""Getting of Wisdom," Learning in Later Life" Edition of the "Australian Journal of Adult Learning" ("AJAL") is not so much concerned with the issue of ageing itself, but more about quality of life regardless of age. It is about taking, but also giving back as best as possible at any…

Health-Seeking Challenges Among Homeless Youth

PubMed Central

Hudson, Angela L.; Nyamathi, Adeline; Greengold, Barbara; Slagle, Alexandra; Koniak-Griffin, Deborah; Khalilifard, Farinaz; Getzoff, Daniel

2010-01-01

Background Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults. Objectives The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons. Methods This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults. Results Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general). Discussion Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services. PMID:20404776

Between modern and traditional values: Informal mental health help-seeking attitudes according to Israeli Arab women, primary care patients and their providers.

PubMed

Ayalon, Liat; Karkabi, Khaled; Bleichman, Igor; Fleischmann, Silvia; Goldfracht, Margalit

2015-06-01

Israeli Arab women under-utilize mental health services. The present study evaluated the use of alternative services for dealing with depression and anxiety among Israeli Arab women and primary care providers. Four focus groups with primary care patients and two focus groups with primary care providers were conducted. Constant comparisons were employed in order to identify major themes related to informal help-seeking behaviors. Three informal help-seeking behaviors were identified: (a) social support, divided into extended family and neighbors versus nuclear family and close friends; (b) religiosity, divided into inner, direct practices and beliefs versus externally mediated ones; and (c) self-help techniques, such as engagement in activities and distancing oneself from the situation. Both social support and religiosity were viewed with ambivalence by primary care patients and providers. The findings suggest that the Arab population in Israel might be lacking informal sources of support at times of mental health needs. © The Author(s) 2014.

Contrasting beliefs about screening for mental disorders among UK military personnel returning from deployment to Afghanistan.

PubMed

Keeling, M; Knight, T; Sharp, D; Fertout, M; Greenberg, N; Chesnokov, M; Rona, R J

2012-12-01

The objective of the study was to elicit beliefs and experiences of the value of a screening programme for mental illness among UK military personnel. Three months after returning from Afghanistan 21 army personnel participated in a qualitative study about mental health screening. One-to-one interviews were conducted and recorded. Data-driven thematic analysis was used. Researchers identified master themes represented by extracts of text from the 21 complete transcripts. Participants made positive remarks on the advantages of screening. Noted barriers to seeking help included: unwillingness to receive advice, a wish to deal with any problems themselves and a belief that military personnel should be strong enough to cope with any difficulties. Participants believed that overcoming barriers to participating in screening and seeking help would be best achieved by making screening compulsory. Although respondents were positive about a screening programme for mental illness, the barriers to seeking help for mental illness appear deep rooted and reinforced by the value ascribed to hardiness.

Treated and Untreated Remission from Problem Drinking in Late Life: Post-Remission Functioning and Health-Related Quality of Life

PubMed Central

Schutte, Kathleen K.; Brennan, Penny L.; Moos, Rudolf H.

2009-01-01

Objective To evaluate the post-remission status of older remitted problem drinkers who achieved stable remission without treatment. Method The post-remission drinking behavior, health-related functioning, life context, coping, and help-seeking of older, untreated (n = 330) and treated (n = 120) former problem drinkers who had been remitted for a minimum of six years were compared twice over the course of six-years to each other and to lifetime nonproblem drinkers (n = 232). Analyses considered the impact of severity of drinking problem history. Results Untreated remitters were more likely than treated remitters to continue to drink, exhibited fewer chronic health problems and less depressive symptomatology, and were less likely to smoke. Untreated remitters’ life contexts were somewhat more benign than those of treated ones, and they were less likely to describe a coping motive for drinking and engage in post-remission help-seeking. Although untreated remitters more closely resembled lifetime nonproblem drinkers than did treated remitters, both untreated and treated remitter groups exhibited worse health-related functioning, more financial and interpersonal stressors, and more post-remission help-seeking than did lifetime nonproblem drinkers. Conclusions Regardless of whether late-life remission was gained without or with treatment, prior drinking problems conveyed a legacy of health-related and life context deficits. PMID:18829184

'Stress, anger, fear and injustice': An international qualitative survey of women's experiences planning a vaginal breech birth.

PubMed

Petrovska, Karolina; Watts, Nicole P; Catling, Christine; Bisits, Andrew; Homer, Caroline Se

2017-01-01

the outcomes of the Term Breech Trial had a profound impact on women's options for breech birth, with caesarean section now seen as the default method for managing breech birth by many clinicians. Despite this, the demand for planned vaginal breech birth from women does exist. This study aimed to examine the experiences of women who sought a vaginal breech birth to increase understanding as to how to care for women seeking this birth option. an electronic survey was distributed to women online via social media. The survey consisted of qualitative and quantitative questions, with the qualitative data being the focus of this paper. Open ended questions sought information on the ways in which woman sourced a clinician skilled in vaginal breech birth and the level of support and quality of information provided from clinicians regarding vaginal breech birth. Thematic analysis was used to analyse and code the qualitative data into major themes. in total, 204 women from over seven countries responded to the survey. Written responses to the open ended questions were categorised into seven themes: Seeking the chance to try for a VBB; Encountering coercion and fear; Putting the birth before the baby?; Dealing with emotional wounds; Searching for information and support; Traveling across boundaries; Overcoming obstacles in the system. for women seeking vaginal breech birth, limited system and clinical support can impede access to balanced information and options for care. Recognition of existing evidence on the safety of vaginal breech birth, as well as the presence of clinical guidelines that support it, may assist in promoting vaginal breech birth as a legitimate option that should be available to women. Copyright © 2016 Elsevier Ltd. All rights reserved.

Public, patient and carers' views on palliative and end-of-life care in India.

PubMed

Ramasamy Venkatasalu, M; Sirala Jagadeesh, N; Elavally, S; Pappas, Y; Mhlanga, F; Pallipalayam Varatharajan, R

2018-06-01

To systematically review the existing evidence on the Indian public, patient and carers' perspectives on palliative and end-of-life care. With a growing population of terminally ill people across the world, there is also an increasing awareness among international health policy makers of the need to improve the quality of life for terminally ill patients. Understanding service users' (patients, family and public) perspectives is crucial in developing and sustaining successful community-centred palliative nursing policies and service models especially in countries like India with diverse population. An integrative review was performed on five databases, using hand searches of key journals and reference citation tracking for empirical studies published in English from 1990 to 2015. A thematic analysis framework was used to analyse and identify key themes. Analysis of the six eligible studies revealed five themes. Themes describe how social, economic, cultural, religious, spiritual and traditional factors influenced the palliative and end-of-life care perspectives and experiences among Indians. They also illustrated preferences relating to place of care, as well as benefits and challenges of family caregiving during the last days of life. Although we found minimal evidence on user perspectives, nurses need to aware of those unique components of context-specific palliative and end-of-life care practices in India - socioeconomic, cultural and religious factors - on their nursing encounters. Nurses need to advocate same in policy development to enable accessibility and utility of palliative and end-of-life care services, which are scant in India. Nurses can be central in gathering the contextual evidence that advocate users' perspectives to inform further studies and national palliative care policies in India. Emerging policies in nursing education need to focus on integrating family-centred palliative and end-of-life care within curricula, whereas nursing practice may promote nurse-led community models to address the patchy palliative and end-of-life service provision in India. © 2017 International Council of Nurses.

Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model.

PubMed

Bee, Penny; Berzins, Kathryn; Calam, Rachel; Pryjmachuk, Steven; Abel, Kathryn M

2013-01-01

Severe parental mental illness poses a challenge to quality of life (QoL) in a substantial number of children and adolescents, and improving the lives of these children is of urgent political and public health concern. This study used a bottom-up qualitative approach to develop a new stakeholder-led model of quality of life relevant to this population. Qualitative data were collected from 19 individuals participating in focus groups or individual interviews. Participants comprised 8 clinical academics, health and social care professionals or voluntary agency representatives; 5 parents and 6 young people (aged 13-18 yrs) with lived experience of severe parental mental illness. Data underwent inductive thematic analysis for the purposes of informing a population-specific quality of life model. Fifty nine individual themes were identified and grouped into 11 key 'meta-themes'. Mapping each meta-theme against existing child-centred quality of life concepts revealed a multi-dimensional model that endorsed, to a greater or lesser degree, the core domains of generic quality of life models. Three new population-specific priorities were also observed: i) the alleviation of parental mental health symptoms, ii) improved problem-based coping skills and iii) increased mental health literacy. The identification of these priorities raises questions regarding the validity of generic quality of life measures to monitor the effectiveness of services for families and children affected by severe mental illness. New, age-appropriate instruments that better reflect the life priorities and unique challenges faced by the children of parents with severe mental illness may need to be developed. Challenges then remain in augmenting and adapting service design and delivery mechanisms better to meet these needs. Future child and adult mental health services need to work seamlessly alongside statutory education and social care services and a growing number of relevant third sector providers to address fully the quality of life priorities of these vulnerable families.

Difficulties in everyday life: young persons with attention-deficit/hyperactivity disorder and autism spectrum disorders perspectives. A chat-log analysis.

PubMed

Ahlström, Britt H; Wentz, Elisabet

2014-01-01

This study focuses on the everyday life of young persons with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). There are follow-up studies describing ADHD, and ASD in adults, and residual impairments that affect life. Few qualitative studies have been conducted on the subject of their experiences of everyday life, and even fewer are from young persons' perspectives. This study's aim was to describe how young persons with ADHD and ASD function and how they manage their everyday life based on analyses of Internet-based chat logs. Twelve young persons (7 males and 5 females aged 15-26) diagnosed with ADHD and ASD were included consecutively and offered 8 weeks of Internet-based Support and Coaching (IBSC). Data were collected from 12 chat logs (445 pages of text) produced interactively by the participants and the coaches. Qualitative content analysis was applied. The text was coded and sorted into subthemes and further interpreted into themes. The findings revealed two themes: "fighting against an everyday life lived in vulnerability" with the following subthemes: "difficult things," "stress and rest," and "when feelings and thoughts are a concern"; and the theme "struggling to find a life of one's own" with the following subthemes: "decide and carry out," "making life choices," and "taking care of oneself." Dealing with the problematic situations that everyday encompasses requires personal strength and a desire to find adequate solutions, as well as to discover a role in society. This study, into the provision of support and coaching over the Internet, led to more in-depth knowledge about these young persons' everyday lives and revealed their ability to use IBSC to express the complexity of everyday life for young persons with ADHD and ASD. The implications of the findings are that using online coaching makes available new opportunities for healthcare professionals to acknowledge these young persons' problems.

Assessment of factors influencing preservation of dignity at life's end: creation and the cross-cultural validation of the preservation of dignity card-sort tool.

PubMed

Periyakoil, Vyjeyanthi S; Noda, Arthur M; Kraemer, Helena Chmura

2010-05-01

Preserving patient dignity is a sentinel premise of palliative care. This study was conducted to gain a better understanding of factors influencing preservation of dignity in the last chapter of life. We conducted an open-ended written survey of 100 multidisciplinary providers (69% response rate) and responses were categorized to identify 2 main themes, 5 subthemes, and 10 individual factors that were used to create the preservation of dignity card-sort tool (p-DCT). The 10-item rank order tool was administered to a cohort of community dwelling Filipino Americans (n = 140, age mean = 61.3, 45% male and 55% female). A Spearman correlation matrix was constructed for all the 10 individual factors as well as the themes and subthemes based on the data generated by the subjects. The individual factors were minimally correlated with each other indicating that each factor was an independent stand-alone factor. The median, 25th and 75th percentile ranks were calculated and "s/he has self-respect" (intrinsic theme, self-esteem subtheme) emerged as the most important factor (mean rank 3.0 and median rank 2.0) followed by "others treat her/him with respect" (extrinsic theme, respect subtheme) with a mean rank = 3.6 and median = 3.0. The p-DCT is a simple, rank order card-sort tool that may help clinicians identify patients' perceptions of key factors influencing the preservation of their dignity in the last chapter of life.

Life-centered ethics, and the human future in space.

PubMed

Mautner, Michael N

2009-10-01

In the future, human destiny may depend on our ethics. In particular, biotechnology and expansion in space can transform life, raising profound questions. Guidance may be found in Life-centered ethics, as biotic ethics that value the basic patterns of organic gene/protein life, and as panbiotic ethics that always seek to expand life. These life-centered principles can be based on scientific insights into the unique place of life in nature, and the biological unity of all life. Belonging to life then implies a human purpose: to safeguard and propagate life. Expansion in space will advance this purpose but will also raise basic questions. Should we expand all life or only intelligent life? Should we aim to create populations of trillions? Should we seed other solar systems? How far can we change but still preserve the human species, and life itself? The future of all life may be in our hands, and it can depend on our guiding ethics whether life will fulfil its full potentials. Given such profound powers, life-centered ethics can best secure future generations. Our descendants may then understand nature more deeply, and seek to extend life indefinitely. In that future, our human existence can find a cosmic purpose.

Insights into the Experiences of Treatment for An Eating Disorder in Men: A Qualitative Study of Autobiographies

PubMed Central

Thapliyal, Priyanka; Mitchison, Deborah; Hay, Phillipa

2017-01-01

Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion criteria were autobiographies of men who had experienced an eating disorder and sought any form of treatment for this, written in the English language, published between 1995 and 2015, and available for purchase in 2016. The search resulted in six books that were thematically analyzed. Analysis of data resulted in two broad themes (1. Positive experiences; 2. Negative experiences) with sub-themes. With regards to the first theme, factors such as concern of staff members, therapist’s expertise (in treating eating disorders in men), and a collaborative treatment approach were considered favorable for treatment. In contrast to the first theme, apathy of staff members, the authors’ own negative preconceptions, treatment providers being perceived as prioritizing financial concerns, perceived as incompetent and judgmental behavior of therapist(s), and time limitations of sessions were considered unfavorable treatment experiences. In this study, the perceived success of treatment depended on therapist’s features and the form of treatment provided. Further research examining these is indicated. PMID:28621727

The workers role in knowledge management and sustainability policies.

