Reflections of Single Turkish International Graduate Students: Studies on Life at a Midwestern University

ERIC Educational Resources Information Center

Burkholder, Jessica Reno

2010-01-01

The research was guided by the research question: How do full-time single Turkish international graduate students conceptualize their experiences as international students? Participants in the study included three doctoral students and three master's students who participated in a series of semi-structured interviews. The data was transcribed and…

Preparing for Successful Transitions beyond Institutional Care in Zimbabwe: Adolescent Girls' Perspectives and Programme Needs

ERIC Educational Resources Information Center

Berejena Mhongera, Pamhidzayi

2017-01-01

This qualitative study explored adolescent girls' perspectives and programme needs as they transition from two institutions in Highfield, Harare, Zimbabwe. The study was guided by the sustainable livelihood and feminist theoretical frameworks. Semi-structured interviews were conducted with 32 adolescent girls (16 inside and 16 outside) from…

Teaching Hispanic English Language Learners in the General Education Classroom: A Phenomenological Study

ERIC Educational Resources Information Center

Mackenzie, Kathleen

2012-01-01

This study used a phenomenological study design to better understand the phenomenon of teaching Hispanic English language learners in the general education setting. Data were collected using semi-structured interviews and researcher memos, and analyzed using the Listening Guide method. The study focused on white, English-speaking teachers to…

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

ERIC Educational Resources Information Center

Reimann, Nicola; Sadler, Ian

2017-01-01

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

A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

ERIC Educational Resources Information Center

Reid, Eric Justin

2015-01-01

This qualitative study explored the perceptions and experiences of IT Managers in publicly traded companies within the San Antonio, Texas area about outsourced data centers. Narrative data was collected using open-ended questions and face-to-face interviews within semi-structured environments. The research questions guided the study: (1)…

We're Graduating, What's Next? Relational Contribution to the Educational Attainment of Black Bermudian Adolescent Boys

ERIC Educational Resources Information Center

Jethwani-Keyser, Monique; Mincy, Ronald; Haldane, Eva

2013-01-01

Guided by ecological and integrative theories of child development, this article examined the associations between multiple systems of influence (school and family) and the educational aspirations of Black Bermudian adolescent boys. This study used qualitative data gleaned from semistructured interviews with students in their senior year at a…

Becoming and Being Academic Women: Perspectives from the Maldives

ERIC Educational Resources Information Center

Maxwell, T. W.; Mohamed, Mizna; Mohamed, Naashia; Naseer, Badhoora; Zahir, Aminath; Nasheeda, Aminath

2015-01-01

This exploratory study aimed at understanding the role of women teaching in a university in the Maldives is a first of its kind. The many studies of academic women in Western countries guided the 20 semi-structured interviews. The data were thematically analysed with the assistance of NVivo. Becoming an academic appeared to be an independent…

Supporting Pre-Service Dance Teachers' Reflection with Different Reflection Procedures

ERIC Educational Resources Information Center

Leijen, Äli; Sööt, Anu

2016-01-01

This article discusses the results of a study that investigated the use of different procedures to support the reflection processes of university-level dance students. As a procedure of unguided reflection, the students were asked to write a free-form essay and, as a form of guided reflection, a semi-structured interview and written reflection…

Exploring Anti-Semitism in the Classroom: A Case Study among Norwegian Adolescents from Minority Backgrounds

ERIC Educational Resources Information Center

Thomas, Paul

2016-01-01

This study explores high school students' views of Jews in one minority-dominated school in Oslo, Norway. Employing a qualitative approach, semistructured interview guides and classroom-based discussions teased out attitudes toward Jews drawing on questions from a nationwide research conducted by The Center for Studies of the Holocaust and…

Stigma among California's Medical Marijuana Patients.

PubMed

Satterlund, Travis D; Lee, Juliet P; Moore, Roland S

2015-01-01

The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This article examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends, and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all.

Stigma Among California's Medical Marijuana Patients

PubMed Central

Satterlund, Travis D.; Lee, Juliet P.; Moore, Roland S.

2014-01-01

The enactment of California's Proposition 215 stipulates that patients may use marijuana for medical reasons, provided that it is recommended by a physician. Yet, medical marijuana patients risk being stigmatized for this practice. This paper examines the way in which medical marijuana patients perceive and process stigma, and how it affects their interactions and experiences with others. Eighteen semi-structured interviews of medical marijuana patients were carried out using a semi-structured interview guide. Most patients circumvented their own physicians in obtaining a recommendation to use medicinal marijuana, and also used a host of strategies in order to justify their medical marijuana use to family, friends and colleagues in order to stave off potential stigma. The stigmatization of medical marijuana thus has a profound effect on how patients seek treatment, and whether they seek medical marijuana treatment at all. PMID:25715067

Informed consent in medical decision-making in commercial gestational surrogacy: a mixed methods study in New Delhi, India.

PubMed

Tanderup, Malene; Reddy, Sunita; Patel, Tulsi; Nielsen, Birgitte Bruun

2015-05-01

To investigate ethical issues in informed consent for decisions regarding embryo transfer and fetal reduction in commercial gestational surrogacy. Mixed methods study employing observations, an interview-guide and semi-structured interviews. Fertility clinics and agencies in Delhi, India, between December 2011 and December 2012. Doctors providing conceptive technologies to commissioning couples and carrying out surrogacy procedures; surrogate mothers; agents functioning as links for surrogacy. Interviews using semi-structured interview guides were carried out among 20 doctors in 18 fertility clinics, five agents from four agencies and 14 surrogate mothers. Surrogate mothers were interviewed both individually and in the presence of doctors and agents. Data on socio-economic context and experiences among and between various actors in the surrogacy process were coded to identify categories of ethical concern. Numerical and grounded theory-oriented analyses were used. Informed consent, number of embryos transferred, fetal reduction, conflict of interest among the involved parties. None of the 14 surrogate mothers were able to explain the risks involved in embryo transfer and fetal reduction. The majority of the doctors took unilateral decisions about embryo transfer and fetal reduction. The commissioning parents were usually only indirectly involved. In the qualitative analysis, difficulties in explaining procedures, autonomy, self-payment of fertility treatment and conflicts of interest were the main themes. Clinical procedural decisions were primarily made by the doctors. Surrogate mothers were not adequately informed. There is a need for regulation on decision-making procedures to safeguard the interests of surrogate mothers. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Agency capacity for recreation science and management: the case of the U.S. Forest Service.

Treesearch

Lee K. Cerveny; Clare M. Ryan

2008-01-01

This report examines the capacity of natural resource agencies to generate scientific knowledge and information for use by resource managers in planning and decisionmaking. This exploratory study focused on recreation in the U.S. Department of Agriculture, Forest Service. A semistructured, open-ended interview guide elicited insights from 58 managers and 28 researchers...

School District Leadership Styles and School Improvement: Evidence from Selected School Principals in the Eastern Cape Province

ERIC Educational Resources Information Center

Moorosi, Pontso; Bantwini, Bongani D.

2016-01-01

The purpose of this study was to investigate how leadership styles in the Eastern Cape school districts support school improvement. Mixed methods research was employed and data was collected through the use of questionnaires and semi-structured interviews with school principals in various districts. The study was guided by the following questions:…

Beyond Declines in Student Body Diversity: How Campus-Level Administrators Understand a Prohibition on Race-Conscious Postsecondary Admissions Policies

ERIC Educational Resources Information Center

Garces, Liliana M.; Cogburn, Courtney D.

2015-01-01

Guided by a bottom-up policy implementation framework, this study draws from semi-structured interviews of 14 campus-level administrators charged with implementing diversity policy at the University of Michigan to investigate how an affirmative action ban (Proposal 2) influenced their efforts in support of racial/ethnic diversity at the…

You Seize What Pops Up: A Qualitative Investigation of the Core Features of School-Based Agricultural Education Professional Development

ERIC Educational Resources Information Center

Easterly, R.G., III.; Myers, Brian E.

2017-01-01

Desimone's core features of professional development (PD) guides the PD for teachers. The purpose of this study was to examine the PD practice of School-Based Agricultural Education (SBAE) teachers in the enthusiastic and growing career stage. Semi-structured telephone interviews were conducted with five teachers from five different states. The…

Students' Conceptual Knowledge of Limits in Calculus: A Two-Part Constructivist Case Study

ERIC Educational Resources Information Center

Adams, Margaret Smolinka

2013-01-01

This case study investigated students' conceptual knowledge of limits in calculus by implementing semi-structured interviews. The constructivist learning principles of Piaget and Inhelder as well as theories of understanding by Skemp guided the study. In Phase I, a pilot study was conducted with 15 students from a Calculus III class. By using…

User-Centered Design of the eyeGuide, a Tailored Glaucoma Behavior Change Program

PubMed Central

Killeen, Olivia; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P.; Newman-Casey, Paula Anne

2016-01-01

PURPOSE We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. PATIENTS Glaucoma patients ≥ age 40 prescribed ≥1 glaucoma medication were included. METHODS The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semi-structured diagnostic and pre-testing interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audio recorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook and identified key themes using NVivo 10.0 to further refine the eyeGuide. RESULTS Twenty-one glaucoma patients were interviewed; mean age 72 ± 12.4 years, five (24%) African-Americans, nine (43%) with poor self-reported adherence, ten (47.6%) ≥ age 75, ten (47.6%) with poor vision and nine (42.9%) women. Qualitative analysis identified five important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients’ beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a web-based module. Participant feedback resulted in revised content. CONCLUSIONS User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content. PMID:27096721

User-centered Design of the eyeGuide: A Tailored Glaucoma Behavior Change Program.

PubMed

Killeen, Olivia J; MacKenzie, Chamisa; Heisler, Michele; Resnicow, Ken; Lee, Paul P; Newman-Casey, Paula Anne

2016-10-01

We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients. Glaucoma patients age 40 years and above prescribed ≥1 glaucoma medication were included. The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semistructured diagnostic and pretesting interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audiorecorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook, and identified key themes using NVivo 10.0 to further refine the eyeGuide. Twenty-one glaucoma patients were interviewed; mean age 72±12.4 years, 5 (24%) African Americans, 9 (43%) with poor self-reported adherence, 10 (47.6%) age 75 years and above, 10 (47.6%) with poor vision, and 9 (42.9%) women. Qualitative analysis identified 5 important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients' beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a Web-based module. Participant feedback resulted in revised content. User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content.

Perspectives of Egyptian research ethics committees regarding their effective functioning.

PubMed

Matar, Amal; Silverman, Henry

2013-02-01

The recent increase in research in the Middle East has been associated with the establishment of research ethics committees (RECs). Our aim was to obtain perspectives of RECs regarding the challenges that impede their effective functioning. We conducted in-depth interviews using a semi-structured interview guide. We transcribed and analyzed the interviews to uncover major themes and subthemes. We identified the following themes: membership composition; training needs of members; availability of human and capital resources; role of the national government; concerns with the informed consent process; government scrutiny of research; investigator-related issues; and concerns with transfer of biological samples to other countries. Our interview study revealed several barriers that need to be considered by appropriate stakeholders to enhance adequate functioning of RECs.

Living on Both Sides of the Fence: A Phenomenological Study of Human Resource Development Professionals as Downsizing Survivors and Strategic Human Resource Development Facilitators

ERIC Educational Resources Information Center

Nackoney, Claire Kostopulos

2012-01-01

This phenomenological study explored how HR professionals who identified themselves as facilitators of strategic HRD (SHRD) perceived the experience of being an organizational agent-downsizing survivor. Criterion and snowball sampling were used to recruit 15 participants for this study. A semi-structured interview guide was used to interview…

Strategies for improved French-language health services: Perspectives of family physicians in northeastern Ontario.