PubMed

Bolis, Ivan; Brunoro, Claudio; Sznelwar, Laerte Idal

2012-01-01

Based on the concepts of sustainability and knowledge management, this article seeks to identify points of contact between the two themes through an exploratory study of existing literature. The first objective is to find, in international literature, the largest number of papers jointly related to the theme of knowledge management and sustainability. In these documents, the authors looked at the kind of relationship existing between the two themes and what the benefits introduced in organizations are. Based on an ergonomic point of view, the second objective of this article is to analyze the role of the worker (whether at the strategic or operational level) and his importance in this context. The results demonstrate that there is very little literature that addresses the two themes together. The few papers found, however, can be said to show the many advantages of introducing sustainability policies supported by adequate knowledge management. Very little has been studied with regards to the role of workers, which could be interpreted as meaning that little importance is given to the proactive role they may play. On the other hand, there is a high potential for future research in these areas, based on the high level of consideration of workers in knowledge management and sustainability literature, as well as in literature in the areas of ergonomics and sociology.

Male nurses and chemical dependency: masterminding the nursing environment.

PubMed

Dittman, Patricia Welch

2008-01-01

Florida men in nursing who are chemically dependent represent a greater percentage of the total number of male nurses than female nurses who are chemically dependent. This study identifies characteristics of 9 men who completed the Florida Intervention Project for Nurses. All participants were interviewed independently and data were analyzed to determine common themes in their behaviors and relationships and how they successfully manipulated professional nursing systems to remain professionally active for prolonged period of time while impaired. A model of caring for nurses with professional impairment graphically depicted the interaction of 2 overarching themes of person and profession. The person theme had 3 subthemes of predetermined risk, altered values, and sensation-seeking behaviors. The profession theme had 6 subthemes of masterminding, professional heteronomy, getting caught, rehabilitation, spirituality, and the nurse becoming the nursed. Findings imply that chemical dependency among male nurses starts in childhood in an abusive family environment and continues throughout the educational process and into the work environment. Findings supporting diversion success include a lack of awareness of the signs and symptoms of impairment by supervisors, poor compliance to drug control procedures, and a common acceptance by peers that impaired men are clinically competent and clinical leaders. When these 3 situations are present, there is greater success in masterminding daily events to maintain undetected drug access.

Midlife crisis perceptions, experiences, help-seeking, and needs among multi-ethnic malaysian women.

PubMed

Wong, Li Ping; Awang, Halimah; Jani, Rohana

2012-01-01

In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting.

'The bloke can be a bit hazy about what's going on': men and cross-border reproductive treatment.

PubMed

Hudson, Nicky; Culley, Lorraine

2013-09-01

While social science research has begun to demonstrate the significant impact of infertility and involuntary childlessness for men, far fewer studies have specifically explored the male experience of, or men's involvement in, infertility treatment-seeking and there are few published studies which specifically describe men's experiences with cross-border reproduction. This paper presents data from the first UK study of transnational treatment-seeking and specifically explores men's involvement in this process. Data from interviews with 10 men and 34 women who were seeking treatment abroad are organized according to three themes: 'going along with it'; 'being a rock'; and 'doing their bit'. The paper argues that gender is an important aspect of the cross-border treatment experience and that both traditional and emergent gender identities are expressed in the process of treatment-seeking. Healthcare providers need to actively explore men's perspectives of the treatment process in all locations, to improve quality of care by reducing men's feelings of marginalization and enhancing their experience of treatment, especially but not exclusively, around the issue of semen collection. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

The Intergenerational Circumstances of Household Food Insecurity and Adversity

PubMed Central

Chilton, Mariana; Knowles, Molly; Bloom, Sandra L.

2017-01-01

ABSTRACT Household food insecurity is linked with exposure to violence and adversity throughout the life course, suggesting its transfer across generations. Using grounded theory, we analyzed semistructured interviews with 31 mothers reporting household food insecurity where participants described major life events and social relationships. Through the lens of multigenerational interactions, 4 themes emerged: (1) hunger and violence across the generations, (2) disclosure to family and friends, (3) depression and problems with emotional management, and (4) breaking out of intergenerational patterns. After describing these themes and how they relate to reports of food insecurity, we identify opportunities for social services and policy intervention. PMID:28503244

Transcending breast cancer, transcending death: a Taiwanese population.

PubMed

Chiu, L

2000-01-01

This study explores transcendence as a lived experience through in-depth, face-to-face interviews of 15 Taiwanese women with breast cancer. A phenomenological research method and Leininger's culture care theory were employed to guide the study. Four themes emerged as characteristic of the current lifeworlds of the study participants. The four themes are giving meaning to suffering, liberating a clinging nature, opening to life and death, and healing with compassion. The findings reveal that the essential structure of transcendence is the capacity of a person to give meaning to suffering, liberate self from a clinging nature, open self to life and death, and heal self with compassion.

The Ties That Bind: Materiality, Identity, and the Life Course in the "Things" Families Keep.

PubMed

Gloyn, Liz; Crewe, Vicky; King, Laura; Woodham, Anna

2018-04-01

Using an interdisciplinary research methodology across three archaeological and historical case studies, this article explores "family archives." Four themes illustrate how objects held in family archives, curation practices, and intergenerational narratives reinforce a family's sense of itself: people-object interactions, gender, socialization and identity formation, and the "life course." These themes provide a framework for professional archivists to assist communities and individuals working with their own family archives. We argue that the family archive, broadly defined, encourages a more egalitarian approach to history. We suggest a multiperiod analysis draws attention to historical forms of knowledge and meaning-making practices over time.

Effect of an Education Program on Improving Help-Seeking among Parents of Junior and Senior High School Students in Japan

PubMed Central

Yoshii, Hatsumi; Watanabe, Yuichiro; Kitamura, Hideaki; Nan, Zhang; Akazawa, Kouhei

2012-01-01

Early intervention in schizophrenia is important for patient prognosis and quality of life. At the time of the first episode, quality of life is influenced by identification of symptoms and by medical help-seeking behavior. In this prospective cohort study, we investigated help-seeking among 2690 parents of junior and senior high school students before and after the parents viewed a newly developed web-based education program aimed at improving knowledge of schizophrenia. Our web-based education program aimed to improve understanding of schizophrenia, including promotion of help-seeking. Many parents (33.1%-50.0%) consulted a physician in a department of psychosomatic medicine when their child experienced symptoms. Characteristics that predicted a decision not to seek psychiatric medical help were having child with all symptoms, younger parent age, and lower family income (p<0.05). After the education program, the rate of parents who sought medical help within 1 week was significantly higher for all symptom categories except sleeplessness (p=0.001). These findings suggest that the present web-based education program was useful in promoting medical help-seeking behavior among parents of junior and senior high school students in Japan. PMID:22980101

Religious insistence on medical treatment. Christian theology and re-imagination.

PubMed

Connors, R B; Smith, M L

1996-01-01

Families and surrogates sometimes use religious themes to justify their insistence on aggressive end-of-life care. Their hope that "God will work a miracle" can halt negotiations with health care professionals and lead to litigation. The possibility of "re-imagining" religious themes, to broaden their scope and present a wider vision of the Christian tradition, may offer a solution.

Nuffield Secondary Science, Theme 2, Continuity of Life.

ERIC Educational Resources Information Center

Wigglesworth, George

Nuffield Secondary Science is a set of tested materials from which teachers can prepare courses for students in grades 9-11 (approximately) who do not intend to major in science. The materials are designed for British secondary schools but are adaptable to other countries. The Teachers' Guide to the entire set of Themes is described in SE 015 440…

How do I love thee? Let me count the ways: parenting during adolescence, attachment styles, and romantic narratives in emerging adulthood.

PubMed

Nosko, Amanda; Tieu, Thanh-Thanh; Lawford, Heather; Pratt, Michael W

2011-05-01

In this longitudinal study, a quantitative and qualitative examination of the associations among parent-child relations, adult attachment styles, and relationship quality and theme in romantic narratives was conducted. Parenting and adult attachment style were assessed through questionnaires, whereas overall quality of romantic relationships (regard and importance), intimacy, and romantic story theme were examined with a life story approach (McAdams, 1993). At ages 17 and 26 years, 100 participants completed a series of questionnaires and also, at age 26, told a story about a "relationship-defining moment" with a romantic partner. Parent-child relations when participants were 17 years old were related predictably to all three attachment styles. About 70% of the sample told romantic stories with a "true love" type of theme. Associations between parent-child relations when the child was 17 and this type of theme in the story told when the participant was 26 were mediated by a more secure (and a less avoidant) attachment style when the participant was 26, as predicted. The implications of these findings for links between attachment models and the life story are discussed. (c) 2011 APA, all rights reserved.

A Qualitative Study of a Maintenance Support Program for Women at Risk of Homelessness: Part 2: Situational Factors.

PubMed

McMaster, Rose; Lopez, Violeta; Kornhaber, Rachel; Cleary, Michelle

2017-06-01

People who are homeless tend to have a number of complex needs. A housing maintenance support program (MSP) for women from the perspectives of clients, case managers and health professionals within the program was explored in this qualitative descriptive study. Interviews were conducted, and data were analysed using thematic analysis. The overarching theme that emerged from the data was "A life-changing event: I have the power to change." This theme was supported by three sub-themes: personal, situational and societal dimensions. In this article, the sub-theme - situational factors, is presented and refers to poverty, resources and services, as well as social support systems. These aspects all impinged on the client's ability to face life changes with optimism towards a better future. Their experiences of disconnection with the community changed for the clients after being part of the MSP. The MSP enabled the clients to feel part of society again, and empowered them to participate in the world around them. Key aspects of inclusion in the world are relationships based on acceptance, connecting with others, being involved and creating a sense of home/community.

How did the Canterbury earthquakes affect physiotherapists and physiotherapy services? A qualitative study.

PubMed

Mulligan, Hilda; Smith, Catherine M; Ferdinand, Sandy

2015-03-01

The recent earthquakes in Canterbury New Zealand ended lives and resulted in disruption to many aspect of life for survivors, including physiotherapists. Physiotherapists often volunteer vital rehabilitation services in the wake of global disasters; however, little is known about how physiotherapists cope with disasters that affect their own communities. The purpose of this study was to investigate how the Canterbury earthquakes affected physiotherapists and physiotherapy services. We use a General Inductive Approach to analyse data obtained from purposively sampled physiotherapists or physiotherapy managers in the Canterbury region. Interviews were audio-recorded and transcribed verbatim. We analysed data from interviews with 27 female and six male participants. We identified four themes: 'A life-changing earthquake' that described how both immediate and on-going events led to our second theme 'Uncertainty'. Uncertainty eroded feelings of resilience, but this was tempered by our third theme 'Giving and receiving support'. Throughout these three themes, we identified a further theme 'Being a physiotherapist'. This theme explains how physiotherapists and physiotherapy services were and still are affected by the Canterbury earthquakes. We recommend that disaster planning occurs at individual, departmental, practice and professional levels. This planning will enable physiotherapists to better cope in the event of a disaster and would help to provide professional bodies with a cohesive set of skills that can be shared with health agencies and rescue organizations. We recommend that the apparently vital skill of listening is explored through further research in order for it to be better accepted as a core physiotherapy skill. Copyright © 2014 John Wiley & Sons, Ltd.

A Qualitative Study on Coping Strategies among Women from Food Insecurity Households in Selangor and Negeri Sembilan.

PubMed

Norhasmah, S; Zalilah, M S; Mohd Nasir, M T; Kandiah, M; Asnarulkhadi, A S

2010-04-01

Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objectives and describe an integrating as well as relational idea from the data. Results showed that households displayed a variety of non-food related coping strategies and food-related coping strategies. Women's descriptions of non-food related coping strategies to food insecurity were categorised into five themes i.e. cloth purchasing behaviors, reduce school-going children's expenditure, delay the payment of bills, adjust lifestyle and increase cash and income earning. Food related coping strategies were categorised into four themes i.e. food stretching, food rationing, food seeking and food anxiety. Food stretching is a strategy of food insecurity that affects the quality of diet. Food rationing comprises coping strategies of food insecurity related to the quantity of food available for household's consumption. Food seeking is a strategy of acquiring food through socially unacceptable ways and food anxiety is a strategy that indicates households allocating money to buy staple food in order to prevent food insecurity. Each coping strategy showed a different level of perceived severity, that is, less severe, quite severe, severe and very severe. In conclusion, the qualitative data provide valuable information for understanding the experiences of food insecurity that can be used as a basis to develop direct indicators that can capture the core behaviours and their level of severity to measure household food insecurity.

Attributions and private theories of mental illness among young adults seeking psychiatric treatment in Nairobi: an interpretive phenomenological analysis.

PubMed

Mbuthia, Judy Wanjiru; Kumar, Manasi; Falkenström, Fredrik; Kuria, Mary Wangari; Othieno, Caleb Joseph

2018-01-01

Mental illness affects every segment of population including young adults. The beliefs held by young patients regarding the causes of mental illness impact their treatment-seeking behaviour. It is pertinent to know the commonly held attributions around mental illness so as to effectively provide psychological care, especially in a resource constrained context such as Kenya. This helps in targeting services around issues such as stigma and extending youth-friendly services. Guided by the private theories interview (PTI-P) and attributional framework, individual semi-structured interviews were carried out with ten young adults of ages 18-25 years about their mental health condition for which they were undergoing treatment. Each interview took 30-45 min. We mapped four attributions (locus of control, stability, controllability and stigma) on PTI-P questions. Data was transcribed verbatim to produce transcripts coded using interpretive phenomenological analysis. These codes were then broken down into categories that could be used to understand various attributions. We found PTI-P to be a useful tool and it elicited three key themes: (a) psychosocial triggers of distress (with themes of negative thoughts, emotions around mental health stigma and negative childhood experiences, parents' separation or divorce, death of a loved one etc.), (b) biological conditions and psychopathologies limiting intervention, and (c) preferences and views on treatment. Mapping these themes on our attributional framework, PTI-P themes presented as causal attributions explaining stigma, locus of control dimensions and stability. External factors were mainly ascribed to be the cause of unstable and uncontrollable attributions including persistent negative emotions and thoughts further exacerbating psychological distress. Nine out of the ten participants expressed the need for more intense and supportive therapy. Our study has provided some experiential evidence in understanding how stigma, internal vs external locus of control, stability vs instability attributions play a role in shaping attitudes young people have towards their mental health. Our study points to psychosocial challenges such as stigma, poverty and lack of social support that continue to undermine mental well-being of Kenyan youth. These factors need to be considered when addressing mental health needs of young people in Kenya.

Stories of chronic kidney disease: listening for the unsayable.