PubMed

Gauthier, Alain P; Timony, Patrick E; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

2015-08-01

To identify strategies to improve the quality of health services for Francophone patients. A series of semistructured key informant interviews. Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist.

Psychiatric nursing staff members' reflections on participating in group-based clinical supervision: a semistructured interview study.

PubMed

Buus, Niels; Angel, Sanne; Traynor, Michael; Gonge, Henrik

2011-04-01

This paper is a report of an interview study exploring psychiatric hospital nursing staff members' reflections on participating in supervision. Clinical supervision is a pedagogical process designed to direct, develop, and support clinical nurses. Participation rates in clinical supervision in psychiatric settings have been reported to be relatively low. Qualitative research indicates that staff members appreciate clinical supervision, but paradoxically, do not prioritize participation and find participation emotionally challenging. Little is known about these contradictory experiences and how they influence participation rates. Twenty-two psychiatric hospital nursing staff members were interviewed with a semistructured interview guide. Interview transcripts were interpreted by means of Ricoeur's hermeneutic method. The respondents understood clinical supervision to be beneficial, but with very limited impact on their clinical practice. Neither management nor the staff effectively prioritized clinical supervision, which added to a downward spiral where low levels of participation undermined the potential benefits of clinical supervision. The respondents embraced and used alternative forums for getting emotional support among peers, but maintained that formalized supervision was the only forum for reflection that could solve the most difficult situations. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Community Perspectives on Drug/Alcohol Use, Concerns, Needs and Resources In Four Washington State Tribal Communities

PubMed Central

Radin, Sandra M.; Kutz, Stephen H.; LaMarr, June; Vendiola, Diane; Vendiola, Michael; Wilbur, Brian; Thomas, Lisa Rey; Donovan, Dennis M.

2016-01-01

Community-university teams investigated substance use, abuse, and dependence (SUAD) and related concerns, needs, strengths, and resources in four Washington State Tribal communities. 153 key community members shared their perspectives through 43 semi-structured interviews and 19 semi-structured focus groups. Qualitative data analysis revealed robust themes: prescription medications and alcohol were perceived as most prevalent and concerning; family and peer influences and emotional distress were prominent perceived risk factors; and SUAD intervention resources varied across communities. Findings may guide future research and the development of much needed strength-based, culturally appropriate, and effective SUAD interventions for American Indians, Alaska Natives, and their communities. PMID:25560464

Tools, strategies and qualitative approach in relation to suicidal attempts and ideation in the elderly.

PubMed

Cavalcante, Fátima Gonçalves; Minayo, Maria Cecília de Souza; Gutierrez, Denise Machado Duran; de Sousa, Girliani Silva; da Silva, Raimunda Magalhães; Moura, Rosylaine; Meneghel, Stela Nazareth; Grubits, Sonia; Conte, Marta; Cavalcante, Ana Célia Sousa; Figueiredo, Ana Elisa Bastos; Mangas, Raimunda Matilde do Nascimento; Fachola, María Cristina Heuguerot; Izquierdo, Giovane Mendieta

2015-06-01

The article analyses the quality and consistency of a comprehensive interview guide, adapted to study attempted suicide and its ideation among the elderly, and imparts the method followed in applying this tool. The objective is to show how the use of a semi-structured interview and the organization and data analysis set-up were tested and perfected by a network of researchers from twelve universities or research centers in Brazil, Uruguay and Colombia. The method involved application and evaluation of the tool and joint production of an instruction manual on data collection, systematization and analysis. The methodology was followed in 67 interviews with elderly people of 60 or older and in 34 interviews with health professionals in thirteen Brazilian municipalities and in Montevideo and Bogotá, allowing the consistency of the tool and the applicability of the method to be checked, during the process and at the end. The enhanced guide and the instructions for reproducing it are presented herein. The results indicate the suitability and credibility of this methodological approach, tested and certified in interdisciplinary and interinstitutional terms.

Perceptions of pharmacogenetic research to guide tobacco cessation by patients, providers and leaders in a tribal healthcare setting

PubMed Central

Avey, Jaedon P; Hiratsuka, Vanessa Y; Beans, Julie A; Trinidad, Susan Brown; Tyndale, Rachel F; Robinson, Renee F

2016-01-01

Aim: Describe patients,’ providers’ and healthcare system leaders’ perceptions of pharmacogenetic research to guide tobacco cessation treatment in an American Indian/Alaska Native primary care setting. Materials & methods: This qualitative study used semistructured interviews with 20 American Indian/Alaska Native current or former tobacco users, 12 healthcare providers and nine healthcare system leaders. Results: Participants supported pharmacogenetic research to guide tobacco cessation treatment provided that a community-based participatory research approach be employed, research closely coordinate with existing tobacco cessation services and access to pharmacogenetic test results be restricted to providers involved in tobacco cessation. Conclusion: Despite a history of mistrust toward genetic research in tribal communities, participants expressed willingness to support pharmacogenetic research to guide tobacco cessation treatment. PMID:26871371

Strategies for improved French-language health services

PubMed Central

Gauthier, Alain P.; Timony, Patrick E.; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

2015-01-01

Abstract Objective To identify strategies to improve the quality of health services for Francophone patients. Design A series of semistructured key informant interviews. Setting Northeastern Ontario. Participants A total of 18 physicians were interviewed. Ten physicians were interviewed in French, 7 physicians were women, and 10 physicians were located in urban communities. Methods Purposive and snowball sampling strategies were used to conduct a series of semistructured key informant interviews with family physicians practising in communities with a large Francophone population. Principles of grounded theory were applied, guided by a framework for patient-professional communication. Results were inductively derived following an iterative data collection–data analysis process and were analyzed using a detailed thematic approach. Main findings Respondents identified several strategies for providing high-quality French-language health services. Some were unique to non–French-speaking physicians (eg, using appropriate interpreter services), some were unique to French-speaking physicians (eg, using a flexible dialect), and some strategies were common to all physicians serving French populations (eg, hiring bilingual staff or having pamphlets and posters in both French and English). Conclusion Physicians interviewed for this study provided high-quality health care by attributing substantial importance to effective communication. While linguistic patient-to-physician concordance is ideal, it might not always be possible. Thus, conscious efforts to attenuate communication barriers are necessary, and several effective strategies exist. PMID:26505060

Implementation of a Medication Reconciliation Assistive Technology: A Qualitative Analysis

PubMed Central

Wright, Theodore B.; Adams, Kathleen; Church, Victoria L.; Ferraro, Mimi; Ragland, Scott; Sayers, Anthony; Tallett, Stephanie; Lovejoy, Travis; Ash, Joan; Holahan, Patricia J.; Lesselroth, Blake J.

2017-01-01

Objective: To aid the implementation of a medication reconciliation process within a hybrid primary-specialty care setting by using qualitative techniques to describe the climate of implementation and provide guidance for future projects. Methods: Guided by McMullen et al’s Rapid Assessment Process1, we performed semi-structured interviews prior to and iteratively throughout the implementation. Interviews were coded and analyzed using grounded theory2 and cross-examined for validity. Results: We identified five barriers and five facilitators that impacted the implementation. Facilitators identified were process alignment with user values, and motivation and clinical champions fostered by the implementation team rather than the administration. Barriers included a perceived limited capacity for change, diverging priorities, and inconsistencies in process standards and role definitions. Discussion: A more complete, qualitative understanding of existing barriers and facilitators helps to guide critical decisions on the design and implementation of a successful medication reconciliation process. PMID:29854251

75 FR 69677 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... interviews will participate in this interview. Questions vary by respondent type. 6. Post-implementation semi... semi-structured interviews will participate in this interview. Questions do not vary by respondent type... each nursing home. 4. Pre-implementation semi-structured interview--The purpose of this interview is to...

The Feasibility of an eLearning Nutrition Education Program for Low-Income Individuals.

PubMed

Stotz, Sarah; Lee, Jung Sun; Rong, Hui; Murray, Deborah

2016-08-09

Online eLearning may be an innovative, efficient, and cost-effective method of providing nutrition education to a diverse low-income audience. The intent of this project is to examine perceptions of nutrition educators regarding the feasibility of an eLearning nutrition education program tailored to low-income Georgians. Semistructured individual interviews were conducted, guided by the constructivist theory. The interview guide focused on three themes: accessibility, literacy, and content. A prototype of the program also served as a talking point. Interviews were conducted in two urban Georgian counties in a location chosen by each participant. We recruited a convenience sample of Georgian nutrition educators (n = 10, 100% female, 50% Black). Interviews were transcribed and analyzed using constant comparative method. Motivation is considered the primary barrier to program feasibility. Neither access to the Internet nor literacy are considered significant barriers. Inclusion of skill-based, visual education methods such as cooking videos, recipes, and step-by-step teaching tools was highlighted. Nutrition educators perceived this program would be a feasible form of nutrition education for the priority audience. Findings from this study will inform the user-centered development of the program. © 2016 Society for Public Health Education.

Patient-Centered Research to Support the Development of the Symptoms of Major Depressive Disorder Scale (SMDDS): Initial Qualitative Research.

PubMed

McCarrier, Kelly P; Deal, Linda S; Abraham, Lucy; Blum, Steven I; Bush, Elizabeth Nicole; Martin, Mona L; Thase, Michael E; Coons, Stephen Joel

2016-04-01

Content valid, patient-reported outcome (PRO) measures of major depressive disorder (MDD) symptoms are needed to assess MDD treatment benefit. While a range of questionnaires are currently available to evaluate aspects of depression from the patient's perspective, their comprehensiveness and qualitative development histories are unclear. The objective of this study was to describe the process and results of the preliminary qualitative development of a new symptom-based PRO measure intended to assess treatment benefit in MDD clinical trials. Qualitative interviews were conducted with adult MDD patients in the USA who recently experienced a major depressive episode. Experienced interviewers conducted concept elicitation (CE) and cognitive interviews using semi-structured interview guides. The CE interview guide was used to elicit spontaneous reports of symptom experiences along with probing to further explore and confirm concepts. The cognitive interview guide was developed to evaluate concept relevance, understandability, and structure of the draft items, and to facilitate further instrument refinement. Forty patients participated in the CE interviews. A total of 3022 symptom codes, representing 84 different concepts were derived from the transcripts. Data from the CE interviews were considered alongside existing literature and clinical expert opinion during an item-generation process, leading to development of a preliminary version of the Symptoms of Major Depressive Disorder Scale (SMDDS). Fifteen patients participated in three waves of cognitive interviews, during which the SMDDS was further refined. The SMDDS is a 35-item PRO measure intended for use as an endpoint in MDD clinical trials to support medical product labeling. The SMDDS uses a 7-day recall period and verbal rating scales. It was developed in accordance with the US Food and Drug Administration (FDA)'s PRO Guidance and best practices. Qualitative interviews have provided evidence for content validity. Future quantitative studies will confirm the SMDDS's measurement properties and support FDA qualification.

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

PubMed

Berian, Julia R; Thomas, Juliana M; Minami, Christina A; Farrell, Paula R; O'Leary, Kevin J; Williams, Mark V; Prachand, Vivek N; Halverson, Amy L; Bilimoria, Karl Y; Johnson, Julie K

2017-04-01

To evaluate a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. Mixed-methods utilizing quantitative surveys and in-depth semi-structured interviews. The Illinois Surgical Quality Improvement Collaborative (ISQIC) utilized a novel Mentor Program to guide surgeons new to QI. All mentor-mentee pairs received the survey (n = 27). Purposive sampling identified a subset of mentors (n = 8) and mentees (n = 4) for in-depth semi-structured interviews. Surgeons with expertise in QI mentored surgeons new to QI. (i) Quantitative: self-reported satisfaction with the mentor program; (ii) Qualitative: key themes suggesting actions and strategies to facilitate mentorship in QI. Mentees expressed satisfaction with the mentor program (n = 24, 88.9%) and agreed that mentorship is vital to ISQIC (n = 24, 88.9%). Analysis of interview data revealed four key themes: (i) nuances of data management, (ii) culture of quality and safety, (iii) mentor-mentee relationship and (iv) logistics. Strategies from these key themes include: utilize raw data for in-depth QI understanding, facilitate presentations to build QI support, identify opportunities for in-person meetings and establish scheduled conference calls. The mentor's role required sharing experiences and acting as a resource. The mentee's role required actively bringing questions and identifying barriers. Mentorship plays a vital role in advancing surgeon knowledge and engagement with QI in ISQIC. Key themes in mentorship reflect strategies to best facilitate mentorship, which may serve as a guide to other collaboratives. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Direct and Indirect Benefits Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

PubMed

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

2015-11-01

There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention. © 2015 American Physical Therapy Association.

Factors Facilitating the Implementation of Church-Based Heart Health Promotion Programs for Older Adults: A Qualitative Study Guided by the Precede-Proceed Model.

PubMed

Banerjee, Ananya Tina; Kin, R; Strachan, Patricia H; Boyle, Michael H; Anand, Sonia S; Oremus, Mark

2015-01-01

To describe the factors facilitating the implementation of heart health promotion programs for older adults in Anglican, United, and Catholic churches. The study used qualitative methods comprising semistructured interviews and focus groups. The interviews and focus groups were conducted in Anglican, Catholic, and United churches located in the Canadian cities of Toronto and Hamilton, Ontario. Twelve ordained pastors and 21 older parishioners who attended church regularly and who had no health conditions were recruited to best explain how churches could be suitable locations for health promotion activities targeting older adults. Twelve semistructured interviews with the pastors and three focus groups with the 21 parishioners were undertaken. A component of the Precede-Proceed model (a model for planning health education and health promotion programs and policies) was applied to the findings after direct content analysis of the data. Participants identified pastor leadership, funding for a parish nurse, community-focused interventions, secured infrastructure, and social support from congregation members as pertinent factors required for implementing health promotion programs in Anglican, United, and Catholic churches. The findings have particular relevance for health promotion and public health because they suggest factors that would be necessary to design church-based heart health promotion programs for older adults at risk of chronic diseases.

How I Learned to Design and Conduct Semi-Structured Interviews: An Ongoing and Continuous Journey

ERIC Educational Resources Information Center

Rabionet, Silvia E.

2011-01-01

Qualitative interviewing is a flexible and powerful tool to capture the voices and the ways people make meaning of their experience Learning to conduct semi-structure interviews requires the following six stages: (a) selecting the type of interview; (b) establishing ethical guidelines, (c) crafting the interview protocol; (d) conducting and…

76 FR 4700 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

.... Questions vary by respondent type. 5. Post-training semi-structured interview--The purpose of this interview.... Questions vary by respondent type. 6. Post-implementation semi-structured interview--The purpose of this... in this interview. Questions do not vary by respondent type. Estimated Annual Respondent Burden...

What Are the Principles That Guide Behaviors in the Operating Room?: Creating a Framework to Define and Measure Performance.

PubMed

Madani, Amin; Vassiliou, Melina C; Watanabe, Yusuke; Al-Halabi, Becher; Al-Rowais, Mohammed S; Deckelbaum, Dan L; Fried, Gerald M; Feldman, Liane S

2017-02-01

To identify the core principles that guide expert intraoperative behaviors and to use these principles to develop a universal framework that defines intraoperative performance. Surgical outcomes are associated with intraoperative cognitive skills. Yet, our understanding of factors that control intraoperative judgment and decision-making are limited. As a result, current methods for training and measuring performance are somewhat subjective-more task rather than procedure-oriented-and usually not standardized. They thus provide minimal insight into complex cognitive processes that are fundamental to patient safety. Cognitive task analyses for 6 diverse surgical procedures were performed using semistructured interviews and field observations to describe the thoughts, behaviors, and actions that characterize and guide expert performance. Verbal data were transcribed, supplemented with content from published literature, coded, thematically analyzed using grounded-theory by 4 independent reviewers, and synthesized into a list of items. A conceptual framework was developed based on 42 semistructured interviews lasting 45 to 120 minutes, 5 expert panels and 51 field observations involving 35 experts, and 135 sources from the literature. Five domains of intraoperative performance were identified: psychomotor skills, declarative knowledge, advanced cognitive skills, interpersonal skills, and personal resourcefulness. Within the advanced cognitive skills domain, 21 themes were perceived to guide the behaviors of surgeons: 18 for surgical planning and error prevention, and 3 for error/injury recognition, rescue, and recovery. The application of these thought patterns was highly case-specific and variable amongst subspecialties, environments, and individuals. This study provides a comprehensive definition of intraoperative expertise, with greater insight into the complex cognitive processes that seem to underlie optimal performance. This framework provides trainees and other nonexperts with the necessary information to use in deliberate practice and the creation of effective thought habits that characterize expert performance. It may help to identify gaps in performance, and to isolate root causes of surgical errors with the ultimate goal of improving patient safety.

Relationships between undergraduates' argumentation skills, conceptual quality of problem solutions, and problem solving strategies in introductory physics

NASA Astrophysics Data System (ADS)

Rebello, Carina M.

This study explored the effects of alternative forms of argumentation on undergraduates' physics solutions in introductory calculus-based physics. A two-phase concurrent mixed methods design was employed to investigate relationships between undergraduates' written argumentation abilities, conceptual quality of problem solutions, as well as approaches and strategies for solving argumentative physics problems across multiple physics topics. Participants were assigned via stratified sampling to one of three conditions (control, guided construct, or guided evaluate) based on gender and pre-test scores on a conceptual instrument. The guided construct and guided evaluate groups received tasks and prompts drawn from literature to facilitate argument construction or evaluation. Using a multiple case study design, with each condition serving as a case, interviews were conducted consisting of a think-aloud problem solving session paired with a semi-structured interview. The analysis of problem solving strategies was guided by the theoretical framework on epistemic games adapted by Tuminaro and Redish (2007). This study provides empirical evidence that integration of written argumentation into physics problems can potentially improve the conceptual quality of solutions, expand their repertoire of problem solving strategies and show promise for addressing the gender gap in physics. The study suggests further avenues for research in this area and implications for designing and implementing argumentation tasks in introductory college physics.

Making compromises: a qualitative study of sugar consumption behaviors during pregnancy.

PubMed

Graham, Jocelyn E; Mayan, Maria; McCargar, Linda J; Bell, Rhonda C

2013-01-01

To explore influences on women's sugar consumption behaviors during pregnancy. Focused ethnography guided this qualitative study. Contrasting experiences between women with varying sugar intakes were investigated using semi-structured interviews. Metropolitan area, Canada. Fifteen women with varying intakes of added sugar, who were in the third trimester of their first pregnancy, participated in this study. Sugar consumption behaviors during pregnancy. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis to inductively derive themes. Pregnant women increased their intake of sugars in an effort to achieve a compromise between meeting nutrition recommendations, lifestyle adjustments, physical symptoms, and cultural norms. Physical symptoms, lack of nutritional guidance, and social pressures were identified as barriers to achieving a diet low in sugars, whereas implementing dietary strategies guided by nutritional knowledge was a facilitator. This research provides insights that may be used to design effective interventions to improve maternal health. Strategies to help pregnant women achieve a healthy diet and limit sugar intake should be guided by nutritional knowledge, dietary awareness, and internal motivations to engage in healthy dietary changes. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Achieving organizational change in pediatric pain management

PubMed Central

Dowden, Stephanie; McCarthy, Maria; Chalkiadis, George

2008-01-01

BACKGROUND: Pain in hospitalized children is often under-treated. Little information exists to guide the process of organizational change with a view to improving pain management practices. OBJECTIVES: To describe the process and results of a hospital-wide review of pain management practices designed to identify deficiencies in service provision and recommend directions for change in a pediatric hospital. DESIGN: Prospective consultation of the clinical staff of a specialist pediatric hospital, using qualitative research methodology involving semistructured individual and group interviews. Recommendations based on the interview findings were made by a hospital-appointed working party. RESULTS: A total of 454 staff (27% of all clinical staff) from a variety of professional backgrounds, representing almost every hospital unit or department, were interviewed. Procedural and persistent (chronic) pain was identified as the area needing the most improvement. Barriers to improving pain management included variability in practice, outmoded beliefs and inadequate knowledge, factors which were seen to contribute to a culture of slow or no change. Recommendations of the working party and changes achieved after the review are described. CONCLUSION: The review process identified deficiencies in the management of pain in children, and barriers to its effective management. With institutional support, the present review has guided improvement. PMID:18719714

Young parents: the role of housing in understanding social inequality.

PubMed

Smith, Debbie; Roberts, Ron

2011-01-01

Since publication of the Social Exclusion Report in 1999, the adverse outcomes associated with young pregnancy have been a focus for Government policy. The ensuing Teenage Pregnancy Strategy sought to reduce social exclusion of young parents and their children. In this exploratory study, semi-structured interviews were conducted with young mothers (n=16) and fathers (n = 5) from a variety of socioeconomic environments, to explore their experience of being a young parent and some of the influences on their sexual and reproductive behaviours. They were recruited from two "more deprived" and two "more affluent" areas (Index of Multiple Deprivation classification). Their personal deprivation was measured by their parents' occupation. Thematic analysis was used to analyse the interview transcripts and identified themes were explored. Although housing was not included as a topic in the interview guide, responses indicated that housing is a cause of stress for young parents throughout and beyond pregnancy. Findings suggest that existing policies on supportive housing units adversely affect the relationship between young parents and between young fathers and their children. It is suggested that existing policies on supportive housing units should be reviewed to produce more supportive environments for parents and child. It was noted that the semi-structured interview method was successful in enabling the researchers to more fully understand the world as experienced by these young parents, and the researchers suggest that this research method may be particularly useful for use with vulnerable groups to suggest effective interventions.

[The semi-structured interview: at the border of public health and anthropology].

PubMed

Imbert, Geneviève

2010-09-01

The interview is the tool for data collection the most used in the context of research conducted in health sciences, human sciences and social sciences. After completing some generalities about the different types of interviews, the focus is on semi-structured interview during its various stages including the processing and data analysis, this from the return of a lived experience of research in work on the border of the field of public health and that of anthropology. If this approach and contextualized the semistructured interview may a priori appear specific, the reader interested in the development of qualitative research in a humanistic perspective and the implementation of multidisciplinary strategies to ascertain its universal character.

Thinking through cancer risk: characterizing smokers' process of risk determination.

PubMed

Hay, Jennifer; Shuk, Elyse; Cruz, Gustavo; Ostroff, Jamie

2005-10-01

The perception of cancer risk motivates cancer risk reduction behaviors. However, common measurement strategies for cancer risk perceptions, which involve numerical likelihood estimates, do not adequately capture individuals' thoughts and feelings about cancer risk. To guide the development of novel measurement strategies, the authors used semistructured interviews to examine the thought processes used by smokers (N = 15) as they considered their cancer risk. They used grounded theory to guide systematic data coding and develop a heuristic model describing smokers' risk perception process that includes a cognitive, primarily rational process whereby salient personal risk factors for cancer are considered and combined, and an affective/attitudinal process, which shifts risk perceptions either up or down. The model provides a tentative explanation concerning how people hold cancer risk perceptions that diverge from rational assessment of their risks and will be useful in guiding the development of non-numerical measurements strategies for cancer risk perceptions.