PubMed

Makaroff, Kara L Schick; Sheilds, Laurene; Molzahn, Anita

2013-12-01

To explore individuals' stories of chronic kidney disease, particularly those aspects of experience that are difficult to discuss using language (i.e. unsayable). Chronic kidney disease is continuous, but it is also life-threatening and sometimes people ask difficult questions about life and death that can be challenging and for some, impossible to discuss. These 'unsayables' are the focus of this article. The unsayable may reside both within and beyond language. Careful analysis of narratives of illness for sayable and unsayable aspects of the experience can help illuminate new areas of concern for people with chronic kidney disease. Narrative inquiry, located in a social constructionist framework, guided this study. Secondary data analysis was conducted with 46 in-depth interviews (collected between 2008-2011) with 14 people living with chronic kidney disease. Through narrative thematic analysis, we identify that the unsayable includes the following five themes: living with death, embodied experiences that were difficult to language, that which was unthinkable, unknowable mystery and that which was untold/unheard. Whereas the first four themes attend to that which is unsayable for people living with chronic kidney disease, the last theme acknowledges that which is unsayable to people living with chronic kidney disease. Not all experiences of illness can be explicitly articulated in language. Listening for both the sayable and unsayable aspects of life with chronic and life-threatening illness is an important nursing role. © 2013 John Wiley & Sons Ltd.

LIFE CYCLE DESIGN FRAMEWORK AND DEMONSTRATION PROJECTS PROFILES OF AT&T AND ALLIED SIGNAL

EPA Science Inventory

Life cycle design seeks to minimize the environmental burden associated with a product life cycle from raw materials acquisition through manufacturing, use, and end-of-life management. ife cycle design emphasizes integrating environmental requirements into the earliest phases of ...

Seeking Help in Domestic Violence Among Muslim Women in Muslim-Majority and Non-Muslim-Majority Countries: A Literature Review.

PubMed

Afrouz, Rojan; Crisp, Beth R; Taket, Ann

2018-01-01

Women from different backgrounds and cultures are at risk of domestic violence. Disclosing the abusive experience and seeking help is not straightforward and easy and might be a complicated and long-term process. Muslim women, like other groups of women, may face various barriers to disclose abusive relationships and for seeking help. Some of the barriers may be common for the majority of Muslim women in different contexts, while others might be related to women's situations and the wider society they live. To identify these barriers and make recommendations for future studies, this article reviews related papers conducted in both Muslim-majority and non-Muslim-majority countries. A critical systematic review of the literature was conducted for identifying Muslim women's barriers in disclosing abuse and seeking help. Twenty-one studies met the inclusion criteria. The main identified barriers are discussed into under four themes: social context, family context, individual factors, and expectations of service providers. Although the researchers tried to investigate various barriers in seeking help, many of them have not focused on structural obstacles. Besides, in many Muslim-majority countries, the issue has not been explored. Therefore, the results of the current article will not apply to those countries. Recommendation for future research comprises more qualitative research compatible with the women's cultures and backgrounds in different societies, focusing more on structural and cultural factors to explore and find women's barriers to seek help.

Spirituality attenuates the association between depression symptom severity and meaning in life.

PubMed

Bamonti, Patricia; Lombardi, Sarah; Duberstein, Paul R; King, Deborah A; Van Orden, Kimberly A

2016-01-01

This cross-sectional study examined whether spirituality moderates the association between depression symptom severity and meaning in life among treatment-seeking adults. Participants were 55 adults (≥60 years of age) newly seeking outpatient mental health treatment for mood, anxiety, or adjustment disorders. Self-report questionnaires measured depression symptom severity (Patient Health Questionnaire-9), spirituality (Spirituality Transcendence Index), and meaning in life (Geriatric Suicide Ideation Scale-Meaning in Life subscale). Results indicated a significant interaction between spirituality and depression symptom severity on meaning in life scores (β = .26, p = .02). A significant negative association between depression symptom severity and meaning in life was observed at lower but not the highest levels of spirituality. In the presence of elevated depressive symptomatology, those participants who reported high levels of spirituality reported comparable levels of meaning in life to those without elevated depressive symptomatology. Assessment of older adult patients' spirituality can reveal ways that spiritual beliefs and practices can be can be incorporated into therapy to enhance meaning in life.

Spirituality Attenuates the Association Between Depression Symptom Severity and Meaning in Life

PubMed Central

Bamonti, Patricia; Lombardi, Sarah; Duberstein, Paul R.; King, Deborah A.; Van Orden, Kimberly A.

2015-01-01

This cross-sectional study examined whether spirituality moderates the association between depression symptom severity and meaning in life among treatment-seeking adults. Participants were 55 adults (≥ 60 years of age) newly seeking outpatient mental health treatment for mood, anxiety, or adjustment disorders. Self-report questionnaires measured depression symptom severity (Patient Health Questionnaire-9), spirituality (Spirituality Transcendence Index), and meaning in life (Geriatric Suicide Ideation Scale-Meaning in Life subscale). Results indicated a significant interaction between spirituality and depression symptom severity on meaning in life scores (β = .26, p = .02). A significant negative association between depression symptom severity and meaning in life was observed at lower but not the highest levels of spirituality. In the presence of elevated depressive symptomatology, those participants who reported high levels of spirituality reported comparable levels of meaning in life to those without elevated depressive symptomatology. Assessment of older adult patients’ spirituality can reveal ways that spiritual beliefs and practices can be can be incorporated into therapy to enhance meaning in life. PMID:25808754

A meta-summary of qualitative findings on the lived experience among culturally diverse domestic violence survivors.

PubMed

Childress, Saltanat

2013-09-01

This meta-summary study explores, extracts, and summarizes themes from related qualitative studies on the lived experiences and coping mechanisms among culturally diverse domestic violence survivors. Using Sandelowski and Barroso's meta-summary strategy, a systematic literature review of articles published between 1990 and 2010 was conducted using a qualitative approach. Of a total of 802 studies, nine met the study inclusion criteria. This meta-summary of nine studies confirms the recurring themes in primary qualitative studies in the literature that illustrate women's experiences of domestic violence. These themes include (a) the effects of violence, (b) the cyclical nature of violence, (c) normalizing and tolerating violence, (d) the strength and resilience of victims, (e) barriers to help-seeking, and (f) the role of substance use in domestic violence. The review shows key cross-cultural differences in women's perceptions of abuse and the causes and strategies for responding to abuse. The review also reveals the lack of studies on domestic violence among women from Central Asia and the former Soviet Union.

Pediatric to Adult Care Transition: Perspectives of Young Adults With Sickle Cell Disease.

PubMed

Porter, Jerlym S; Wesley, Kimberly M; Zhao, Mimi S; Rupff, Rebecca J; Hankins, Jane S

2017-10-01

The aim of this study was to explore perspectives of transition and transition readiness of young adult patients (YAs) with sickle cell disease (SCD) who have transitioned to adult health care. In all, 19 YAs with SCD (ages 18-30 years) participated in one of three focus groups and completed a brief questionnaire about transition topics. Transcripts were coded and emergent themes were examined using the social-ecological model of adolescent and young adult readiness for transition (SMART). Themes were consistent with most SMART components. Adult provider relationships and negative medical experiences emerged as salient factors. YAs ranked choosing an adult provider, seeking emergency care, understanding medications/medication adherence, knowing SCD complications, and being aware of the impact of health behaviors as the most important topics to include in transition programming. The unique perspectives of YAs can inform the development and evaluation of SCD transition programming by incorporating the identified themes. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

What support do health visitor mentors need?

PubMed

Morton, Sarah

2013-08-01

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

The transition from pediatric to adult care for youth with epilepsy: Basic biological, sociological, and psychological issues.

PubMed

Camfield, Peter; Camfield, Carol; Busiah, Kanetee; Cohen, David; Pack, Alison; Nabbout, Rima

2017-04-01

Transition from pediatric to adult health care for adolescents with epilepsy is challenging for the patient, family, and health care workers. This paper is the first of three that summarize the main findings from the 2nd Symposium on Transition in Epilepsies, held in Paris from June 14-25, 2016. In this paper we describe five basic themes that have an important effect on transition. First, there are important brain changes in adolescence that leave an imbalance between risk taking and pleasure seeking behaviors and frontal executive function compared with adults. Second, puberty is a major change during the transition age. The three most important but separate neuroendocrine axes involved in puberty are gonadarche (activation of the gonads), adrenarche (activation of adrenal androgen production), and activation of the growth hormone-insulin like growth factor. Third, sexual debut occurs during the transition years, and at an earlier age in adolescents with epilepsy than controls. Adult sexual performance is often unsatisfactory. Although AED-induced alterations in sexual hormones and temporal lobe epilepsy may play a role in hyposexuality, depression, anxiety, and other social factors appear most important. Fourth, psychological development is very important with an evolution from an early stage (ages 10-13years) with concrete thinking, to a middle stage (ages 14-17) with analytic and more abstract introspective thinking, and then to a late stage (ages 18-21) with at least the beginnings of adult reasoning. Epilepsy may derail this relatively orderly progression. Adolescents with autistic spectrum disorder may present with severe behavior problems that are sometimes related to undiagnosed epilepsy. Fifth, bone health in adolescence is critical to establish adequate mineralization for all of adult life. While AED interference with Vitamin D metabolism is important, there is evidence that the effects of AEDs on bone are more complex and involve changes in remodeling. Hence, some non-inducing AEDs may have a significant effect on bone health. All five of these themes lead to recommendations for how to approach adolescents and young adults during transition and some specific interventions to achieve maximum long-term adult independence and quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Intellect and Public Life: Essays on the Social History of Academic Intellectuals in the United States.

ERIC Educational Resources Information Center

Bender, Thomas

Eight essays discuss the relation of urban patterns of intellectual life and academic forms of higher learning. Themes that run through the essays include: the increasing incorporation of academic culture into the center of American life, socially and intellectually, is accompanied and causally related to a progressive impoverishment of the public…

'I stayed with my illness': a grounded theory study of health seeking behaviour and treatment pathways of patients with obstetric fistula in Kenya.

PubMed

Khisa, Anne M; Omoni, Grace M; Nyamongo, Isaac K; Spitzer, Rachel F

2017-09-29

Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women's health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing? We used grounded theory methodology to analyse data from narratives of women during inpatient stay after fistula surgery in 3 hospitals in Kenya. Emergent themes contributed to generation of substantive theory and a conceptual framework on the health seeking behaviour of fistula patients. We recruited 121 participants aged 17 to 62 years whose treatment pathways are presented. Participants delayed health seeking, living with fistula illness after their first encounter with unresponsive hospitals. The health seeking trajectory is characterized by long episodes of staying home with illness for decades and consulting multiple actors. Staying with fistula illness entailed health seeking through seven key actions of staying home, trying home remedies, consulting with private health care providers, Non-Governmental organisations, prayer, traditional medicine and formal hospitals and clinics. Long treatment trajectories at hospital resulted from multiple hospital visits and surgeries. Seeking treatment at hospital is the most popular step for most women after recognizing fistula symptoms. We conclude that the formal health system is not responsive to women's needs during fistula illness. Women suffer an illness with a chronic trajectory and seek alternative forms of care that are not ideally placed to treat fistula illness. The results suggest that a robust health system be provided with expertise and facilities to treat obstetric fistula to shorten women's treatment pathways.

Physical activity participation among families of children with visual impairments and blindness.

PubMed

Columna, Luis; Dillon, Suzanna Rocco; Dolphin, Michelle; Streete, Denzil A; Hodge, Samuel R; Myers, Beth; Norris, Michael L; McCabe, Lindsay; Barreira, Tiago V; Heffernan, Kevin S

2017-10-25

Physical activity (PA) provides multiple benefits to children with visual impairments (VI) and their families. However, the empirical literature base is underdeveloped on how family PA experiences impact participation for children with VI. The purpose of this study was two-fold; that is: (a) to explore why families with children with VI seek out and participate in PA, and (b) to describe the strategies and supports needed by families of children with VI to improve PA participation. The research method was descriptive-qualitative positioned in the theoretical framework of the theory of planned behavior. Participants were parents of children with VI (n = 10) who took part in one-on-one semi-structured telephone interviews. Interview recordings were transcribed and analyzed using a thematic line-by-line analysis. Three salient, recurrent, and interrelated themes emerged from the data analyses. These themes were: (a) committed, (b) challenged, and (c) access. Findings revealed that parents valued PA, but they lacked the skills to teach and advocate for their children regarding PA. As a consequence, parents voiced the need for a support system that would allow their families to be more physically active. Implications for Rehabilitation Results of this study demonstrated that parents valued physical activity, but they lacked the skills necessary to confidently engage their children in physical activity. Physical activity interventions are needed to enhance the quality of life of children with visual impairments and their families. Physical activity programs and interventions are most likely to enhance intentions to engage in physical activity among children with visual impairments and their parents. Results demonstrated that parents of children with visual impairments were interested to work side-by-side with physical activity professionals to enhance recreational physical activity opportunities available to their children.

Running free: embracing a healthy lifestyle through distance running.

PubMed

Shipway, Richard; Holloway, Immy

2010-11-01

Sport and leisure activity contribute to both health and quality of life. There is a dearth of qualitative studies on the lived experiences of active people, so the aim of this paper is to develop a deeper understanding of the experiences of one particular group of active leisure participants, distance runners, and to highlight the associated health and well-being benefits that result from participating in this increasingly popular form of active leisure. In doing so, this paper will briefly explore the potential opportunities and implications for sport and leisure policy and provision, and highlight examples of how distance running could positively contribute towards government objectives linked to tackling obesity levels, healthy living and physical well-being. It is suggested that similar benefits also exist across other forms of physical activity, exercise and sport. Qualitative methods of enquiry were adopted to understand the nature of the social world of long distance runners through interviews and observations, which were thematically analyzed. One of the key themes emerging from the data was the desire to embrace a healthy lifestyle, which then led to the emergence of four main sub-themes. The first was linked to the importance of seeking self-esteem and confirmation through running; second, an investigation of a selection of negative aspects associated with exercise addiction; third, the need to exercise among sport and leisure participants; and finally, an understanding of the concept of the 'running body'. Cautionary notes also identified negative aspects associated with exercise and physical activity. The findings highlight the potential role that distance running can play as an easily accessible and enjoyable leisure activity, one that can help facilitate increased participation in exercise and physical activity as an integral part of an active and healthy lifestyle.

'That red flag on your file': misinterpreting physical symptoms as mental illness.