Graduate Global Public Health Education: Activities and Outcomes in Relation to Student Prior Experience

PubMed Central

Jackson, Suzanne F.; Cole, Donald C.

2013-01-01

The Dalla Lana School of Public Health uses an “add-on” or concentration model of global health education. Records of masters’ graduate cohorts across five disciplinary fields from 2006 to 2009 were classified as to prior experience at application and completion of global health concentration requirements. Alumni from the first two cohorts (2006-08 and 2007-09) were interviewed using a semi-structured interview guide. Prior experience was not linked consistently with the number of elective courses, location of practica or completion of requirements. Successful completion of the global health requirements depended more on the student’s base disciplinary program. Interviewed alumni with medium prior experience reported greater satisfaction with the concentration. Alumni with lower prior experience wanted more courses and support with practica. The pros and cons of a concentration model of global public health graduate education are discussed. PMID:23618475

Building Community: Stakeholder Perspectives on Walking in Malls and Other Venues.

PubMed

Belza, Basia; Miyawaki, Christina E; Allen, Peg; King, Diane K; Marquez, David X; Jones, Dina L; Janicek, Sarah; Rosenberg, Dori; Brown, David R

2017-10-01

Mall walking has been a popular physical activity for decades. However, little is known about why mall managers support these programs or why adults choose to walk. Our study aim was to describe mall walking programs from the perspectives of walkers, managers, and leaders. Twenty-eight walkers, 16 walking program managers, and six walking program leaders from five states participated in a telephone or in-person semi-structured interview (N = 50). Interview guides were developed using a social-ecological model. Interviews were recorded, transcribed verbatim, and analyzed thematically. All informants indicated satisfaction with their program and environmental features. Differences in expectations were noted in that walkers wanted a safe, clean, and social place whereas managers and leaders felt a need to provide programmatic features. Given the favorable walking environments in malls, there is an opportunity for public health professionals, health care organizations, and providers of aging services to partner with malls to promote walking.

Stakeholders' perceptions of transferability criteria for health promotion interventions: a case study.

PubMed

Trompette, Justine; Kivits, Joëlle; Minary, Laetitia; Cambon, Linda; Alla, François

2014-11-04

The effects of health promotion interventions are the result not only of the interventions themselves, but also of the contexts in which they unfold. The objective of this study was to analyze, through stakeholders' discourse, the characteristics of an intervention that can influence its outcomes. This case study was based on semi-structured interviews with health promotion stakeholders involved in a regional program (PRALIMAP). General hypotheses on transferability and on how the intervention is presumed to produce its effects were used to construct an interview guide. Interviews were analyzed using thematic coding. Twenty-three stakeholders were interviewed. Results showed stakeholders made few references to population and environment characteristics. Three themes emerged as significant for the stakeholders: implementation modalities and methodology, modalities used to mobilize actors; and transferability-promoting factors and barriers. Our work contributes to a better understanding not only of transferability factors, but also of stakeholders' perceptions of them, which are just as important, because those perceptions themselves are a factor in mobilization of actors, implementation, and transferability.

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

Impact of patients' religious and spiritual beliefs in pharmacy: from the perspective of the pharmacist.

PubMed

Daher, Moustafa; Chaar, Betty; Saini, Bandana

2015-01-01

Socio-cultural perspectives including religious and spiritual beliefs affect medicine use and adherence. Increasingly communities that pharmacists serve are diverse and pharmacists need to counsel medicine use issues with ethical and cultural sensitivity as well as pharmaceutical competence. There is very little research in this social aspect of pharmacy practice, and certainly none conducted in Australia, an increasingly multicultural, diverse population. The purpose of this study was to explore, from a pharmacy practitioner's viewpoint, the frequency and nature of cases where patients' articulated religious/spiritual belief affect medicine use; and pharmacist perspectives on handling these issues. Qualitative method employing semi-structured interviews with pharmacy practitioners, constructed around an interview guide. Pharmacist participants were recruited purposively from areas of linguistic diversity in Sydney, New South Wales, Australia. Verbatim transcription and thematic analyses were performed on the data. Thematic analyses of 21 semi-structured interviews depicted that scenarios where religious and spiritual belief and medication use intersect were frequently encountered by pharmacists. Patient concerns with excipients of animal origin and medication use while observing religious fasts were the main issues reported. Participants displayed scientific competence; however, aspects of ethical sensitivity in handling such issues could be improved. This novel study highlights the urgent need for more research, training and resource development for practitioners serving patients in multi-faith areas. Copyright © 2015 Elsevier Inc. All rights reserved.

Knowing 'something is not right' is beyond intuition: development of a clinical algorithm to enhance surveillance and assist nurses to organise and communicate clinical findings.

PubMed

Brier, Jessica; Carolyn, Moalem; Haverly, Marsha; Januario, Mary Ellen; Padula, Cynthia; Tal, Ahuva; Triosh, Henia

2015-03-01

To develop a clinical algorithm to guide nurses' critical thinking through systematic surveillance, assessment, actions required and communication strategies. To achieve this, an international, multiphase project was initiated. Patients receive hospital care postoperatively because they require the skilled surveillance of nurses. Effective assessment of postoperative patients is essential for early detection of clinical deterioration and optimal care management. Despite the significant amount of time devoted to surveillance activities, there is lack of evidence that nurses use a consistent, systematic approach in surveillance, management and communication, potentially leading to less optimal outcomes. Several explanations for the lack of consistency have been suggested in the literature. Mixed methods approach. Retrospective chart review; semi-structured interviews conducted with expert nurses (n = 10); algorithm development. Themes developed from the semi-structured interviews, including (1) complete, systematic assessment, (2) something is not right (3) validating with others, (4) influencing factors and (5) frustration with lack of response when communicating findings were used as the basis for development of the Surveillance Algorithm for Post-Surgical Patients. The algorithm proved beneficial based on limited use in clinical settings. Further work is needed to fully test it in education and practice. The Surveillance Algorithm for Post-Surgical Patients represents the approach of expert nurses, and serves to guide less expert nurses' observations, critical thinking, actions and communication. Based on this approach, the algorithm assists nurses to develop skills promoting early detection, intervention and communication in cases of patient deterioration. © 2014 John Wiley & Sons Ltd.

Friendship in inclusive physical education.

PubMed

Seymour, Helena; Reid, Greg; Bloom, Gordon A

2009-07-01

Social interaction and development of friendships between children with and without a disability are often proposed as potential outcomes of inclusive education. Physical activity specialists assert that exercise and sport environments may be conducive to social and friendship outcomes. This study investigated friendship in inclusive physical education from the perspective of students with (n = 8) and without (n = 8) physical disabilities. All participants attended a reversely integrated school and were interviewed using a semistructured, open-ended format. An adapted version of Weiss, Smith, and Theeboom's (1996) interview guide exploring perceptions of peer relationships in the sport domain was used. Four conceptual categories emerged from the analysis: development of friendship, best friend, preferred physical activities and outcomes, and dealing with disability. The results demonstrated the key characteristics of best friends and the influential role they play.

Guided self-help for mental health disorders in children and young people with chronic neurological conditions: A qualitative evaluation.

PubMed

Bennett, Sophie D; Coughtrey, Anna E; Heyman, Isobel; Greally, Suzanna; Clarkson, Harriet; Bhattacharyya, Tuhina; Lewis, Corah; Varadkar, Sophia; Shafran, Roz

2018-03-09

Children with neurological conditions such as epilepsy are at high risk of developing mental health disorders. Guided self-help can be used to increase access to psychological therapies. When developing and evaluating interventions, it is important to obtain the views of service-users about their acceptability. A telephone-guided self-help intervention was used to treat common mental health difficulties in children and young people with neurological conditions. The intervention was not adapted in content to account for chronic illness. This study therefore reports on qualitative interviews with participants to determine the acceptability of the intervention. Semi-structured interviews were conducted with 27 participants (25 parents and 2 young people) who had undertaken a telephone-delivered guided self-help intervention for common mental health difficulties in the context of a paediatric neurological condition. Transcripts were analysed thematically using the framework approach. Thirteen themes were extracted, organised into three main domains, which covered: the practicalities of telephone guided self-help treatment; the outcomes of the intervention; and the extent to which adaptation was needed for chronic illness. Most families found the intervention helpful in working towards their specific goals and noticed changes for the child and/or parents and family. Participants had a positive experience of the intervention and the majority of parents found the standard intervention with individualised goals sufficient to meet the young person's mental health needs. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

'My pain was stronger than my happiness': experiences of caesarean births from Lebanon.

PubMed

Kabakian-Khasholian, Tamar

2013-11-01

the rising trends in caesarean section have been partially attributed to women's requests. Many studies in developed and very few in developing countries have attempted to understand this phenomenon. This qualitative study explores experiences of women having caesarean section on demand in a middle-income country with a private health-care system. an inductive qualitative design, using face-to-face semi-structured interviews. women were identified and recruited through a perinatal database and selected obstetricians' clinics in the Greater Beirut area in Lebanon. a purposive sample of women who had a caesarean childbirth within the four months preceding the interview, were visited for an interview at home using a semi-structured interview guide. Thematic content analysis was conducted on a sub-sample of 22 women who requested a caesarean birth. lack of information about caesarean sections fosters women's fear from labour pain and acts as the main impetus for women to consider caesareans as the pain free alternative. Findings reveal health-care providers' role in reinforcing beliefs about caesarean sections being the way for pain free deliveries by overestimating the safety of the procedure and disregarding postpartum health issues. caesarean birth is presented to women as a safe option for 'pain free' childbirth. This needs to be considered within the cultural context of understanding safety and pain as well as the dynamics of power in maternity care. Health-care professionals need to explore these dimensions and promote women's informed choice as well as encouraging the normality of birth. Copyright © 2012 Elsevier Ltd. All rights reserved.

Athletic Directors' Barriers to Hiring Athletic Trainers in High Schools

PubMed Central

Mazerolle, Stephanie M.; Raso, Samantha R.; Pagnotta, Kelly D.; Stearns, Rebecca L.; Casa, Douglas J.

2015-01-01

Context In its best-practices recommendation, the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs urged all high schools to have a certified athletic trainer (AT) on staff. Despite the recommendation, many high schools lack the medical services of an AT. Objective To examine the barriers that athletic directors (ADs) face in hiring ATs in public high schools and in providing medical coverage for their student-athletes. Design Qualitative study. Setting Semistructured telephone interviews. Patients or Other Participants Twenty full-time public high school ADs (17 men, 3 women) from various geographical regions of the United States (6 North, 4 South, 4 Midwest, 6 West) participated. Data saturation guided the total number of participants. Data Collection and Analysis We completed telephone interviews guided by a semistructured questionnaire with all participants. Interviews were recorded and transcribed verbatim. Multiple-analyst triangulation and peer review were included as steps to establish data credibility. We analyzed the data using the principles of the general inductive approach. Results We identified 3 themes. Lack of power represented the inability of an AD to hire an AT, which was perceived to be a responsibility of the superintendent and school board. Budget concerns pertained to the funding allocated to specific resources within a school, which often did not include an AT. Nonbudget concerns represented rural locations without clinics or hospitals nearby; misconceptions about the role of an AT, which led to the belief that first-aid–trained coaches are appropriate medical providers; and community support from local clinics, hospitals, and volunteers. Conclusions Many ADs would prefer to employ ATs in their schools; however, they perceive that they are bound by the hiring and budgeting decisions of superintendents and school boards. Public school systems are experiencing the consequences of national budget cuts and often do not have the freedom to hire ATs when other school staff are being laid off. PMID:26509776

Athletic Directors' Barriers to Hiring Athletic Trainers in High Schools.

PubMed

Mazerolle, Stephanie M; Raso, Samantha R; Pagnotta, Kelly D; Stearns, Rebecca L; Casa, Douglas J

2015-10-01

In its best-practices recommendation, the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs urged all high schools to have a certified athletic trainer (AT) on staff. Despite the recommendation, many high schools lack the medical services of an AT. To examine the barriers that athletic directors (ADs) face in hiring ATs in public high schools and in providing medical coverage for their student-athletes. Qualitative study. Semistructured telephone interviews. Twenty full-time public high school ADs (17 men, 3 women) from various geographical regions of the United States (6 North, 4 South, 4 Midwest, 6 West) participated. Data saturation guided the total number of participants. We completed telephone interviews guided by a semistructured questionnaire with all participants. Interviews were recorded and transcribed verbatim. Multiple-analyst triangulation and peer review were included as steps to establish data credibility. We analyzed the data using the principles of the general inductive approach. We identified 3 themes. Lack of power represented the inability of an AD to hire an AT, which was perceived to be a responsibility of the superintendent and school board. Budget concerns pertained to the funding allocated to specific resources within a school, which often did not include an AT. Nonbudget concerns represented rural locations without clinics or hospitals nearby; misconceptions about the role of an AT, which led to the belief that first-aid-trained coaches are appropriate medical providers; and community support from local clinics, hospitals, and volunteers. Many ADs would prefer to employ ATs in their schools; however, they perceive that they are bound by the hiring and budgeting decisions of superintendents and school boards. Public school systems are experiencing the consequences of national budget cuts and often do not have the freedom to hire ATs when other school staff are being laid off.

Athletic Directors' Barriers to Hiring Athletic Trainers in High Schools.

PubMed

Mazerolle, Stephanie M; Raso, Samantha; Pagnotta, Kelly D; Stearns, Rebecca; Casa, Douglas J

2015-09-18

  In its best-practices recommendation, the Inter-Association Task Force for Preventing Sudden Death in Secondary School Athletics Programs urged all high schools to have a certified athletic trainer (AT) on staff. Despite the recommendation, many high schools lack the medical services of an AT.   To examine the barriers that athletic directors (ADs) face in hiring ATs in public high schools and in providing medical coverage for their student-athletes.   Qualitative study.   Semistructured telephone interviews.   Twenty full-time public high school ADs (17 men, 3 women) from various geographical regions of the United States (6 North, 4 South, 4 Midwest, 6 West) participated. Data saturation guided the total number of participants.   We completed telephone interviews guided by a semistructured questionnaire with all participants. Interviews were recorded and transcribed verbatim. Multiple-analyst triangulation and peer review were included as steps to establish data credibility. We analyzed the data using the principles of the general inductive approach.   We identified 3 themes. Lack of power represented the inability of an AD to hire an AT, which was perceived to be a responsibility of the superintendent and school board. Budget concerns pertained to the funding allocated to specific resources within a school, which often did not include an AT. Nonbudget concerns represented rural locations without clinics or hospitals nearby; misconceptions about the role of an AT, which led to the belief that first-aid-trained coaches are appropriate medical providers; and community support from local clinics, hospitals, and volunteers.   Many ADs would prefer to employ ATs in their schools; however, they perceive that they are bound by the hiring and budgeting decisions of superintendents and school boards. Public school systems are experiencing the consequences of national budget cuts and often do not have the freedom to hire ATs when other school staff are being laid off.

Teaching Accelerated Second-Degree Nursing Students: Educators From Across the United States Share Their Wisdom.

PubMed

Christoffersen, Jean E

2017-04-01

Over the past decade, there has been a proliferation of accelerated second-degree (ASD) nursing programs. These programs are designed to educate students with prior degrees in increasingly shorter periods of time than they have traditionally been educated. As a result, nurse educators and administrators in these programs need to tailor their approaches to best meet the educational needs of this unique cohort. This qualitative study sought to elicit best practices from nursing faculty across the United States. Previous investigators primarily examined a limited number of programs from the same region. In this study, a roughly equal number of participants experienced in teaching ASD students from across the United States were recruited. Initially focus groups were conducted to form a semistructured interview guideline, which was then was used to guide participant interviews. Results of the interview data were analyzed using standard qualitative research techniques of concept analyses. Themes that emerged were (a) extreme organization, (b) engage students through active listening, (c) mutual respect, (d) engage via life/work experience, (e) effective pedagogy adaptations, and (f) early immersion. The specifics of these themes will be useful in guiding faculty and program directors involved with ASD nursing students. © 2016 Wiley Periodicals, Inc.

Professionals’ Recommended Strategies to Improve Australian Adolescents’ Knowledge of Nutrition and Food Systems

PubMed Central

Sadegholvad, Sanaz; Yeatman, Heather; Parrish, Anne-Maree; Worsley, Anthony

2017-01-01

Background: Education and policy measures within schools are valuable strategies to promote health. This study explored views of experienced food-related educators, researchers and policy-makers regarding their recommended strategies to improve Australian adolescents’ knowledge of nutrition and food systems (N&FS). Methods: Semi-structured interviews were conducted with twenty-one experienced food-related experts from across Australia. Interviews were conducted either by telephone or face-to-face. Recorded interviews were transcribed verbatim and analyzed thematically. Results: Five central themes and five sub-themes were identified from food professionals’ suggestions for best strategies to improve adolescents’ knowledge of N&FS. The central themes included: (1) specific improvements in schools’ core curricula; (2) pre-service and in-service training of school teachers about N&FS; (3) training students to develop a critical mind about N&FS issues; (4) multidisciplinary collaborations to improve school-based N&FS education; and (5) a supportive N&FS education environment for students. Conclusion and implication: These findings provide a guide for curriculum developers, educational policy developers, and food educators to incorporate the suggested N&FS strategies into Australian education programs in order to improve Australian adolescents’ knowledge and skills of N&FS issues. The results of this investigation also may assist the development of international N&FS curricula guides. PMID:28783108

Professionals' Recommended Strategies to Improve Australian Adolescents' Knowledge of Nutrition and Food Systems.

PubMed

Sadegholvad, Sanaz; Yeatman, Heather; Parrish, Anne-Maree; Worsley, Anthony

2017-08-07

Education and policy measures within schools are valuable strategies to promote health. This study explored views of experienced food-related educators, researchers and policy-makers regarding their recommended strategies to improve Australian adolescents' knowledge of nutrition and food systems (N&FS). Semi-structured interviews were conducted with twenty-one experienced food-related experts from across Australia. Interviews were conducted either by telephone or face-to-face. Recorded interviews were transcribed verbatim and analyzed thematically. Five central themes and five sub-themes were identified from food professionals' suggestions for best strategies to improve adolescents' knowledge of N&FS. The central themes included: (1) specific improvements in schools' core curricula; (2) pre-service and in-service training of school teachers about N&FS; (3) training students to develop a critical mind about N&FS issues; (4) multidisciplinary collaborations to improve school-based N&FS education; and (5) a supportive N&FS education environment for students. These findings provide a guide for curriculum developers, educational policy developers, and food educators to incorporate the suggested N&FS strategies into Australian education programs in order to improve Australian adolescents' knowledge and skills of N&FS issues. The results of this investigation also may assist the development of international N&FS curricula guides.

Men's experience of a guided self-help intervention for hot flushes associated with prostate cancer treatment.

PubMed

Grunfeld, E A; Hunter, M S; Yousaf, O

2017-04-01

Up to 80% of men who receive androgen deprivation therapy report hot flushes and for many these are associated with reduced quality of life. However it is recognised that there are a number of barriers to men's engagement with support to manage symptoms and improve quality of life. This qualitative study was embedded within a larger randomised controlled trial (MANCAN) of a guided self-help cognitive behavioural intervention to manage hot flushes resulting among men receiving androgen deprivation therapy. The study aimed to explore the engagement and experiences with the guided self-help intervention. Twenty men recruited from the treatment arm of the MANCAN trial participated in a semi-structured interview exploring acceptability of the intervention, factors affecting engagement and perceived usefulness of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a Framework approach. Over two thirds of respondents (69%) reported reading the intervention booklet in full and over 90% reporting practising the relaxation CD at least once a week. Analysis of the interviews identified three super-ordinate themes and these related to changes in hot flush symptomatology (learned to cope with hot flushes in new ways), the skills that participants had derived from the intervention (promoting relaxation and reducing stressors), and to a broader usefulness of the intervention (broader impact of the intervention and skills). The present study identified positive engagement with a guided self-help intervention and that men applied the skills developed through the intervention to help them undertake general lifestyle changes. Psycho-educational interventions (e.g. cognitive behaviour therapy, relaxation, and positive lifestyle elements) offer the potential to be both effective and well received by male cancer survivors.

Use of Skype in interviews: the impact of the medium in a study of mental health nurses.

PubMed

Oates, Jennifer

2015-03-01

To discuss the use of Skype as a medium for undertaking semi-structured interviews. Internet-based research is becoming increasingly popular, as communication using the internet takes a bigger role in our working and personal lives. Technology such as Skype allows research encounters with people across geographical divides. The semi-structured interview is a social encounter with a set of norms and expectations for both parties ( Doody and Noonan 2012 ). Proceedings must take account of the social context of both semi-structured interviews per se, and that of internet mediated communication. The findings of the qualitative phase of a mixed-methods study are compared with other reports comparing the use of Skype with face-to-face and telephone interviews. This paper is a methodological discussion of the use of Skype as an online research methodology. Choosing Skype as a means of interviewing may affect the characteristics of participants and decisions about consent. Rapport, sensitivity and collaboration may be addressed differently in Skype interviews compared with face-to-face interviews. Skype offers researchers the opportunity to reach a geographical spread of participants more safely, cheaply and quickly than face-to-face meetings. Rapport, sensitivity and degrees of collaboration can be achieved using this medium. The use of Skype as a medium for semi-structured interview research is better understood. This paper contributes to the growing body of literature on the use of the internet as a medium for research by nurses.

International Adaptation: Psychosocial and parenting experiences of caregivers who travel to the United States to obtain acute medical care for their seriously ill child

PubMed Central

Margolis, Rachel; Ludi, Erica; Pao, Maryland; Wiener, Lori

2013-01-01

Despite the increasing trend of travel for medical purposes, little is known about the experience of parents and other caregivers who come to the United States specifically to obtain medical treatment for their seriously ill child. In this exploratory, descriptive qualitative study, we used a semi-structured narrative guide to conduct in-depth interviews with 22 Spanish or English-speaking caregivers about the challenges encountered and adaptation required when entering a new medical and cultural environment. Caregivers identified the language barrier and transnational parenting as challenges while reporting hospital staff and their own families as major sources of support. Using the results of the study as a guide, clinical and program implications are provided and recommendations for social work practice discussed. PMID:23947542

Responsibility and burden from the perspective of seniors' family caregivers: a qualitative study in Shanghai, China.

PubMed

Zeng, Li; Zhu, Xiaoping; Meng, Xianmei; Mao, Yafen; Wu, Qian; Shi, Yan; Zhou, Lanshu

2014-01-01

This study aimed to explore the experience of seniors' family caregivers with regarding the responsibility, burden and support needs during caregiving in Shanghai, China. An exploratory, descriptive, qualitative design was used and a semi-structure interview was conducted. A convenience sample of 11 participants in two community service centers in Shanghai was recruited. Data saturation guided the size of the sample. The Colaizzi method of empirical phenomenology was used for interviewing and analyzing data obtained from 11 caregivers. Three major themes were found: It is a hard work; It is my responsibility; Social support is not enough. The findings of the study are practical and helpful for health care providers to develop appropriate caregiver support services, to balance the responsibility and burden of caregivers, and to consider the factors influencing the utility of support services.