PubMed

Happell, Brenda; Ewart, Stephanie B; Bocking, Julia; Platania-Phung, Chris; Stanton, Robert

2016-10-01

To ascertain the views and experiences of mental health consumers regarding the availability and quality of care and treatment received for their physical health needs. People diagnosed with mental illness have higher occurrence of physical health problems. Responsive health care services are crucial for prevention and management of physical health problems, and for reducing disparities in health between people diagnosed with mental illness and those who are not. There is limited research giving voice to consumer perspectives on their experiences with health care providers. Exploratory qualitative. Focus group interviews with mental health consumers accessed via a consumer network group in a region of Australia (n = 31). All interview audio recordings were transcribed professionally. Interviews were thematically analysed. The main themes were: symptomising; failure to act and alertness to prejudice. The first two themes were consumer perceptions of the actions and behaviours of health professionals, and the third describes consumer responses to these behaviours and actions. Consumers described increased risks of illness and death because of undiagnosed physical illness despite their physical health advice-seeking as the reason for the health consultation. Health care providers' non-recognition of physical health problems presents a clear example of a significant and potentially life threatening health inequity. The service provider responses described by participants suggest that mental health consumers' physical health needs may not be taken seriously. Clinicians need to take seriously the physical health needs and concerns of people with mental illness. Nurses can play a crucial role in the prevention of diagnostic overshadowing as part of a broader direction of balancing biomedical perspectives with other approaches to health care. © 2016 John Wiley & Sons Ltd.

Ovarian Cancer Survivors’ Experiences of Self-Advocacy: A Focus Group Study

PubMed Central

Hagan, Teresa L.; Donovan, Heidi S.

2014-01-01

Purpose/Objectives To explore ovarian cancer survivors’ experiences of self-advocacy in symptom management. Research Approach Descriptive, qualitative. Setting A public café in an urban setting. Participants 13 ovarian cancer survivors aged 26–69 years with a mean age of 51.31. Methodologic Approach Five focus groups were formed. Focus group discussions were audio recorded and transcribed verbatim. The content was analyzed using the constant comparison method with axial coding. In-depth interviews with 5 of the 13 participants occurred via telephone one to five months after each focus group meeting to clarify and expand on identified themes. Preliminary findings were shared with all participants for validation. Findings Two major themes emerged from the data: (a) knowing who I am and keeping my psyche intact, and (b) knowing what I need and fighting for it. Exemplar quotations illustrate the diverse dimensions of self-advocacy. In addition, a working female-centric definition of self-advocacy was attained. Conclusions Women have varying experiences with cancer- and treatment-related symptoms, but share a common process for recognizing and meeting their needs. Self-advocacy was defined as a process of learning one’s needs and priorities as a cancer survivor and negotiating with healthcare teams, social supports, and other survivors to meet these needs. Interpretation This phenomenologic process identified key dimensions and a preliminary definition of self-advocacy that nurses can recognize and support when patients seek and receive care consistent with their own needs and preferences. Knowledge Translation Self-advocacy among female cancer survivors is a process of recognizing one’s needs and priorities and fighting for them within their cancer care and life. Practitioners can support female cancer survivors through the process of self-advocacy by providing them with skills and resources in making informed choices for themselves. PMID:23454476

Establishing the values for patient engagement (PE) in health-related quality of life (HRQoL) research: an international, multiple-stakeholder perspective.

PubMed

Haywood, Kirstie; Lyddiatt, Anne; Brace-McDonnell, Samantha J; Staniszewska, Sophie; Salek, Sam

2017-06-01

Active patient engagement is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout the research process. However, guidance for patient engagement (PE) in HRQoL research does not exist, the evidence-base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. This is the first study to explore the values that should underpin PE in contemporary HRQoL research to help inform future good practice guidance. A modified 'World Café' was hosted as a collaborative activity between patient partners, clinicians and researchers: self-nominated conference delegates participated in group discussions to explore values associated with the conduct and consequences of PE. Values were captured via post-it notes and by nominated note-takers. Data were thematically analysed: emergent themes were coded and agreement checked. Association between emergent themes, values and the Public Involvement Impact Assessment Framework were explored. Eighty participants, including 12 patient partners, participated in the 90-min event. Three core values were defined: (1) building relationships; (2) improving research quality and impact; and (3) developing best practice. Participants valued the importance of building genuine, collaborative and deliberative relationships-underpinned by honesty, respect, co-learning and equity-and the impact of effective PE on research quality and relevance. An explicit statement of values seeks to align all stakeholders on the purpose, practice and credibility of PE activities. An innovative, flexible and transparent research environment was valued as essential to developing a trustworthy evidence-base with which to underpin future guidance for good PE practice.

Take Me Out to the Ball Game: Science Outreach to Non-traditional Audiences

NASA Astrophysics Data System (ADS)

Norsted, B. A.

2010-08-01

Science outreach often targets audiences that are already interested in science and are looking for related educational experiences for themselves or their families. The University of Wisconsin Geology Museum (UWGM) with funding from the NASA Astrobiology Institute (NAI) is targeting unique venues and thereby new audiences who may not typically seek out science outreach events. With this goal in mind, in June, 2009 the UWGM and NAI sponsored an "Astrobiology Night at the Ballpark" at the Madison Mallards Ballpark, the local Madison, Wisconsin minor league baseball venue. At the game, 6,250 attendees were exposed to current NASA-funded astrobiology research being conducted at the University of Wisconsin-Madison. Fans were greeted at the gate by volunteers passing out a nine-card pack of extremophile trading cards, each of which featured a different extremophile group (e.g. halophiles, cryophiles, and barophiles). Next, participants could interact with project scientists, graduate students and museum staff at four exploration stations, where each station highlighted astrobiology themes (i.e. extremophiles, banded iron formation, earth's oldest rocks, earth's oldest fossils). Before the game began, the video board on the field was used to broadcast short NASA videos about recent Mars missions as well as the search for life in space. Additionally, inning breaks were used as fun opportunities to engage fans through an "Alien vs. Kids" tug-of-war as well as the distribution of Frisbees with an astrobiology timeline printed on them. Engaging the broader public at a non-science venue is a means to breaking down perceived barriers between scientists and the general public. We found Mallards fans to be receptive and ready to connect with our science themes. Tapping into a new audience also builds a larger awareness of our museum and University, expanding our impact in the community.

Ovarian cancer survivors' experiences of self-advocacy: a focus group study.

PubMed

Hagan, Teresa L; Donovan, Heidi S

2013-03-01

To explore ovarian cancer survivors' experiences of self-advocacy in symptom management. Descriptive, qualitative. A public café in an urban setting. 13 ovarian cancer survivors aged 26-69 years with a mean age of 51.31. Five focus groups were formed. Focus group discussions were audio recorded and transcribed verbatim. The content was analyzed using the constant comparison method with axial coding. In-depth interviews with 5 of the 13 participants occurred via telephone one to five months after each focus group meeting to clarify and expand on identified themes. Preliminary findings were shared with all participants for validation. Two major themes emerged from the data: (a) knowing who I am and keeping my psyche intact, and (b) knowing what I need and fighting for it. Exemplar quotations illustrate the diverse dimensions of self-advocacy. In addition, a working female-centric definition of self-advocacy was attained. Women have varying experiences with cancer- and treatment-related symptoms, but share a common process for recognizing and meeting their needs. Self-advocacy was defined as a process of learning one's needs and priorities as a cancer survivor and negotiating with healthcare teams, social supports, and other survivors to meet these needs. This phenomenologic process identified key dimensions and a preliminary definition of self-advocacy that nurses can recognize and support when patients seek and receive care consistent with their own needs and preferences. Self-advocacy among female cancer survivors is a process of recognizing one's needs and priorities and fighting for them within their cancer care and life. Practitioners can support female cancer survivors through the process of self-advocacy by providing them with skills and resources in making informed choices for themselves.

Life on the Iowa Prairies.

ERIC Educational Resources Information Center

Swaim, Ginalie, Ed.

1985-01-01

A theme issue of the Iowa State Historical Department magazine ("The Goldfinch") focuses on elementary readings and activities about Iowa prairie life. A total of 13 articles is included. In "History Makers," eight letters recount student and teacher prairie experiences. "The Prairie: Problems or Paradise?" recounts…

Changing Needs for Information and Support in an Online System for Parents of Children With Kidney Disease

PubMed Central

Pinsk, Maury; Nicholas, David

2017-01-01

Background: Pediatric chronic kidney disease is psychologically, financially, and physically demanding on parents providing care. Parents often feel isolated because of the rarity of the condition, and geographic isolation often compounds this perception in Canada. Many parents seek assistance online for both information and social support. Objective: This study examines an online portal, titled “Ability Online,” which was designed to provide support and information to a diverse group of parents using chat facilities, bulletin boards, and e-mail. Specifically, we sought to identify how the technologies offered in this system related to the support and information seeking needs for parents. Secondary aims of determining possible reasons for attrition over time were explored as well. Design: Mixed methodology sequential exploratory design using the qualitative methodology of descriptive interpretation. Setting: Telephone interviews. Patients: Twenty parents of pediatric patients with chronic kidney disease from four Canadian centers who engaged in an online social support system “Ability Online.” Measurements: Interview transcripts generated from 20 taped phone conversations were reviewed from parents who engaged in the online system, and the themes derived from these transcripts served to generate semistructured interview questions that focused on their use of, and perceived benefit from, this technology for social support. Follow-up telephone interviews were then conducted with a 6-person subset of the original group in an effort to further define the impact of technology on their experience. This same smaller cohort provided data on social supports, caregiver satisfaction, and caregiver stress. Results: Many parents experience a progression through which their needs for knowledge and support change over time. Specifically, parents describe a transition from pure information seeking, to seeking parental interaction, mutual support and collaboration, and ultimately to advocacy. Parents described how technology could be used to address those needs. Limitations: Our cohort was slightly more educated and representative of more urban populations than published data reflecting the population of North American pediatric patients living with kidney disease. Conclusions: Our data suggest themes of technology use influencing the goals of online support seeking. While our findings are preliminary, further study may inform Web designers to identify the changing needs of participants in designing such online support networks, and minimize the reasons that participants fail to adopt, or terminate their online experiences. PMID:28717515

To tame a volcano: patients with borderline personality disorder and their perceptions of suffering.

PubMed

Perseius, Kent-Inge; Ekdahl, Susanne; Asberg, Marie; Samuelsson, Mats

2005-08-01

The aim of the study was to investigate life situations, suffering, and perceptions of encounter with psychiatric care among 10 patients with borderline personality disorder. The results are based on a hermeneutic interpretation of narrative interviews in addition to biographical material (diary excerpts and poems). The interpretation revealed three comprehensive theme areas: life on the edge , the struggle for health and dignity-a balance act on a slack wire over a volcano , and the good and the bad act of psychiatric care in the drama of suffering . These theme areas form a movement back and forth-from despair and unendurable suffering to struggle for health and dignity and a life worth living. Common beliefs regarding these patients among personnel and implications for psychiatric care are discussed in relation to the results.

Attitudes towards attrition among UK trainees in obstetrics and gynaecology.

PubMed

Gafson, Irene; Currie, Jane; O'Dwyer, Sabrina; Woolf, Katherine; Griffin, Ann

2017-06-02

Physician dissatisfaction in the workplace has consequences for patient safety. Currently in the UK, 1 in 5 doctors who enter specialist training in obstetrics and gynaecology leave the programme before completion. Trainee attrition has implications for workforce planning, organization of health-care services and patient care. The authors conducted a survey of current trainees' and former trainees' views concerning attrition and 'peri-attrition' - a term coined to describe the trainee who has seriously considered leaving the specialty. The authors identified six key themes which describe trainees' feelings about attrition in obstetrics and gynaecology: morale and undermining; training processes and paperwork; support and supervision; work-life balance and realities of life; NHS environment; and job satisfaction. This article discusses themes of an under-resourced health service, bullying, lack of work-life balance and poor personal support.

The experiences of security industry contractors working in Iraq: an interpretative phenomenological analysis.

PubMed

Messenger, Katy; Farquharson, Lorna; Stallworthy, Pippa; Cawkill, Paul; Greenberg, Neil

2012-07-01

To explore the occupational experiences of private security contractors working in a war zone and how it impacts on their mental health. Semistructured interviews were conducted with seven contractors employed by a large UK-based private security company. Interpretative phenomenological analysis was used to analyze the interview transcripts. Participants also completed the 12-item General Health Questionnaire and the Posttraumatic Stress Disorder Checklist. Four overarching themes emerged: the appeal of the job; vulnerability; keep going; and seeking help for stress in the workplace. No clinically significant levels of distress were reported. Contractors are frequently exposed to stressors known to increase risk of psychiatric difficulty in military personnel. A number of potential protective factors were identified. Only a minority of participants were open to seeking help for mental health difficulties.

Curiosity Killed the Cocktail? Curiosity, Sensation Seeking, and Alcohol-related Problems in College Women

PubMed Central

Lindgren, Kristen P.; Mullins, Peter M.; Neighbors, Clayton; Blayney, Jessica A.

2010-01-01

Curiosity, composed of two factors: exploration and absorption, has been previously associated with life satisfaction, life meaningfulness, and enhanced positive affect. It also shares some overlap with sensation seeking, which has been linked to alcohol use and other addictive behaviors. The present research explored the association between curiosity and college women’s problematic drinking in the context of sensation seeking. Participants (79 women) completed questionnaires measuring curiosity, sensation seeking, alcohol consumption, and consequences related to alcohol consumption. A zero-inflated negative binomial model indicated that curiosity and sensation seeking accounted for unique variance in alcohol-related problems after controlling for drinking. The curiosity factors had opposing relationships to alcohol-related problems: higher scores on absorption were associated with more alcohol related problems whereas higher scores on exploration were associated with fewer alcohol related problems. Should findings be replicated, the curiosity factors may represent additional prevention and intervention targets. Future directions for research about curiosity and drinking and for the inclusion of positive psychology constructs in addictive behaviors research are discussed. PMID:20080358

76 FR 39221 - HUD Debt Collection: Revisions and Update to the Procedures for the Collection of Claims

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

...' Group Life Insurance and ``Basic Life'' Federal Employees' Group Life Insurance premiums are considered to be normal life insurance premiums; all optional Federal Employees' Group Life Insurance premiums... Other Actions, would include the procedures that apply when HUD seeks satisfaction of debts owed to HUD...

Understanding the experiences and quality of life issues of Bahraini women with breast cancer.

PubMed

Jassim, Ghufran A; Whitford, David L

2014-04-01

We explored the experiences of Bahraini women who have survived breast cancer and their perception of quality of life after diagnosis. We conducted in depth, semi-structured face-to-face interviews with twelve women diagnosed with breast cancer. A qualitative method using semi-structured interviews on a purposive sample of 12 Bahraini women with breast cancer was conducted. Similarities and differences in women's experience were identified through thematic analysis of interview transcripts using a constant comparative approach. The themes identified were meaning of cancer and quality of life, spirituality and beliefs about causes of breast cancer, coping mechanisms, impact of illness and change in relationships. Quality of life was framed in terms of the ability to perform daily duties with emphasis on the physical component of quality of life. Themes that differed from previous western studies included a heavy emphasis on spiritual practices for comfort; the use of traditional clothing (hijab and abaya) to hide hair and body changes; the important role played by the family and husband in treatment decisions and concerns regarding satisfying the sexual needs of the husband, which were related to a fear of losing the husband to a second wife. Evil eye, stress and God's punishment were believed to be fundamental causes of the disease. The emotional shock of the initial diagnosis, concerns about whether to reveal the diagnosis and a desire to live a normal life were consistent with previous studies. However, cultural and religious issues such as role of the husband and impact of prayers were also important here. These themes are important to healthcare professionals for ensuring an individualized approach to the treatment of women with breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quality of life in treatment-seeking patients with obsessive-compulsive disorder with and without major depressive disorder.

PubMed

Cassin, Stephanie E; Richter, Margaret A; Zhang, K Anne; Rector, Neil A

2009-07-01

To compare the quality of life of patients with obsessive-compulsive disorder (OCD) with and without depression comorbidity. Treatment-seeking outpatients (n = 56) with OCD (n = 28) or comorbid OCD and major depressive disorder (MDD) (n = 28), matched by age, sex, and antidepressant medication use, completed a multidimensional measure of quality of life. Patients with comorbid OCD and MDD reported significantly greater decrements in their subjective feelings, social relations, and a composite measure of general activities (for example, overall well-being and life satisfaction) in comparison with patients with OCD without MDD. These differences were not owing to the presence of other Axis I comorbid disorders. Treatments addressing depression comorbidity in the context of primary OCD are required to improve the quality of life of this severely affected population of OCD sufferers.

Women's experiences of living with neurogenic bladder and bowel after spinal cord injury: life controlled by bladder and bowel.

PubMed

Nevedal, Andrea; Kratz, Anna L; Tate, Denise G

2016-01-01

Neurogenic bladder and bowel (NBB) is a chronic condition hindering the functioning and quality of life (QOL) of people with spinal cord injury (SCI). NBB research has focused on men with SCI leaving unanswered questions about women's experiences of living with NBB. The purpose of this study was to identify and describe women's experiences of living with SCI and NBB. Secondary analysis of semi-structured interviews from a larger qualitative study of women with SCI (N = 50) was carried out. Transcripts were coded for bowel and bladder content. Pile-sorting techniques were used to identify emergent themes related to NBB. Meta-themes were categorized under the International Classification of Functioning, Disability and Health. Bladder and bowel topics were spontaneously discussed by 46 out of 50 study participants suggesting the salience of this issue for women with SCI. We identified 6 meta-themes: life controlled by bladder and bowel, bladder and bowel accidents, women's specific challenges, life course disruption, bladder and bowel medical management, and finding independence. Findings describe concerns, strategies, and the detrimental impact of NBB in the lives of women with SCI. Findings inform policy makers, health care and rehabilitation professionals to improve accessibility and quality of life for women with NBB. Women with spinal cord injury (SCI) reported gender specific challenges to living with neurogenic bladder and bowel (NBB). Interventions designed for women with SCI can address these problems and provide recommendations for prevention and treatment. Women described the detrimental impact of NBB on life course expectations, emotional, social, physical health, and quality of life domains. Psychosocial and educational programs can be developed to address these challenges and improve overall quality of life. Recommendations for special treatment and policy considerations are needed to maximize women's independence and health while living with NBB after SCI.

Women's experiences of participation in a feminist group for women with complex mental health issues.

PubMed

Clements Eaton, Emma Catherine; Cox, Rachel

2015-01-01

A sample of women (n = 5) participated in a qualitative service evaluation concerning an open-ended, therapeutic group for women only. Data analysis followed suggestions by Halcomb and Davidson (2006). Main themes derived from the evaluation included: 'Groups are different from individual work', 'Belonging/ not being alone', 'Performance in the group', 'The group as a safety net', 'Life improvements and hope for the future' and 'The extent of emotional despair felt'. In this paper, several sub-themes within the main themes and relevant theories and implications for theory and service provision are discussed.

Women's experiences of ovulation testing: a qualitative analysis.

PubMed

Jones, Georgina; Carlton, Jill; Weddell, Sarah; Johnson, Sarah; Ledger, William L

2015-12-21

The introduction of home digital ovulation tests (OTs) has provided a simple solution for women wishing to optimise the timing of intercourse when trying to conceive. However, despite this, very little is understood about women's experiences of using these tests. We carried out qualitative, semi-structured telephone interviews with women who were seeking to conceive (not actively undergoing clinical investigation/fertility treatment) from the general UK population. The interviews were conducted following participation in a randomised controlled trial (RCT) in which participants were either provided with digital home OTs to assist in timing intercourse (n = 18) or advised to have intercourse every 2-3 days (n = 18). The interviews were digitally recorded, transcribed and then analysed using Framework analysis to identify the themes. Data saturation was reached after 36 interviews. The use of the OT appeared to elicit 10 key themes, which could be described within the context of three overarching issues: 1) a positive impact (understanding the menstrual cycle, confirming when ovulating, emotional support, improving the relationship), 2) a negative impact (changing sex life and relationship with their partner, the emotional consequences of prolonged use, questions and uncertainty about what their results mean for them) and 3) the experiences of trying to conceive in general (use of clinical guidance and emotional experience). Overall, the use of home OTs were found to affect women's thoughts and feelings in multiple ways during attempts to conceive. Although some women reported a range of negative experiences when using OTs, they also reported similar negative experiences when trying to conceive without using the tests. However, there were many positive themes associated with OT use, including an increased understanding of the menstrual cycle, confirmation of ovulation timing and providing a source of help and support when trying to conceive. Overall, when women are trying to conceive, ensuring they have access to high-quality information, including use of OT, may be of benefit to help address some of the questions and uncertainties that were raised by the participants in this study. NCT01084304.

Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses.

PubMed

Colquhoun, Heather L; Carroll, Kelly; Eva, Kevin W; Grimshaw, Jeremy M; Ivers, Noah; Michie, Susan; Sales, Anne; Brehaut, Jamie C

2017-09-29

Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions. Using purposive sampling, semi-structured 60-90-min telephone interviews were conducted with experts in theories related to A&F from a range of fields (e.g., cognitive, health and organizational psychology, medical decision-making, economics). Guided by detailed descriptions of A&F interventions from the health care literature, interviewees described how they would approach the problem of designing improved A&F interventions. Specific, theory-informed hypotheses about the conditions for effective design and delivery of A&F interventions were elicited from the interviews. The resulting hypotheses were assigned by three coders working independently into themes, and categories of themes, in an iterative process. We conducted 28 interviews and identified 313 theory-informed hypotheses, which were placed into 30 themes. The 30 themes included hypotheses related to the following five categories: A&F recipient (seven themes), content of the A&F (ten themes), process of delivery of the A&F (six themes), behavior that was the focus of the A&F (three themes), and other (four themes). We have identified a set of testable, theory-informed hypotheses from a broad range of behavioral and social science that suggest conditions for more effective A&F interventions. This work demonstrates the breadth of perspectives about A&F from non-healthcare-specific disciplines in a way that yields testable hypotheses for healthcare A&F interventions. These results will serve as the foundation for further work seeking to set research priorities among the A&F research community.

What Is Career Success for Academic Hospitalists? A Qualitative Analysis of Early-Career Faculty Perspectives.

PubMed

Cumbler, Ethan; Yirdaw, Essey; Kneeland, Patrick; Pierce, Read; Rendon, Patrick; Herzke, Carrie; Jones, Christine D

2018-06-01

Understanding the concept of career success is critical for hospital medicine groups seeking to create sustainably rewarding faculty positions. Conceptual models of career success describe both extrinsic (compensation and advancement) and intrinsic (career satisfaction and job satisfaction) domains. How hospitalists define career success for themselves is not well understood. In this study, we qualitatively explore perspectives on how early-career clinician-educators define career success. We developed a semistructured interview tool of open-ended questions validated by using cognitive interviewing. Transcribed interviews were conducted with 17 early-career academic hospitalists from 3 medical centers to thematic saturation. A mixed deductiveinductive, qualitative, analytic approach was used to code and map themes to the theoretical framework. The single most dominant theme participants described was "excitement about daily work," which mapped to the job satisfaction organizing theme. Participants frequently expressed the importance of "being respected and recognized" and "dissemination of work," which were within the career satisfaction organizing theme. The extrinsic organizing themes of advancement and compensation were described as less important contributors to an individual's sense of career success. Ambivalence toward the "academic value of clinical work," "scholarship," and especially "promotion" represented unexpected themes. The future of academic hospital medicine is predicated upon faculty finding career success. Clinician-educator hospitalists view some traditional markers of career advancement as relevant to success. However, early-career faculty question the importance of some traditional external markers to their personal definitions of success. This work suggests that the selfconcept of career success is complex and may not be captured by traditional academic metrics and milestones. © 2018 Society of Hospital Medicine

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

PubMed

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

2016-08-01

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

Taiwanese adult cancer patients' reports of using complementary therapies.

PubMed

Lu, Jui-Hua; Tsay, Shiow-Luan; Sung, Su-Ching

2010-01-01

More information is needed by cancer clinicians regarding cancer patients' use of complementary and alternative medicine (CAM). In this qualitative study, in-depth interviews were used to obtain the reports of adult cancer patients regarding their use of CAM. Seven cancer patients (4 women, 3 men) who reported using CAM were recruited by snowball sampling. Content analysis was used to examine the interview transcriptions. Five themes and multiple categories were identified related to CAM use: (1) facing the challenges of cancer (I can't be defeated, need to cooperate with conventional medical treatment, rebuilding my confidence), (2) handling the physical and psychological distress of CAM use (extra loading due to the therapy, uncertainty and fear about the efficacy of CAM, being understood and supported, feeling guilty about being sick, (3) lifestyle disruption (altering social life, changing family living style), (4) having reasons for seeking other therapies (finding a way to cure the disease, boosting my immunity, improving my overall health status, and prolonging life and searching for peace of mind), and (5) unresolved practical concerns about CAM (finding an easy and effective way to practice CAM, needing CAM to be integrated into mainstream health care, and where to get the related information). Adult Taiwanese cancer patients who use CAM do experience burdens secondary to CAM use and prefer that oncology specialists be more informed about CAM. Oncology specialists who know where adult cancer patients could obtain helpful information about CAM would help to decrease the burdens that patients who use CAM experience.

Center for Biophotonics Science and Technology (CBST).

PubMed

Chuang, Frank

2004-01-01

The Center for Biophotonics Science and Technology (CBST) is the only center in the country funded by the National Science Foundation and devoted to the study of light and radiant energy in biology and medicine. Our consortium of 10 world-class academic institutions and research laboratories is comprised of physical and life scientists, physicians and engineers - along with industry participants, educators and community leaders - working together to bring biophotonics to the forefront of mainstream science. The three main arms of CBST are (1) Science and Technology, (2) Education, and (3) Knowledge Transfer. The research sponsored by the center focuses on critical themes that are expected to have significant impact on current biomedical science and technology. Projects include the development of new methods in optical microscopy that work well beyond the diffraction limit; ultrafast, high-intensity X-ray lasers to resolve the structure of single biomolecules, and new devices and sensors for minimally - or noninvasive medical applications. CBST is developing a new curriculum, along with training materials, internships and research fellowships to introduce biophotonics to students and teachers at all educational levels. Finally, the knowledge transfer component of CBST is seeking to catalyze the rapid growth of biophotonics as a new technology sector by supplying intellectual capital and tools to stimulate the growth of new products and new companies. By coupling the center's biophotonics research projects with industry partners and sponsors, a unique R&D environment is created to expand the use of photons in the development of life sciences, bioengineering and health care.

Managing One's Symptoms: A Qualitative Study of Low-Income African Americans With Advanced Cancer.

PubMed

Yeager, Katherine A; Sterk, Claire E; Quest, Tammie E; DiIorio, Colleen; Vena, Catherine; Bauer-Wu, Susan

2016-01-01

African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life. The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do. A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management. Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience. This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms. As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.

Children and adolescents living with atopic eczema: an interpretive phenomenological study with Chinese mothers.

PubMed

Cheung, Winnie K H; Lee, Regina L T

2012-10-01

This article is a report on a phenomenological study of Chinese mothers' experiences of caring for their children who were living with atopic eczema. A mother's attitude and personality may have a direct influence on her child's adherence to treatment for atopic eczema. Thus, good communication between healthcare professionals and the mother is essential. Treatment and care should also be culturally appropriate. Using an interpretive phenomenological method, 14 interviews were conducted in Hong Kong, China from September 2007 to August 2008, with nine mothers caring for their children who were living with atopic eczema. Crist and Tanner's circular process of hermeneutic interpretive phenomenology was chosen to guide the data analysis. Mothers' coping patterns involved persistently dealing with enduring demands and seeking alternative therapies that were aimed at curing the disease. Four themes finally emerged from the data: (1) dealing with extra mothering, (2) giving up their life, (3) becoming an expert and (4) living with blame and worry. Mothers' coping patterns involved persistently finding ways to relieve their children's suffering with the aim of curing the disease and dealing with their own emotions related to the frustration resulting from giving up their life and living with blame and worry. The study findings provide nurses with an empathic insight into mothers' feelings and the enduring demands of caring for children with atopic eczema, and help nurses to develop culturally sensitive interventions, reinforce positive coping strategies, increase family function and improve health outcomes. © 2011 Blackwell Publishing Ltd.