Women's Educational Needs and Perceptions About Survivorship Following Bilateral Mastectomy.

PubMed

Suplee, Patricia D; Jerome-D'Emilia, Bonnie; Boiler, Jennifer L K

2016-08-01

More women are choosing to have a bilateral mastectomy to treat unilateral breast cancer despite it not being considered the standard of care. Women are making this choice for various reasons, including anxiety of follow-up screening of the other breast, risk of cancer recurrence for the rest of their lives, and desire to maintain control over the localized cancer. Currently, evidence-based information is lacking regarding this treatment choice. In addition, the concept of survivorship has yet to be examined in this population of women. This study aimed to explore women's educational needs and perceptions about survivorship following bilateral mastectomy as a treatment for unilateral breast cancer. In-depth interviews were conducted with 23 women using a semistructured interview guide. Data were elicited, coded, and analyzed using thematic analysis. Two themes were identified that addressed education and survivorship.

Improving Junior Infantry Officer Leader Development and Performance

DTIC Science & Technology

2017-06-09

researcher used a qualitative literature review and semi-structured interview methodology to analyze Army leadership theories and leader development...researcher used a qualitative literature review and semi-structured interview methodology to analyze Army leadership theories and leader development...CHAPTER 3 RESEARCH METHODOLOGY ..............................................................132 CHAPTER 4 QUALITATIVE ANALYSIS

Experiences of the Breast Cancer Patients Undergoing Radiotherapy at a Public Hospital Peshawar Pakistan

PubMed Central

Habibullah, Gulzar; Gul, Raisa; Cassum, Shanaz; Elahi, Rehana

2018-01-01

Objective: This study aimed to explore the experiences of female breast cancer patients undergoing radiotherapy (RT) in a public hospital in Peshawar, Pakistan. Methods: This study employed a descriptive exploratory method. A purposive sample of 14 breast cancer women undergoing RT was selected for this study. Data were collected over the period of 5 months, using a semi-structured interview guide and conducting in-depth face-to-face interviews. These interviews were audio taped and transcribed by a bilingual transcriber. The translated version of the interview was coded, and the analysis was done manually. Results: Four main categories emerged from data analysis, which were: feelings and perceptions of the patients, their challenges, coping strategies, and teaching and informational needs. Conclusions: Women undergoing RT in this culture experience more intense psychological effects, as compared to the physical effects. Keeping in mind, the magnitude of the emotional stress experienced by the participants, recommendations for policy reforms, and training for female RT staff are suggested based on findings of this research. PMID:29607379

Why do some people with type 2 diabetes who are using insulin have poor glycaemic control? A qualitative study

PubMed Central

Tong, Wen Ting; Vethakkan, Shireene Ratna; Ng, Chirk Jenn

2015-01-01

Objective To explore factors influencing poor glycaemic control in people with type 2 diabetes using insulin. Research design A qualitative method comprising in-depth individual interviews. A semistructured interview guide was used. The interviews were audiorecorded, transcribed verbatim and analysed using a thematic approach. Participants Seventeen people with type 2 diabetes using insulin with glycated haemoglobin (HbA1c) ≥9% for >1 year. Setting The Primary Care Clinic and Diabetes Clinic in the University of Malaya Medical Centre (UMMC), Malaysia. Results Data analysis uncovered four themes: lifestyle challenges in adhering to medical recommendations; psychosocial and emotional hurdles; treatment-related factors; lack of knowledge about and self-efficacy in diabetes self-care. Conclusions Factors that explain the poor glycaemic control in people with type 2 diabetes using insulin were identified. Healthcare providers could use these findings to address patients’ concerns during consultations and help to improve glycaemic control. PMID:25633285

Social circus program (Cirque du Soleil) promoting social participation of young people living with physical disabilities in transition to adulthood: a qualitative pilot study.

PubMed

Loiselle, Frédéric; Rochette, Annie; Tétreault, Sylvie; Lafortune, Michel; Bastien, Josée

2018-05-29

To explore the perceived impact of a social circus program on the participation level of young adults' living with physical disabilities from their own and their parents' perspective. Exploratory phenomenological qualitative design. A social circus program was offered for nine months. Perceived participation level was documented through pre and post semi-structured interviews. A pretested interview guide was used. Interviews were transcribed and coded by two independent researchers. The average age of the participants (n = 9) was 20.0 ± 1.4 years with 2/9 being female. Participation was perceived as being improved after the intervention from both perspectives (participants and parents) mainly for communication, mobility, relationships, community life and responsibilities. The intervention was perceived as strengthening self-perception and self-efficacy, which in turn enhanced participation level and decreased parents' bounding. The results show promises for social circus as a new approach in adult physical rehabilitation for this population in transition.

A guided self-help intervention targeting psychological distress among head and neck cancer and lung cancer patients: motivation to start, experiences and perceived outcomes.

PubMed

Krebber, Anne-Marie H; van Uden-Kraan, Cornelia F; Melissant, Heleen C; Cuijpers, Pim; van Straten, Annemieke; Becker-Commissaris, Annemarie; Leemans, C René; Verdonck-de Leeuw, Irma M

2017-01-01

Recent results of a randomized clinical trial showed that a guided self-help intervention (based on problem-solving therapy) targeting psychological distress among head and neck cancer and lung cancer patients is effective. This study qualitatively explored motivation to start, experiences with and perceived outcomes of this intervention. Data were collected from semi-structured interviews of 16 patients. All interviews were audio-recorded and transcribed verbatim. Data were analyzed individually by two coders and coded into key issues and themes. Patients participated in the intervention for intrinsic (e.g. to help oneself) and for extrinsic reasons (e.g. being asked by a care professional or to help improve health care). Participants indicated positive and negative experiences with the intervention. Several participants appreciated participating as being a pleasant way to work on oneself, while others described participating as too confrontational. Some expressed their disappointment as they felt the intervention had brought them nothing or indicated that they felt worse temporarily, but most participants perceived positive outcomes of the intervention (e.g. feeling less distressed and having learned what matters in life). Cancer patients have various reasons to start a guided self-help intervention. Participants appreciated the guided self-help as intervention to address psychological distress, but there were also concerns. Most participants reported the intervention to be beneficial. The results suggest the need to identify patients who might benefit most from guided self-help targeting psychological distress and that interventions should be further tailored to individual cancer patients' requirements.

Giving hope, ticking boxes or securing services? A qualitative study of respiratory physiotherapists' views on goal-setting with people with chronic obstructive pulmonary disease.

PubMed

Summers, Rachael H; Ballinger, Claire; Nikoletou, Dimitra; Garrod, Rachel; Bruton, Anne; Leontowitsch, Miranda

2017-07-01

To explore respiratory physiotherapists' views and experiences of using goal-setting with people with chronic obstructive pulmonary disease in rehabilitation settings. A total of 17 respiratory physiotherapists with ⩾12 months current or previous experience of working with patients with chronic obstructive pulmonary disease in a non-acute setting. Participants were diverse in relation to age (25-49 years), sex (13 women), experience (Agenda for Change bands 6-8) and geographic location. Data were collected via face-to-face qualitative in-depth interviews (40-70 minutes) using a semi-structured interview guide. Interview locations were selected by participants (included participants' homes, public places and University). Interviews followed an interview guide, were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis; constant comparison was made within and between accounts, and negative case analysis was used. Three themes emerged through the process of analysis: (1) 'Explaining goal-setting'; (2) 'Working with goals'; and (3) 'Influences on collaborative goal-setting'. Goal-setting practices among respiratory physiotherapists varied considerably. Collaborative goal-setting was described as challenging and was sometimes driven by service need rather than patient values. Lack of training in collaborative goal-setting at both undergraduate and postgraduate level was also seen as an issue. Respiratory physiotherapists reflected uncertainties around the use of goal-setting in their practice, and conflict between patients' goals and organisational demands. This work highlights a need for wider discussion to clarify the purpose and implementation of goal-setting in respiratory rehabilitation.

Views of Classroom Teachers Concerning Students with Reading Difficulties

ERIC Educational Resources Information Center

Kayabasi, Zehra Esra Ketenoglu

2017-01-01

This study aimed to try to understand the views and attitudes of classroom teachers concerning students with reading difficulties. Data was collected using the semi-structured interview technique, which is among the qualitative data collection techniques. The researcher prepared a semi-structured interview with 5 questions to be addressed to…

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

PubMed Central

2014-01-01

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

Decision-making about prenatal genetic testing among pregnant Korean-American women.

PubMed

Jun, Myunghee; Thongpriwan, Vipavee; Choi, Jeeyae; Sook Choi, Kyung; Anderson, Gwen

2018-01-01

to understand the prenatal genetic testing decision-making processes among pregnant Korean-American women. a qualitative, descriptive research design. referrals and snowball sampling techniques were used to recruit 10 Korean-American women who had been recommended for amniocentesis during pregnancy in the United States (U.S.). All participants were born in Korea and had immigrated to the U.S. The number of years living in the U.S. ranged from 4 to 11 (M=5.7). various regional areas of the U.S. the researchers conducted face-to-face or phone interviews using semi-structured interview guides. The interviews were conducted in the Korean language and lasted approximately 50-100minutes. The interview guides focused on the decision-making process and experiences with prenatal genetic testing, as well as reflections on the decisions. Four core themes emerged related to the participants' decision-making processes, according to their descriptions. These themes are (1) facing the challenges of decision-making, (2) seeking support, (3) determining one's preferred role in the decision-making process, and (4) feeling uncomfortable with the degree of patient autonomy in U.S. health care. researchers concluded that many distinctive factors influence the decision-making processes used by pregnant Korean-American women. The results have the potential to improve shared decision-making practices regarding prenatal genetic testing. clinicians need to understand the sociocultural underpinnings of pregnant Korean-American immigrants regarding prenatal genetic screening and testing as an initial step to engage these patients in shared decision-making. Published by Elsevier Ltd.

Perceptions of Primary Care-Based Breastfeeding Promotion Interventions: Qualitative Analysis of Randomized Controlled Trial Participant Interviews

PubMed Central

Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-01-01

Abstract Objective This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. Subjects and Methods A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Results Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Conclusions Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates. PMID:22621223

Perceptions of primary care-based breastfeeding promotion interventions: qualitative analysis of randomized controlled trial participant interviews.

PubMed

Andaya, Elise; Bonuck, Karen; Barnett, Josephine; Lischewski-Goel, Jennifer

2012-12-01

This study examined women's perceptions and reported effects of routine, primary care-based interventions to increase breastfeeding. A subsample (n=67) of participants in randomized controlled trials (RCTs) completed semistructured exit interviews at 6 months postpartum. RCT arms included the following: (a) routine pre-/postnatal lactation consultant (LC) support (LC group); (b) electronic prompts (EP) guiding providers to discuss breastfeeding during prenatal care visits (EP group); (c) a combined intervention (LC+EP group); and (d) controls. Interview transcripts were coded and analyzed in MAX.qda. Key findings included the following: (1) Brief, non-directive assessment of feeding via postpartum interviews focused attention upon feeding practices. When coupled with breastfeeding promotion interventions, interviews promoted breastfeeding. (2) The EP and LC interventions were complementary: EPs influenced initiation, while LCs helped overcome barriers and sustain breastfeeding. (3) Prenatal intent to feed both breastmilk and formula was associated with the greatest receptivity to study messages. Findings underscore the need for interventions across the continuum of care. Trained LCs in prenatal/postpartum settings and prenatal care providers play important complementary roles that, when coupled with brief telephone feeding assessments, may improve breastfeeding rates.