Swedish medical students' expectations of their future life

PubMed Central

Andersson, Jenny; Johansson, Eva E.; Verdonk, Petra; Lagro-Janssen, Antoine; Hamberg, Katarina

2011-01-01

Objectives: To investigate future life expectations among male and female medical students in their first and final year. Methods The study was cross-sectional and conducted at a Swedish medical school. Out of 600 invited students, 507 (85%) answered an open-ended question about their future life, 298 (59%) first-year students and 209 (41%) last-year students. Women constituted 60% of the respondents. A mixed model design was applied; qualitative content analysis was utilized to create statistically comparable themes and categories. Results Students’ written answers were coded, categorized and clustered into four themes: “Work”, “Family”, “Leisure” and “Quality of personal life”. Almost all students included aspects of work in their answers. Female students were more detailed than male ones in their family concerns. Almost a third of all students reflected on a future work-life balance, but considerations regarding quality of personal life and leisure were more common among last-year students. Conclusions Today’s medical students expect more of life than work, especially those standing on the doorstep of working life. They intend to balance work not only with a family but also with leisure activities. Our results reflect work attitudes that challenge the health care system for more adaptive working conditions. We suggest that discussions about work-life balance should be included in medical curricula.

Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence.

PubMed

Carolan, C M; Smith, A; Davies, G R; Forbat, L

2018-03-01

Many individuals affected by cancer who experience emotional distress report not wanting help. This review aims to understand why individuals affected by cancer seek, accept or decline help for emotional distress and what influences these actions. A systematic review and thematic synthesis of the qualitative literature was conducted. Using pre-defined search terms, four electronic databases were searched from January 2000 to May 2016. Pre-determined inclusion and exclusion criteria were then applied. Identified papers were quality appraised. In total, 32 papers were included in the synthesis. Four themes emerged from data synthesis: attaining normality-the normality paradox; being emotionally literate; perceptions of help; needs-support gap. Attaining normality is ideographic, context dependent and temporally situated; some individuals maintain normality by not seeking/declining help whereas others seek/accept help to achieve a new normality. Thus, attaining normality paradoxically functions to explain both why individuals sought/accepted help or did not seek/declined help. Data indicate that a context dependent, systems thinking approach is merited to enhance psychosocial care. In particular, clinicians must actively explore the personal context of an individual's distress to ensure that help desired and help offered are mutually understood. Further research must address the limitations of the current evidence base to advance theoretical understanding. © 2017 John Wiley & Sons Ltd.

Dreams and Dynamics. Selected Papers from the Annual Conference of the International Association of School Librarianship (22nd, Adelaide, South Australia, Australia, September 27-30, 1993).

ERIC Educational Resources Information Center

Hannesdottir, Sigrun Klara, Ed.; And Others

The themes of the 22nd Annual International Association of School Librarianship conference were: "Building a Picture of Society in the Year 2000"; "Literature--Themes of the '90s Towards the Future"; "Education--Partnerships To Develop Life-Long Learners"; and "Technology into the 21st Century." The…

Social Change and Family Policies. Key Papers, Part I. International CFR Seminar (20th, Melbourne, Australia, August 19-24, 1984).

ERIC Educational Resources Information Center

Collins, Randall; And Others

These papers from an International Committee on Family Research (CFR) seminar explore seven themes, four of which are presented in Part 1. The first set of papers approach the question of whether the family is worth supporting and the related issue of pressures, conflicts, and expectations of family life (Theme 1). Randall Collins discusses…

The clinical nurse educator as leader.

PubMed

Adelman-Mullally, Theresa; Mulder, Cindy K; McCarter-Spalding, Deborah E; Hagler, Debra A; Gaberson, Kathleen B; Hanner, Mary Beth; Oermann, Marilyn H; Speakman, Elizabeth T; Yoder-Wise, Patricia S; Young, Patricia K

2013-01-01

The National League for Nursing recognizes leadership as an important aspect of the educator role. The purpose of this article is to describe leadership in the context of clinical nursing education and how clinical nurse educators enact leadership. The article identifies particular nursing practice skills and strengths that clinicians bring to nursing education that enhance leadership knowledge, skills, and abilities. After review of several leadership models, we identified five overarching themes that demonstrate how clinical nurse educators exemplify the various models including role modeling, providing vision, helping students to learn, challenging the system or status quo, and seeking relational integrity. We explicate the themes with examples affirming the leadership potential of clinical nurse educators, and suggest ways in which nursing faculty members and administrators might draw on the leadership capital of clinical nurse educators. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mixed Feelings about the Diagnosis of Type 2 Diabetes Mellitus: A Consequence of Adjusting To Health Related Quality Of Life

PubMed Central

Low, Lee Lan; Tong, Seng Fah; Low, Wah Yun

2015-01-01

This study aims to explore patients’ reactions to the diagnosis of type 2 diabetes mellitus (T2DM) and their health related quality of life. We adopted a qualitative exploratory study design using a thematic analysis. Twelve patients with T2DM for more than a 2-year duration were interviewed using a semi-structured interview guide. Both purposive and theoretical samplings were used for data collection. The in-depth interviews were audio-taped and transcribed verbatim, followed by line-by-line coding and constant comparison to identify the themes. Data management was facilitated using Nvivo 10. Patients shared their mixed feelings about the diagnosis of T2DM. Six domains of quality of life emerged from these interviews, namely physical and social functioning, work function and social obligations, dietary freedom and conforming to treatment standard. Diabetes management needs to take these themes and patients’ feelings associated with their quality of life into consideration. PMID:24851592

Understanding the Life Histories of Pregnant-Involved Young Aboriginal Women With Substance Use Experiences in Three Canadian Cities.

PubMed

Shahram, Sana Z; Bottorff, Joan L; Kurtz, Donna L M; Oelke, Nelly D; Thomas, Victoria; Spittal, Patricia M

2017-01-01

Despite attention paid to substance use during pregnancy, understandings of young Aboriginal women's experiences based on their perspectives have been virtually absent in the published literature. This study's objective was to understand the life experiences of pregnant-involved young Aboriginal women with alcohol and drugs. Semi-structured interviews to gather life histories were conducted with 23 young Aboriginal women who had experiences with pregnancy, and alcohol and drug use. Transcribed interviews were analyzed for themes to describe the social and historical contexts of women's experiences and their self-representations. The findings detail women's strategies for survival, inner strength, and capacities for love, healing, and resilience. Themes included the following: intersectional identities, life histories of trauma (abuse, violence, and neglect; intergenerational trauma; separations and connections), the ever-presence of alcohol and drugs, and the highs and lows of pregnancy and mothering. The findings have implications for guiding policy and interventions for supporting women and their families. © The Author(s) 2016.

Teaching in the Field: What Teacher Professional Life Histories Tell About How They Learn to Teach in the Outdoor Learning Environment

NASA Astrophysics Data System (ADS)

Feille, Kelly K.

2017-06-01

This research investigates the professional life histories of upper elementary science teachers who were identified as effective both within the classroom and in the outdoor learning environment (OLE). The narratives of five teachers, collected through semistructured and open-ended interviews, provided the data for the study. Professional life histories were constructed for each teacher participant and an analysis of the teacher narratives identified the themes of teacher development across the voices of the participants. Narrative reasoning was used to unify those themes into a hypothetical professional life history as reported in this manuscript. Implications of this research can be realized for stakeholders in the preparation of pre-service teachers as well as the development of in-service teachers. Future research regarding the early induction years of new teachers, impacts of inclusion of the OLE in pre-service teacher instruction, and teacher experiences regarding professional development relating to efforts to include the OLE in formal education should be investigated.

The Attitudes, Needs, and Requirements at End of Life in the Republic of Georgia (Comparative Analysis of Groups of Patients With Cancer and Elders).

PubMed

Chikhladze, Nana; Tebidze, Nino; Chabukiani, Tamar; Chabukiani, Nana; Chkhartishvili, Nikoloz; Jincharadze, Memed; Kordzaia, Dimitri

2018-01-01

In developing a model of palliative care, the attitudes, needs, and requirements of its beneficiaries recognizing the limited remaining life expectancy need to be met. We aimed to map and compare these issues at the end of life in the groups of patients with advanced cancer and elderly individuals. The prospective study based on the analysis of semistructured interviews was conducted. Fifty individuals aged older than 85 and 50 incurable patients with advanced cancer were studied. Transcripts of interviews were analyzed qualitatively (the interviews were divided into logically completed themes, and the compliance of each with one of the levels of Abraham Maslow pyramid was determined) and quantitatively (data comparisons of 2 groups were tested in bivariate analysis using Pearson χ 2 or Fisher exact test. Two-sided significance tests were used; P value of <.05 was deemed significant). It was assumed that 120 themes were relevant to a certain level of Maslow pyramid. Their comparison showed small differences in the narratives of the patients with advanced cancer and elderly individuals aged 85 and older-concerning the past, present, and future terms of lives. In studied themes explicitly prevail the stories that are consistent with satisfaction of the upper levels of the hierarchy of needs and demands of Maslow: social relation (belonging), love, esteem, and transcendence. The attitudes, needs, and requirements at the end of life of the people are basically similar, regardless of what determined the sense of limitation of the remaining life-incurable disease or advanced age.

Sexual Experience of Iranian Women in Their Middle Life: A Qualitative Approach.

PubMed

Moghasemi, Sedigheh; Ozgoli, Giti; Ahmadi, Fazlollah; Simbar, Masomeh

2018-01-01

Sexual problems are common among the middle-aged women; however, there is no deep understanding of sexuality in midlife. The current study aimed to investigate Iranian women's attitudes and experiences about sexual life changes in midlife. This is a descriptive qualitative study. Seventeen women aged 40 -65 years old were purposively selected from urban health centers in Gorgan, Iran, in 2015. Face-to-face, semi-structured and in-depth interviews were conducted for data collection until data saturation was attained. The resulting data were analyzed based on Graneheim and Lundman's approach. MAXQDA 10 was used for organization of data. Data analysis demonstrated seventh sub-themes and three themes. The emerged themes were entitled (1) "Continuous paradox over being a sexual agent" with three subthemes of beliefs on asexuality as socially accepted view for women in midlife, changing in motivation for sex and changing in sexual performance, (2) "Considering menopause; opportunities and threats for sexual life" with two subthemes of menopause related cons for sexual life and menopause related pros in sexual life, and (3) "Coping strategies for changes in sexuality in midlife" with two subthemes of different psychological reactions to changes that have influenced the sex and take practical steps for restoration of sexual attraction. The findings demonstrated that middle-aged women in a male-dominant culture encounter paradox over being a sexual agent. In a bio-psycho-social approach, they perceived menopause as an opportunity or threat for their own sexuality. Following the conflicts, threats and changes of sexuality in midlife, they adopt diverse coping strategies to improve their sexual relationships and preserve their family.

Recognizing Life-threatening Features of Dengue in Children and Health Seeking Behavior in Dengue Emergency Amongst Parents and Carers: A Cross-sectional study in Gombak District, Malaysia.

PubMed

Ariffin, F; Ramli, A S; Naim, N; Selamat, M I; Syed-Jamal, S J

2014-10-01

Dengue is life-threatening and the paediatric population is highly susceptible to complications. Deterioration can occur rapidly and ability to recognise early warning signs is crucial. This study aims to determine the knowledge and awareness of parents and carers and to predict their ability in recognising life-threatening symptoms and signs of dengue in children and to assess their health-seeking behaviour in dengue emergency. Methods This is a crosssectional study involving parents and carers of children ≤ 12 years old in schools and kindergartens in the Gombak district. Demographic details, knowledge on life-threatening symptoms and signs of dengue and health-seeking behaviour were collected using a self-administered questionnaire and knowledge scoring was done. The questionnaire was pilot tested with a Cronbach alpha of 0.82. The results were analysed using SPSS version 20.0. Results Total respondents were 866 with 44.8% men and 55.2% women. The mean age was 40.3 years (SD ± 5.7). Knowledge score of dengue life threatening features among respondents were good (30.0%) to average (56.8%). Respondents were able to recognise fever (98.5%), petechial rash (97.1%) and bleeding (65.2%) but were less able to recognise abdominal pain (22.3%) and passing less urine (28.2%) as life threatening dengue features. However, the ability to recognise fever is a poor predictor in recognising life threatening dengue in children compared to all other symptoms which were good predictors. A respondent that recognise stomach pain or neck stiffness were five times more likely to recognise life-threatening dengue. Respondents preferred to bring their children to the clinic (50.8%) or hospital (37.8%) themselves Instead of calling for ambulance. Worryingly, some would give antipyretics (3.6%) or wait for improvements (7.8%). Conclusion Concerted efforts by the schools, healthcare professionals and health authorities are required to educate parents and carers to identify life-threatening features of dengue and to improve their health seeking-behaviour.

Nursing Philosophy of community mental health nurses in Japan: A qualitative, descriptive study.

PubMed

Tanaka, Koji; Hasegawa, Masami; Nagayama, Yutaka; Oe, Masato

2018-04-01

The present study reports the findings of a qualitative, descriptive study that sought to clarify nursing philosophy for community mental health nurses (CMHN) working at independent psychiatric home-visit nursing agencies in Japan. We carried out participant observation and semistructured interviews with 13 CMHN in rural and urban areas. We identified eight subthemes and three higher-order themes based on these subthemes. CMHN embraced a nursing philosophy in which they: (i) have respect for consumers' ways of life and their self-realization; (ii) find harmony between view of life and work; and (iii) build communities where residents support each other beyond their roles. Together, these themes constitute a valuable nursing philosophy that supports the recovery of people with mental illness. The themes could also help educate professionals about principles and meanings relevant to recovery, which are regarded as key to changing the professional's care paradigm from a biomedical model to a recovery model. © 2017 Australian College of Mental Health Nurses Inc.

Marital satisfaction through the lens of Iranian women: a qualitative study.

PubMed

Tavakol, Zeinab; Moghadam, Zahra Behboodi; Nasrabadi, Alireza Nikbakht; Iesazadeh, Nikzad; Esmaeili, Maryam

2016-01-01

One of the common concepts to show the happiness and stability of marriage is the concept of marital satisfaction. Marital satisfaction plays an important role in the stability of marriage. This study was conducted to explain the perception of marital satisfaction among Iranian women. This study was conducted between March and September 2015 by common qualitative content analysis approach through semi-structured interviews and 19 participants were selected by purposive sampling. With the analysis of data two themes: (maturity of personality) which included a sub-theme of blossoming of feelings, and (romantic interaction) consisted of three sub-themes of; mutual support, sense of peace and joyful dependence emerged. Marital life can lead to the development of people and lovely interaction between them. Surely it needs to passing of time and self-knowing and couple-knowing of each other. Family consultants need the perception of how couple's interaction is, also they need to understand about couples who can communicate well to each other so they can overcome many life's other deficiencies.

Creating an eLearning Resource to Improve Knowledge and Understanding of Pregnancy in the Context of HIV Infection

PubMed Central

Kelly, Carmel; Reid, Esther; Lohan, Maria; Alderdice, Fiona; Spence, Dale

2014-01-01

Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. This paper presents how we sought to translate the evidence from a qualitative study of the perspectives of HIV affected pregnant women and expectant fathers on the care they received, from the pre conception to post natal period, into educational material for maternity care practice. Narrative scripts were written based on the original research interviews, with care taken to reflect the key themes from the research. We explore the way in which the qualitative findings bring to life patient and partner experiences and what it means for nurses, midwives and doctors to be prepared to care for couples affected by HIV. In so doing, we challenge the inequity between the dominance of biomedical knowledge over understanding the patient experience in the preparation of health professionals to care for HIV affected women and men who are having a baby or seeking to have a baby. PMID:25317982

Stress, Burnout and Coping Strategies in Preclinical Medical Students.

PubMed

Fares, Jawad; Al Tabosh, Hayat; Saadeddin, Zein; El Mouhayyar, Christopher; Aridi, Hussam

2016-02-01

It is acknowledged that physicians do not seek the same expert aid for themselves as they would offer their patients. In their preclinical years, medical students appear to espouse comparable behavior. To many, medicine is described as a never-ending path that places the student under heavy stress and burnout from the beginning, leaving him/her vulnerable and with insufficient coping methods. Hence, the objective of this study is to 1) explore the prevalence of stress and burnout among preclinical medical students, and 2) propose solutions to decrease stress and burnout and improve medical education in the preclinical years. A detailed scholarly research strategy using Google Scholar, Scopus, Embase, MEDLINE and PubMed was implemented to highlight key themes that are relevant to preclinical medical students' stress and burnout. Stress varied among different samples of medical students and ranged between 20.9% and 90%. Conversely, burnout ranged between 27% and 75%. Methods that help in reducing the incidence of stress and burnout by promoting strategies that focus on personal engagement, extracurricular activities, positive reinterpretation and expression of emotion, student-led mentorship programs, evaluation systems, career counseling and life coaching should be adopted.

Stress, Burnout and Coping Strategies in Preclinical Medical Students

PubMed Central

Fares, Jawad; Al Tabosh, Hayat; Saadeddin, Zein; El Mouhayyar, Christopher; Aridi, Hussam

2016-01-01

It is acknowledged that physicians do not seek the same expert aid for themselves as they would offer their patients. In their preclinical years, medical students appear to espouse comparable behavior. To many, medicine is described as a never-ending path that places the student under heavy stress and burnout from the beginning, leaving him/her vulnerable and with insufficient coping methods. Hence, the objective of this study is to 1) explore the prevalence of stress and burnout among preclinical medical students, and 2) propose solutions to decrease stress and burnout and improve medical education in the preclinical years. A detailed scholarly research strategy using Google Scholar, Scopus, Embase, MEDLINE and PubMed was implemented to highlight key themes that are relevant to preclinical medical students’ stress and burnout. Stress varied among different samples of medical students and ranged between 20.9% and 90%. Conversely, burnout ranged between 27% and 75%. Methods that help in reducing the incidence of stress and burnout by promoting strategies that focus on personal engagement, extracurricular activities, positive reinterpretation and expression of emotion, student-led mentorship programs, evaluation systems, career counseling and life coaching should be adopted. PMID:27042604

Looking at the Camp: Paleolithic Depiction of a Hunter-Gatherer Campsite

PubMed Central

García-Diez, Marcos; Vaquero, Manuel

2015-01-01

Landscapes and features of the everyday world were scarcely represented in Paleolithic art, especially those features associated with the human landscape (huts and campsites). On the contrary, other figurative motifs (especially animals) and signs, traditionally linked to the magic or religious conceptions of these hunter-gatherer societies, are the predominant themes of Upper Paleolithic art. This paper seeks to present an engraved schist slab recently found in the Molí del Salt site (North-eastern Iberia) and dated at the end of the Upper Paleolithic, ca. 13,800 years ago. This slab displays seven semicircular motifs that may be interpreted as the representation of dome-shaped huts. The analysis of individual motifs and the composition, as well as the ethnographic and archeological contextualization, suggests that this engraving is a naturalistic depiction of a hunter-gatherer campsite. Campsites can be considered the first human landscape, the first area of land whose visible features were entirely constructed by humans. Given the social meaning of campsites in hunter-gatherer life-styles, this engraving may be considered one of the first representations of the domestic and social space of a human group. PMID:26629824

Creating an eLearning resource to improve knowledge and understanding of pregnancy in the context of HIV infection.

PubMed

Kelly, Carmel; Reid, Esther; Lohan, Maria; Alderdice, Fiona; Spence, Dale

2014-10-14

Patient narratives have much to teach healthcare professionals about the experience of living with a chronic condition. While the biomedical narrative of HIV treatment is hugely encouraging, the narrative of living with HIV continues to be overshadowed by a persuasive perception of stigma. This paper presents how we sought to translate the evidence from a qualitative study of the perspectives of HIV affected pregnant women and expectant fathers on the care they received, from the pre conception to post natal period, into educational material for maternity care practice. Narrative scripts were written based on the original research interviews, with care taken to reflect the key themes from the research. We explore the way in which the qualitative findings bring to life patient and partner experiences and what it means for nurses, midwives and doctors to be prepared to care for couples affected by HIV. In so doing, we challenge the inequity between the dominance of biomedical knowledge over understanding the patient experience in the preparation of health professionals to care for HIV affected women and men who are having a baby or seeking to have a baby.

Ectothermic telomeres: it's time they came in from the cold.

PubMed

Olsson, Mats; Wapstra, Erik; Friesen, Christopher

2018-03-05

We review the evolutionary ecology and genetics of telomeres in taxa that cannot elevate their body temperature to a preferred level through metabolism but do so by basking or seeking out a warm environment. This group of organisms contains all living things on earth, apart from birds and mammals. One reason for our interest in this synthetic group is the argument that high, stable body temperature increases the risk of malignant tumours if long, telomerase-restored telomeres make cells 'live forever'. If this holds true, ectotherms should have significantly lower cancer frequencies. We discuss to what degree there is support for this 'anti-cancer' hypothesis in the current literature. Importantly, we suggest that ectothermic taxa, with variation in somatic telomerase expression across tissue and taxa, may hold the key to understanding ongoing selection and evolution of telomerase dynamics in the wild. We further review endotherm-specific effects of growth on telomeres, effects of autotomy ('tail dropping') on telomere attrition, and costs of maintaining sexual displays measured in telomere attrition. Finally, we cover plant ectotherm telomeres and life histories in a separate 'mini review'.This article is part of the theme issue 'Understanding diversity in telomere dynamics'. © 2018 The Authors.

Pastoral care professionals in health and mental health care: recognizing classic and newer versions of ageism.

PubMed

Kane, Michael N; Green, Diane L; Jacobs, Robin J

2011-01-01

Pastoral care professionals are cognizant of many forms of prejudice and discrimination in society and health care environments. Ageism is perhaps the least likely to be challenged as prejudice or discrimination. Ageist perception is suspicious of the health and cognitive ability of older persons; without consideration of emotional, spiritual, or social abilities. While positive and negative ageist attributions are culturally abundant, new and subtle versions of ageism offer convincing guidance about personal responsibility for health status and insist on personal social engagement. Older persons who are not free of disease or disability may be viewed as culpable for their failure to age well. Additionally, elders may be expected to maintain social involvement; especially through volunteerism. Elders who are unable or unwilling to engage in volunteerism may be viewed as selfish or irresponsible. If individuals are held responsible for their health as they age, then services and reimbursement for service may be limited to evidence-based medical interventions that result in complete recovery rather than life-quality improvement and only for "worthy" individuals. This paper seeks to heighten the awareness of pastoral care professionals to common ageist themes found in health and mental care service delivery.

The psychology of men's health: maximizing masculine capital.

PubMed

Gough, Brendan

2013-01-01

Mortality and morbidity statistics show that men on average die younger than women and are more prone to many nongendered illnesses. Social constructions of masculinity have been implicated in men's poorer health, although it is now recognized that masculinity is a complex, multifaceted entity, elements of which can prove health-promoting. This special issue, "Men's health: Masculinity and other influences on male health behaviors," brings together a range of psychological research that demonstrates how masculinities work in different health-related situations, ranging from lifestyle choices to life-threatening diseases. A cross-cutting theme concerns how masculine "capital" can function to both constrain and open up healthy practices. In the first of two sections, seven papers focus on public health issues, including physical exercise, alcohol consumption, and help-seeking. The second section then covers illness-related phenomena, including male-specific cancers, sports-induced disability, and male sterilization. These six papers examine how masculinities inhibit and promote coping with difficult embodied states with different groups of men. This special issue offers important insights on masculinities and health from methodologically diverse investigations, and highlights how masculinities can be deployed to improve the health of men across different contexts. PsycINFO Database Record (c) 2013 APA, all rights reserved

Invisibility, safety and psycho-social distress among same-sex attracted women in rural South Australia.

PubMed

Edwards, Jane

2005-01-01

Available work from North America indicates that same-sex attracted (SSA) individuals enjoy aspects of rural life but nonetheless report encountering homophobia and experiencing isolation from SSA networks. The experience of prejudice and social isolation are often associated with psycho-social distress among the general population of same-sex attracted individuals. Little is known of how SSA women experience life in rural areas of Australia and how this influences their psycho-social wellbeing. This was a small-scale qualitative study using guided interviews to explore the experience of SSA women living in rural areas of South Australia. Seven women identifying as same-sex attracted were interviewed. In addition, a woman who provides a counseling and support service for same-sex attracted women was also interviewed. All interviews were audiotaped and transcribed verbatim and were then analysed for emergent themes. Summaries of the interviews, based on the emergent themes, were sent to all interviewees so that they could verify or challenge the validity of the emergent themes, as well as to allow them to remove any information they felt might identify them. Most women had felt 'different' while growing up; almost unanimously describing themselves as having been 'tomboys'. However, the lack of visible SSA role models in rural areas, together with a lack of SSA social networks, did not allow some of the women to identify and name their same-sex attraction. For many of the women in this study, it was visits to the state capital, where they had the opportunity to meet other SSA women, which precipitated them identifying themselves as same-sex attracted. In light of this new knowledge, some women denied their same-sex attraction and entered into heterosexual relationships, often entailing marriage. Other women entered same-sex relationships but tried to keep them invisible within their communities. Rural communities are frequently close-knit environments, where 'everybody knows everybody'. In such settings, much of the conduct of daily life is visible to other community members and may be closely scrutinized. In such locations, women initially try to keep their same sex attraction invisible. Women rarely comment on the threat of violence that underpins the attempt to keep same-sex identity or relationships secret. Nevertheless, even while it remains a largely unarticulated factor, it was a powerful one fueling the maintenance of their invisibility. Fear of violence ranges from the threat of overt physical violence to more commonly voiced concerns over 'mundane' harassment. Fear of social violence, in the form of rejection and ostracism, is the most frequently nominated factor motivating women to keep same-sex attraction invisible in rural settings. While keeping their same-sex identity and relationships invisible offers women some safety from physical and social violence, it may pose dangers for their psycho-social well-being. Trying to keep SSA relationships invisible within communities involves women censoring their behaviour while in public. Invisibility also gives rise to isolation, since women do not have the opportunity to form same-sex attracted social networks. Furthermore, some women experience great psycho-social distress as their awareness of their same-sex attraction becomes increasingly incongruent with the established pattern of their lives. Women find it very difficult to seek appropriate forms of help if they do experience psycho-social problems. Concerns over confidentiality means that women are extremely reluctant to seek help and support locally. Distance is a powerful mediating factor in both women's experience of distress and their capacity to seek help to ameliorate it. For women who live in closer proximity to the state capital, the capacity to meet other SSA women and engage in same-sex attracted social activities helps ease their sense of difference and isolation. Likewise, should they wish to utilize counseling or support services, it is relatively easy for them to do so. However, women living at greater distances from a capital city experience greater isolation and loneliness. Moreover, their ability to confidentially access appropriate services is markedly curtailed. Same-sex attracted women living in rural areas need social contact with other SSA women, where their safety and confidentiality can be assured. They also need access to safe, confidential and appropriate services. Telephone and internet services are one way of anonymously and confidentially giving women access to information and support. Peer support networks, internet and telephone networks need to be further developed. Ways in which specialist gay and lesbian services and locally based health and human services could collaborate to provide accessible and acceptable services and to help women develop safe and confidential social networks need to be identified and trialled.

An Aristotelian Account of Minimal Chemical Life

NASA Astrophysics Data System (ADS)

Bedau, Mark A.

2010-12-01

This paper addresses the open philosophical and scientific problem of explaining and defining life. This problem is controversial, and there is nothing approaching a consensus about what life is. This raises a philosophical meta-question: Why is life so controversial and so difficult to define? This paper proposes that we can attribute a significant part of the controversy over life to use of a Cartesian approach to explaining life, which seeks necessary and sufficient conditions for being an individual living organism, out of the context of other organisms and the abiotic environment. The Cartesian approach contrasts with an Aristotelian approach to explaining life, which considers life only in the whole context in which it actually exists, looks at the characteristic phenomena involving actual life, and seeks the deepest and most unified explanation for those phenomena. The phenomena of life might be difficult to delimit precisely, but it certainly includes life's characteristic hallmarks, borderline cases, and puzzles. The Program-Metabolism-Container (PMC) model construes minimal chemical life as a functionally integrated triad of chemical systems, which are identified as the Program, Metabolism, and Container. Rasmussen diagrams precisely depict the functional definition of minimal chemical life. The PMC model illustrates the Aristotelian approach to life, because it explains eight of life's hallmarks, one of life's borderline cases (the virus), and two of life's puzzles.

An Aristotelian account of minimal chemical life.