Caring for people with AIDS: nurses' attitudes and feelings.

PubMed

Breault, A J; Polifroni, E C

1992-01-01

A qualitative, non-experimental study was conducted to identify the feelings and attitudes that nurses associate with caring for people with AIDS. Data collection and analysis were guided by the phenomenological method. Cognitive dissonance theory served as the theoretical framework to view the experience of caring for someone with AIDS. Data analysis of audiotaped, semi-structured interviews resulted in the identification of six mutually inclusive as well as exclusive themes which represent the attitudes and feelings of nurses: fear, anger, sympathy, self-enhancement, fatigue and helplessness. Particularly evident were differences in the way respondents perceived and treated AIDS patients who are intravenous drug users and those who are homosexuals.

Religion and Spirituality in Surrogate Decision Making for Hospitalized Older Adults.

PubMed

Geros-Willfond, Kristin N; Ivy, Steven S; Montz, Kianna; Bohan, Sara E; Torke, Alexia M

2016-06-01

We conducted semi-structured interviews with 46 surrogate decision makers for hospitalized older adults to characterize the role of spirituality and religion in decision making. Three themes emerged: (1) religion as a guide to decision making, (2) control, and (3) faith, death and dying. For religious surrogates, religion played a central role in end of life decisions. There was variability regarding whether God or humans were perceived to be in control; however, beliefs about control led to varying perspectives on acceptance of comfort-focused treatment. We conclude that clinicians should attend to religious considerations due to their impact on decision making.

Religion and Spirituality in Surrogate Decision Making for Hospitalized Older Adults

PubMed Central

Geros, Kristin N.; Ivy, Steven S.; Montz, Kianna; Bohan, Sara E.; Torke, Alexia M.

2015-01-01

We conducted semi-structured interviews with 46 surrogate decision makers for hospitalized older adults to characterize the role of spirituality and religion in decision making. Three themes emerged: (1) religion as a guide to decision making, (2) control, and (3) faith, death and dying. For religious surrogates, religion played a central role in end of life decisions. There was variability regarding whether God or humans were perceived to be in control; however beliefs about control led to varying perspectives on acceptance of comfort-focused treatment. We conclude that clinicians should attend to religious considerations due to their impact on decision making. PMID:26337437

Components of nurse innovation: a model from acute care hospitals.

PubMed

Neidlinger, S H; Drews, N; Hukari, D; Bartleson, B J; Abbott, F K; Harper, R; Lyon, J

1992-12-01

Components that promote nurse innovation in acute care hospitals are explicated in the Acute Care Nursing Innovation Model. Grounded in nursing care delivery systems and excellent management-organizations perspectives, nurse executives and 30 nurse "intrapreneurs" from 10 innovative hospitals spanning the United States shared their experiences and insights through semistructured, tape-recorded telephone interviews. Guided by interpretive interactionist strategies, the essential components, characteristics, and interrelationships are conceptualized and described so that others may be successful in their innovative endeavors. Successful innovation is dependent on the fit between and among the components; the better the fit, the more likely the innovation will succeed.

A Hierarchy of Medicine: Health Strategies of Elder Khmer Refugees in the United States

ERIC Educational Resources Information Center

Lewis, Denise C.

2007-01-01

This study addresses ways Khmer refugee elders utilize traditional herbal medicine with Western biomedicine in the treatment and prevention of illnesses. Methods include semi-structured and informal interviews with elders and family members, semi-structured interviews with local health care providers and Khmer physicians, and participant…

Post-Evaluation of an Entrepreneurship Program for Inner-City Youth

ERIC Educational Resources Information Center

Doucet, LaRon

2010-01-01

This study evaluated program graduates of National Foundation for Teaching Entrepreneurship 1 to years after completing the program in inner city schools of Los Angeles, California. Twenty-seven out of 150 graduates participated in 2 semi-structured interviews in Northern and Southern California, or long semi-structured telephone interviews for…

Semi-Structured Interview Protocol for Constructing Logic Models

ERIC Educational Resources Information Center

Gugiu, P. Cristian; Rodriguez-Campos, Liliana

2007-01-01

This paper details a semi-structured interview protocol that evaluators can use to develop a logic model of a program's services and outcomes. The protocol presents a series of questions, which evaluators can ask of specific program informants, that are designed to: (1) identify key informants basic background and contextual information, (2)…

The Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale: Initial Psychometric and Outcome Support

ERIC Educational Resources Information Center

Donohue, Brad; Strada, Marilyn J.; Rosales, Rocio; Taylor-Caldwell, Aundrea; Hise, Dortha; Ahman, Sarah; Lefforge, Noelle L.; Kopof, Monique; Devore, Greg; Soares, Bruno; Radkovich, Ben; Laino, Rowena

2006-01-01

There has been recent pressure for practitioners to consider cultural variables when implementing evidence-based interventions. Therefore, the Semistructured Interview for Consideration of Ethnic Culture in Therapy Scale (SSICECTS) was empirically developed to address this issue. First, psychometric properties of a 6-item scale were evaluated in…

Development of the Learning Health System Researcher Core Competencies.

PubMed

Forrest, Christopher B; Chesley, Francis D; Tregear, Michelle L; Mistry, Kamila B

2017-08-04

To develop core competencies for learning health system (LHS) researchers to guide the development of training programs. Data were obtained from literature review, expert interviews, a modified Delphi process, and consensus development meetings. The competencies were developed from August to December 2016 using qualitative methods. The literature review formed the basis for the initial draft of a competency domain framework. Key informant semi-structured interviews, a modified Delphi survey, and three expert panel (n = 19 members) consensus development meetings produced the final set of competencies. The iterative development process yielded seven competency domains: (1) systems science; (2) research questions and standards of scientific evidence; (3) research methods; (4) informatics; (5) ethics of research and implementation in health systems; (6) improvement and implementation science; and (7) engagement, leadership, and research management. A total of 33 core competencies were prioritized across these seven domains. The real-world milieu of LHS research, the embeddedness of the researcher within the health system, and engagement of stakeholders are distinguishing characteristics of this emerging field. The LHS researcher core competencies can be used to guide the development of learning objectives, evaluation methods, and curricula for training programs. © Health Research and Educational Trust.

Skin-to-Skin Contact Facilitates More Equal Parenthood - A Qualitative Study From Fathers' Perspective.

PubMed

Olsson, Emma; Eriksson, Mats; Anderzén-Carlsson, Agneta

A descriptive design was used where 20 fathers of premature infants were interviewed using a semi-structured interview-guide. The guide contained the following five topics: the fathers' feelings about and experiences of using skin-to-skin contact (SSC), the physical environment at the Neonatal Intensive Care unit, staff attitudes, and whether SSC had any impact on the relationship with their partner and other children in the family. The interviews were analyzed using directed qualitative content analysis and the results compared with those of a qualitative systematic review by Anderzén-Carlsson and colleagues. The result shows that the fathers' overall experience of SSC was positive and as in the aforementioned review, they described experiences that were both gratifying and challenging. They felt more included and just as important as the mother because SSC and the demands placed on them by the premature birth helped them to achieve more equal parenthood. The fathers' overall experiences of SSC were positive as they felt included in their infants' care and just as important as the mothers. To a great degree the theoretical model tested was supported, although some weaknesses and differences were identified. It is important to include fathers in neonatal care and recognize that they feel equally important as mothers in caring for premature infants. Copyright © 2017 Elsevier Inc. All rights reserved.

A qualitative study on healthcare professionals' perceived barriers to insulin initiation in a multi-ethnic population.

PubMed

Lee, Yew Kong; Lee, Ping Yein; Ng, Chirk Jenn

2012-07-04

Nationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals' views on barriers to starting insulin therapy in people with type 2 diabetes. Healthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach. Insulin initiation was found to be affected by patient, healthcare professional and system factors. Patients' barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals' barriers include negative attitudes towards insulin therapy and the 'legacy effect' of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges. Tackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds.

Perceptions and experiences of elderly residents in a nursing home.

PubMed

Evangelista, Renata Alessandra; Bueno, Alexandre de Assis; Castro, Paulo Alexandre de; Nascimento, Jessica Neto; Araújo, Neilene Teixeira de; Aires, Graciele Pereira

2014-12-01

The objective of this study was to evaluate the perception of the elderly residents of a long-stay nursing home on the process of institutionalization. We interviewed 14 subjects, five women and nine men, aged between 60 and 92 years. Data collection was conducted with a semi-structured sociodemographic interview, which presented the guiding question: "Tell me about how is your life, what do you do and how did you come to live here". From the analysis, we found topics related to feelings of abandonment, loneliness, anger, ingratitude, living with chronic pain, satisfaction of property in the nursing home, productivity and social relationship. Given the thematic analysis, it was possible to group them into three categories such as: what the elderly feel, what the elderly perceive and what the elderly desire. As a result, we need public policies that addresses to the service provided by institutions regarding elderly expectations.

Influence of abuse on condom negotiation among Mexican-American women involved in abusive relationships.

PubMed

Davila, Yolanda R

2002-01-01

This study explored cultural and gender perspectives of abuse on condom negotiation behaviors for AIDS prevention among Mexican-American women in abusive intimate relationships. A convenience sample of 20 abused women participated in the study. Data were collected through a demographic questionnaire and audiotaped responses to a semistructured interview guide. Content analysis using QSR NUDIST was used to analyze the verbatim transcriptions of all participant interviews. The predominant category, "He always got his way," was developed in response to the content of the verbatim transcriptions. The category was further expanded to include the self-descriptive subcategories of "He beat me," "He made me feel bad," and "He forced me." Through content analysis, a relationship between abuse by male sexual partners and condom negotiation for AIDS prevention was identified. Trustworthiness of the data collection and analysis was established through methods suggested by Lincoln and Guba.

African American Girls’ Ideal Dating Relationship Now and In the Future

PubMed Central

Debnam, Katrina J.; Howard, Donna E.; Garza, Mary A.; Green, Kerry M.

2014-01-01

Adolescence is a particularly important and challenging time for developing long lasting romantic relationship patterns. However, limited empirical research has explored teen perceptions of ideal partner characteristics during adolescence or their significance to the quality of current and future relationships. Semi-structured in-depth interviews were conducted with 33 African American high school girls to shed light on the qualities desired in their dating relationships and relational factors that influence teen dating behaviors. Guided by the Social Ecological Framework, interviews were transcribed verbatim and entered into ATLAS.ti, for coding and analysis. Girls discussed the important influence of parents in choosing a partner and provided positive depictions of friendship and marriage with a suitable partner. More research is needed to understand how and why adolescents desire particular characteristics, how socialization shapes teen perceptions and how these preferences may be related to current and future adolescent dating choices, including violence perpetration and victimization. PMID:28943670

Retaining Low-Income Minority Cancer Patients in a Depression Treatment Intervention Trial: Lessons Learned.

PubMed

Wells, Anjanette A; Palinkas, Lawrence A; Williams, Sha-Lai L; Ell, Kathleen

2015-08-01

Previously published work finds significant benefit from medical and behavioral health team care among safety-net patients with major depression. This qualitative study assessed clinical social worker, psychiatrist and patient navigator strategies to increase depression treatment among low-income minority cancer patients participating in the ADAPt-C clinical depression trial. Patient care retention strategies were elicited through in-depth, semi-structured interviews with nine behavioral health providers. Using grounded theory, concepts from the literature and dropout barriers identified by patients, guided interview prompts. Retention strategies clustered around five dropout barriers: (1) informational, (2) instrumental, (3) provider-patient therapeutic alliance, (4) clinic setting, and (5) depression treatment. All strategies emphasized the importance of communication between providers and patients. Findings suggest that strong therapeutic alliance and telephone facilitates collaborative team provider communication and depression treatment retention among patients in safety-net oncology care systems.