PubMed

Bedau, Mark A

2010-12-01

This paper addresses the open philosophical and scientific problem of explaining and defining life. This problem is controversial, and there is nothing approaching a consensus about what life is. This raises a philosophical meta-question: Why is life so controversial and so difficult to define? This paper proposes that we can attribute a significant part of the controversy over life to use of a Cartesian approach to explaining life, which seeks necessary and sufficient conditions for being an individual living organism, out of the context of other organisms and the abiotic environment. The Cartesian approach contrasts with an Aristotelian approach to explaining life, which considers life only in the whole context in which it actually exists, looks at the characteristic phenomena involving actual life, and seeks the deepest and most unified explanation for those phenomena. The phenomena of life might be difficult to delimit precisely, but it certainly includes life's characteristic hallmarks, borderline cases, and puzzles. The Program-Metabolism-Container (PMC) model construes minimal chemical life as a functionally integrated triad of chemical systems, which are identified as the Program, Metabolism, and Container. Rasmussen diagrams precisely depict the functional definition of minimal chemical life. The PMC model illustrates the Aristotelian approach to life, because it explains eight of life's hallmarks, one of life's borderline cases (the virus), and two of life's puzzles.

How Can an Emergency Department Assist Patients and Caregivers at the End of Life?

MedlinePlus

... Assist in the recognition and understanding of the natural changes associated with the end of life and ... of life to attempt the reversal of the natural death process and seek care starting in the ...

A Literature Review of Randomized Controlled Trials of the Organization of Care at the End of Life

ERIC Educational Resources Information Center

Thomas, Roger E.; Wilson, Donna; Sheps, Sam

2006-01-01

We searched nine electronic databases for randomized controlled trials (RCTs) about care at the end of life and found 23 RCTs. We assessed their quality using the criteria of the Cochrane Collaboration. The RCTs researched three themes: (a) the effect of providing palliative care through dedicated community teams on quality of life, on the…

Reducing Hispanic children's obesity risk factors in the first 1000 days of life: a qualitative analysis.

PubMed

Woo Baidal, Jennifer A; Criss, Shaniece; Goldman, Roberta E; Perkins, Meghan; Cunningham, Courtney; Taveras, Elsie M

2015-01-01

Modifiable behaviors during the first 1000 days (conception age 24 months) mediate Hispanic children's obesity disparities. We aimed to examine underlying reasons for early life obesity risk factors and identify potential early life intervention strategies. We conducted 7 focus groups with 49 Hispanic women who were pregnant or had children < age 24 months. Domains included influences on childhood obesity risk factors and future intervention ideas. We analyzed data with immersion-crystallization methods until no new themes emerged. Themes included coping with pregnancy may trump healthy eating and physical activity; early life weight gain is unrelated to later life obesity; fear of infant hunger drives bottle and early solids introduction; beliefs about infant taste promote early solids and sugary beverage introduction; and belief that screen time promotes infant development. Mothers identified physicians, nutritionists, and relatives as important health information sources and expressed interest in mobile technology and group or home visits for interventions. Opportunities exist in the first 1000 days to improve Hispanic mothers' understanding of the role of early life weight gain in childhood obesity and other obesity risk factors. Interventions that link health care and public health systems and include extended family may prevent obesity among Hispanic children.

Health Coaching in Severe COPD After a Hospitalization: A Qualitative Analysis of a Large Randomized Study.

PubMed

Benzo, Roberto P; Kirsch, Janae L; Hathaway, Julie C; McEvoy, Charlene E; Vickers, Kristin S

2017-11-01

We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore the health-coaching intervention as seen from the perspective of the participants who received the intervention and the coaches who delivered it. Semistructured participant interviews ( n = 24) and a focus group of all health coaches ( n = 3) who participated in this study were conducted. Interviews and focus group were recorded and transcribed verbatim. Transcripts were analyzed using coding and categorizing techniques and thematic analysis. Mixed-method triangulation was used to merge quantitative and qualitative data. Content analysis revealed 4 predominant themes of the coaching intervention: health-coaching relationship, higher participant confidence and reassurance (most related to improvement in physical quality of life), improved health-care system access (most related to decreased hospital readmissions), and increased awareness of COPD symptoms (most related to improvement in emotional quality of life). The strongest theme was the relationship with the health coach, including coach style and motivational interviewing approach. Health coaches' focus group also noted the importance of the coaching relationship as the most significant theme. This study provided themes to further inform the delivery and implementation of health-coaching interventions in patients with COPD after hospital discharge. Health coaching forged partnerships and created a platform for patient engagement, which was confirmed by both participants and health coaches. Copyright © 2017 by Daedalus Enterprises.

Is death our business? Philosophical conflicts over the end-of-life in old age psychiatry.

PubMed

McKellar, Duncan; Ng, Felicity; Chur-Hansen, Anna

2016-01-01

Old age psychiatrists work with end-of-life (EOL) issues and encounter patient deaths, but death and dying have received limited focus in old age psychiatry training and research. This qualitative study explores old age psychiatrists' experience of and approach to working with patients at the EOL. Australian old age psychiatrists were purposively sampled and interviewed in-depth. Data saturation was achieved after nine participant interviews. Verbatim transcripts were analysed for themes, which were independently verified. Two dichotomous overarching themes were identified. Death is not our business reflected participants' experience of working in a mental health framework and incorporated four themes: death should not occur in psychiatry; working in a psychiatric treatment model; keeping a distance from death and unexpected death is a negative experience. Death is our business reflected participants' experience of working in an aged care context and incorporated four themes: death is part of life; encountering the EOL through dementia care; doing EOL work and expected death is a positive experience. Participants reported conflict because of the contradictory domains in which they work. They were comfortable working with patients at the EOL when death was expected, particularly in dementia. By contrast, they struggled with death as an adverse outcome in circumstances influenced by mental health culture, which was characterised by risk management, suicide prevention and a focus on recovery. This study has implications for models of care underpinning old age psychiatry. An integrated person-centred model of care may provide a contextually appropriate approach for practice.

Former patients' experiences of recovery from self-harm as an individual, prolonged learning process: a phenomenological hermeneutical study.

PubMed

Tofthagen, Randi; Talseth, Anne Grethe; Fagerstrøm, Lisbeth Maria

2017-10-01

To explore, describe and understand former patients' experiences of recovery from self-harm. Previous research shows that a person's development towards a more secure self-image, mastery of their emotions, an understanding of what triggers self-harm and mastery of new ways to cope with problems are central to recovery. Recovery from self-harm is still a relatively new field of research. A phenomenological hermeneutical approach. Eight participants were interviewed in 2013. Inclusion criteria were as follows: to have committed no self-harm during the past 2 years, to have experienced recovery and to be 18 or older. We analysed data using a phenomenological hermeneutical method. The findings resulted in three themes with subthemes. The first theme, the turning point, occurred at the start of the recovery process. Participants learned to choose life, verbally express their inner pain and reconcile with their life histories. In the second theme, coping with everyday life, participants learned how to choose alternative actions instead of self-harm and attend to their basic, physical needs. In the third theme, valuing close relationships and relationships with mental health nurses, participants learned to receive support from close relationships with others and mental health nurses. A tentative model illustrates the comprehensive understanding of the recovery process, described as an individual, prolonged learning process. To achieve recovery, persons who self-harm need guidance and knowledge of how to realize a personal learning process. More research is needed on how mental health nurses can support individual transition processes and thereby facilitate recovery. © 2017 John Wiley & Sons Ltd.

Let him not be alone: perspectives of older British South Asian minority ethnic patients on dying in acute hospitals.

PubMed

Venkatasalu, Munikumar Ramasamy

2017-09-02

To investigate older British South Asians' views on dying at acute hospitals. Older people, including those from ethnic minorities prefer 'home as a haven' for their last days of life; however, they are more likely to die in hospital. Constructive grounded theory was used as a methodological approach that informed data collection to data analysis. Open meetings with 11 local South Asian community organisations enabled the researchers to recruit a total of 55 older South Asians in this study. Data were collected using gender-based focus groups (n=5) and in-depth, semi-structured interviews (n=29). Transcripts were analysed using Nvivo 9. Three key themes were identified: 'mistrust', 'let him not be alone' and 'family as a protective shield'. The theme 'mistrust' is explored through examination of beliefs, attitudes and expectations about 'hospital' as a place in the care of the dying. The theme of 'let him not be alone' draws the family's preferences and concerns in relation to leaving their older dying relative alone in the hospital. The final theme of 'family as a protective shield' describes the element of family care as a protective shield for their older one to have peaceful end-of-life care moments in the hospital. Allowing older relatives to die in hospital seems to evoke feelings of missed filial responsibilities and guilt among family carers among older ethnic minorities. The presence of cultural paranoia and mistrust often led minorities to experience sub-standard end-of-life care in acute hospitals.

Risk Taking and Decision Making in Kidney Paired Donation: A Qualitative Study by Semistructured Interviews.

PubMed

Baines, L S; Dulku, H; Jindal, R M; Papalois, V

2018-06-01

Despite excellent outcomes of kidney paired donation (KPD), little is known about how a patient's frame (apply cognitive bias) or weight (attribute value) and concerns relating to risk, justice, and equity affect his or her decision-making process. A pilot study consisting of 3 KPD transplant recipients and 3 KPD kidney donors in the last year was conducted to identify and explore themes in decision making and risk taking. The pilot study was followed by the main study comprised of 20 recipients who had already undergone KPD transplantation and 20 donors who had undergone donor nephrectomy. We conducted semistructured interviews in this cohort and analyzed the data thematically. Each donor-recipient pair was interviewed together to facilitate dyadic conversation and provide deeper insight into the decision-making process leading to transplant and donation. Common themes to both recipient and donor decision making included quality of life; characteristics of the unknown donor and post-transplant expectations. Recipient-specific themes included failure to reach life span milestones, experiences of fellow patients, and altruistic desire to expand the donor pool. Donor-specific themes included balancing existing life commitments with the recipient's need for a kidney, equity and mental accounting in kidney exchange (comparable quality of the kidney received versus the kidney donated), and logistical justice for the recipient. Donors and recipients frame and weight the concepts of risk, justice, and equity differently. This may have direct implications to facilitating patient-centered communication and engagement in KPD pairs. Copyright © 2018 Elsevier Inc. All rights reserved.

Assessment of Factors Influencing Preservation of Dignity at Life's End: Creation and the Cross-Cultural Validation of the Preservation of Dignity Card-Sort Tool

PubMed Central

Noda, Arthur M.; Chmura Kraemer, Helena

2010-01-01

Abstract Background Preserving patient dignity is a sentinel premise of palliative care. This study was conducted to gain a better understanding of factors influencing preservation of dignity in the last chapter of life. Methods We conducted an open-ended written survey of 100 multidisciplinary providers (69% response rate) and responses were categorized to identify 2 main themes, 5 subthemes, and 10 individual factors that were used to create the preservation of dignity card-sort tool (p-DCT). The 10-item rank order tool was administered to a cohort of community dwelling Filipino Americans (n = 140, age mean = 61.3, 45% male and 55% female). A Spearman correlation matrix was constructed for all the 10 individual factors as well as the themes and subthemes based on the data generated by the subjects. Results The individual factors were minimally correlated with each other indicating that each factor was an independent stand-alone factor. The median, 25th and 75th percentile ranks were calculated and “s/he has self-respect” (intrinsic theme, self-esteem subtheme) emerged as the most important factor (mean rank 3.0 and median rank 2.0) followed by “others treat her/him with respect” (extrinsic theme, respect subtheme) with a mean rank = 3.6 and median = 3.0. Conclusion The p-DCT is a simple, rank order card-sort tool that may help clinicians identify patients' perceptions of key factors influencing the preservation of their dignity in the last chapter of life. PMID:20420549

Perspectives on Home Care Quality

PubMed Central

Kane, Rosalie A.; Kane, Robert L.; Illston, Laurel H.; Eustis, Nancy N.

1994-01-01

Home care quality assurance (QA) must consider features inherent in home care, including: multiple goals, limited provider control, and unique family roles. Successive panels of stakeholders were asked to rate the importance of selected home care outcomes. Most highly rated outcomes were freedom from exploitation, satisfaction with care, physical safety, affordability, and physical functioning. Panelists preferred outcome indicators to process and structure, and all groups emphasized “enabling” criteria. Themes highlighted included: interpersonal components of care; normalizing life for clientele; balancing quality of life with safety; developing flexible, negotiated care plans; mechanisms for accountability and case management. These themes were formulated differently according to the stakeholders' role. Providers preferred intermediate outcomes, akin to process. PMID:10140158

Personaltiy correlates of the joy of life.

PubMed

Tolor, A

1978-07-01

Hypothesized that greater diversity of joy and more intense levels of joy would be associated with low hopelessness, high sensation seeking the perception of the world as just, and high sensitization as compared with high repression. It also was predicted that female Ss would score higher in sources of joy and in intensity as compared to males. One hundred and thirty-four college students were administered the Joy of Life Scale, Hopelessness Scale, Sensation Seeking Scale, Just World Scale, and Revised Repression-Sensitization Scale. The hypothesis was supported for sensation seeking in that High Sensation Seekers assigned significantly (p less than .05) higher mean intensity ratings to experiences that produced joy of life, than did Low Sensation Seekers. Contrary to expectation, there was a nonsignificant trend for sensitizers, when compared with repressors, to select fewer joy-related experiences and to evaluate these experiences as less joyful. The experiences that most often led to high levels of joy were those referrable to positive emotional events.

A model of adaptation of overseas nurses: exploring the experiences of Japanese nurses working in Australia.

PubMed

Kishi, Yuka; Inoue, Kumiyo; Crookes, Patrick; Shorten, Allison

2014-04-01

The purpose of the study was to investigate the experiences of Japanese nurses and their adaptation to their work environment in Australia. Using a qualitative research method and semistructured interviews, the study aimed to discover, describe, and analyze the experiences of 14 Japanese nurses participating in the study. A qualitative study. Fourteen Japanese registered nurses working in Australian hospitals participated in the study. Individual semistructured interviews were conducted from April to June in 2008. Thematic analysis was used to identify themes within the data. Analysis of qualitative open-ended questions revealed the participants' adaptation process. It consists of three themes or phases: seeking (S), acclimatizing (A), and settling (S), subsequently named the S.A.S. model. The conceptual model of the adaptation processes of 14 Japanese nurses working in Australia includes the seeking, acclimatizing, and settling phases. Although these phases are not mutually exclusive and the process is not necessarily uniformly linear, all participants in this study passed through this S.A.S. model in order to adapt to their new environment. The S.A.S. model of adaptation helps to describe the experiences of Japanese overseas qualified nurses working in Australian hospitals. Future research is needed to examine whether this model can be applied to nurses from other countries and in other settings outside Australia.