Nursing care of AIDS patients in Uganda.

PubMed

Fournier, Bonnie; Kipp, Walter; Mill, Judy; Walusimbi, Mariam

2007-07-01

This article reports the findings from a participatory action research study concerning the experience of Ugandan nurses caring for individuals with HIV illness. Six key informants from government and non-governmental organizations were interviewed using a semistructured format. Six nurses from a large national referral hospital in Kampala, Uganda, participated in 10 focus group meetings during a period of 11 months. In-depth interviews, focus groups, and photovoice were used to collect the data. Findings indicate that nurses faced many challenges in their daily care, including poverty, insufficient resources, fear of contagion, and lack of ongoing education. Nurses experienced moral distress due to the many challenges they faced during the care of their patients. Moral distress may lead nurses to quit their jobs, which would exacerbate the acute shortage of nurses in Uganda. This study provides important knowledge for guiding clinical practice and nursing education in resource-constrained countries like Uganda.

The immigration experience among elderly Korean immigrants.

PubMed

Lee, Y-M

2007-06-01

The purpose of this preliminary, qualitative study was to describe elderly Korean immigrants' perception of stressors they experienced through immigration and the acculturation process. The methodology used was naturalistic inquiry, a descriptive approach used to elicit the elderly immigrants' own perception of their immigration and acculturation experiences. The six elderly Korean immigrants were interviewed via a semi-structured, open-ended interview guide. The main stressors identified by the subjects as a result of adjusting to life in the United States were language barriers, isolation and loneliness, fear of dependence upon their children, fear of being a burden, financial problems, transportation problems, discrimination, and fear of death. These Korean elders also perceived changes in the traditional family values of respect for elders and support for the aged. The results of this research help to provide an understanding of the immigration and acculturation experiences of elderly Korean immigrants.

Somali Refugees' Perceptions of Mental Illness.

PubMed

Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

2015-01-01

Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

"What's the difference?" women's wheelchair basketball, reverse integration, and the question(ing) of disability.

PubMed

Spencer-Cavaliere, Nancy; Peers, Danielle

2011-10-01

The inclusion of able-bodied athletes within disability sport, a phenomenon known as reverse integration, has sparked significant debate within adapted physical activity. Although researchers and practitioners have taken up positions for or against reverse integration, there is a lack of supporting research on the experiences of athletes who already play in such settings. In this study, we explore how competitive female athletes who have a disability experience reverse integration in Canadian wheelchair basketball. Athletic identity was used as the initial conceptual framework to guide semistructured interviews with nine participants. The results suggest that participation in this context contributed to positive athletic identities. Interviews also pointed to the unexpected theme of "what's the difference?" that this sporting context provided a space for the questioning and creative negotiation of the categories of disability and able-bodiedness. Methodologically, this paper also explores the possibilities and challenges of inter- worldview and insider-outsider research collaboration.

Responsibility and burden from the perspective of seniors’ family caregivers: a qualitative study in Shanghai, China

PubMed Central

Zeng, Li; Zhu, Xiaoping; Meng, Xianmei; Mao, Yafen; Wu, Qian; Shi, Yan; Zhou, Lanshu

2014-01-01

Objectives: This study aimed to explore the experience of seniors’ family caregivers with regarding the responsibility, burden and support needs during caregiving in Shanghai, China. Materials and methods: An exploratory, descriptive, qualitative design was used and a semi-structure interview was conducted. A convenience sample of 11 participants in two community service centers in Shanghai was recruited. Data saturation guided the size of the sample. The Colaizzi method of empirical phenomenology was used for interviewing and analyzing data obtained from 11 caregivers. Results: Three major themes were found: It is a hard work; It is my responsibility; Social support is not enough. Conclusion: The findings of the study are practical and helpful for health care providers to develop appropriate caregiver support services, to balance the responsibility and burden of caregivers, and to consider the factors influencing the utility of support services. PMID:25126186

Successful Students Who Are Deaf or Hard of Hearing and Culturally and/or Linguistically Diverse in Inclusive Settings.

PubMed

Ayantoye, Catherine Adekemi; Luckner, John L

2016-01-01

The population of students who are deaf or hard of hearing is becoming more culturally and/or linguistically diverse. However, there is a paucity of practitioner literature and research available to professionals and families to guide decision making about daily practices with these students and their families. The study identified factors that contribute to the success of students who are deaf or hard of hearing and from culturally and/or linguistically diverse backgrounds who receive the majority of their education in inclusive settings. Students were recruited from two schools in two school districts in a western state. Students, educators, interpreters, and parents participated in individual in-depth, semi-structured interviews. Observations of the students were also done. Analysis of the data included coding the transcribed interviews and the field notes to identify common themes. Seven themes emerged and are reported. Recommendations for future research are provided.

The awareness of experience innovation and an application in private hospitals.

PubMed

Luleci, Nimet Emel; Gemlik, Hatice Nilay; Bektas, Gulfer; Manioglu, Yagmur

2015-10-01

To evaluate the perspective of private hospitals regarding experience innovation. The qualification-type study was conducted in Istanbul, Turkey, in February 2015, and comprised 17 hospitals where patients and employees were interviewed using a semi-structured consultation guide. The employees were examined regarding the meaning of innovation, awareness of experience innovation and its measurement. The patients were asked about the reason for choosing a hospital, the actual reason for arrival at the hospital and the impressions while leaving the hospital. Based on the obtained answers, experience innovation was examined. Of the 87 subjects interviewed, 51(59%) were patients and 36(41%) were hospital employees. Overall, there were 61(70%) women and 26(30%) men in the age range of 21-75 years. It was observed that the tendencies of hospitals for innovation activities were high, but they confused it with novelty. Investments made without taking experience innovation into account do not convert into targeted results.

The Federal Nursing Services Award. Enlisted women with breast cancer: balancing demands and expectations.

PubMed

Wilmoth, Margaret Chamberlain

2003-07-01

Diagnosis with breast cancer is not an automatic cause for discharge from the military. Therefore, it is important to know how this disease impacts enlisted women in the military. This study describes how enlisted women manage diagnosis and treatment within the context of their military careers. Grounded theory guided the study methodology. Audiotaped semistructured interviews were conducted three times over 9 months to learn how treatment impacted work demands. Data saturation was attained after 46 interviews were conducted. Participants had to balance demands and expectations among the Military Career and Military Medical Subsystems and their Social Support Subsystem. Support from the chain of command was critical in women's ability to balance demands and expectations of career, family, and illness. Military nurses are in a unique position to create strategies that will assist enlisted women in coping with breast cancer.

Why Women Join the Military: Enlistment Decisions and Postdeployment Experiences of Service Members and Veterans.

PubMed

Mankowski, Mariann; Tower, Leslie E; Brandt, Cynthia A; Mattocks, Kristin

2015-10-01

Over the past three decades women's enlistment has continued to increase. In an effort to help social workers better meet the needs of female veterans, this study sought to learn women's enlistment motivations and postdeployment experiences. This qualitative study was nested within the Women Veterans Cohort Study. Using a semistructured interview guide, authors interviewed 18 enlisted female service members and veterans. The themes that emerged, based on grounded theory, included not only opportunity and calling, but also outcomes. Unexpectedly, enlistment resulted in a professional military career, with over half of the participants making the military their life's work. Further study on the motivation, retention, and the reintegration needs of women postmilitary is necessary, particularly with military recruitment targets of 20 percent women by the year 2020 and the increased awareness of the military as a potentially hostile work environment for women.

Examining the Relationship Between Intimate Partner Violence and Concern for Animal Care and Safekeeping.

PubMed

Wuerch, Melissa A; Giesbrecht, Crystal J; Price, Jill A B; Knutson, Tracy; Wach, Frances

2017-03-01

The current study examined the knowledge and experience of animal welfare and human service providers in urban and rural communities of Saskatchewan, Canada. Nine exploratory qualitative interviews were conducted to gather a more in-depth understanding of whether the concern for animal care and safekeeping impacts the decision to leave situations of intimate partner violence. The interviews were semistructured and guided by four questions, which were designed, reviewed, and revised based on feedback from a community-based research team. Thematic analysis highlighted important findings, allowing for the generation of suggestions for improvement of current supports and services offered. The current study findings suggest that concern for animal care and safekeeping creates significant barriers regarding the decision to leave situations of intimate partner violence and abuse, warranting further research to inform support services and resources within a Canadian context.

The Ars Moriendi Model for Spiritual Assessment: A Mixed-Methods Evaluation.

PubMed

Vermandere, Mieke; Warmenhoven, Franca; Van Severen, Evie; De Lepeleire, Jan; Aertgeerts, Bert

2015-07-01

To explore nurses' and physicians' experiences with the ars moriendi model (AMM) for spiritual assessment. Convergent, parallel, mixed-methods. Palliative home care in Belgium. 17 nurses and 4 family physicians (FPs) in the quantitative phase, and 19 nurses and 5 FPs in the later qualitative phase. A survey was used to investigate first impressions after a spiritual assessment. Descriptive statistics were applied for the analysis of the survey. In a semistructured interview a few weeks later, nurses and physicians were asked to describe their experiences with using the AMM. Interviews were audio recorded, transcribed, and qualitatively analyzed. Quantitative and qualitative results were compared to see whether the findings were confirmative. The survey assessed the feasibility of the AMM for use in palliative home care, whereas the semistructured interviews collected in-depth descriptions of healthcare providers' (HCPs') experiences with the AMM. The AMM was perceived as valuable. Many patients shared their wishes and expectations about the end of life. Most HCPs said they felt that the patient-provider relationship had been strengthened as a result of the spiritual assessment. Almost all assessments raised new issues; however, many dyads had informally discussed spiritual issues before. The current study suggests that HCPs believe that the AMM is a useful spiritual assessment tool. Guided by the model, HCPs can gather information about the context, life story, and meaningful connections of patients, which enables them to facilitate person-centered care. The AMM appears to be an important tool for spiritual assessment that can offer more insight into patients' spirituality and help nurses to establish person-centered end-of-life care.

Developing and sustaining human resources in the health supply chain in Ethiopia: barriers and enablers.

PubMed

Kälvemark Sporrong, Sofia; Traulsen, Janine M; Damene Kabtimer, Woynabeba; Mekasha Habtegiorgis, Bitsatab; Teshome Gebregeorgise, Dawit; Essah, Nana Am; Khan, Sara A; Brown, Andrew N

2016-01-01

The health supply chain is often the weakest link in achieving the health-related Millennium Development Goals and universal health coverage, requiring trained professionals who are often unavailable. In Ethiopia there have been recent developments in the area of health supply chain management. The aim of this study was to explore the current status of the development of human resources in health supply chain management in Ethiopia and to identify important factors affecting this development. A series of face-to-face interviews with key stakeholders was carried out in 2014. The interviews were conducted using a semi-structured interview guide. The interview guide comprised 51 questions. A qualitative analysis of transcripts was made. A total of 25 interviews were conducted. Three themes were identified: General changes: recognition, commitment and resources, Education and training, and Barriers and enablers. Results confirm the development of human resources in health supply chain management in many areas. However, several problems were identified including lack of coordination, partly due to the large number of stakeholders; reported high staff mobility; and a lack of overall strategy regarding the job/career structures necessary for maintaining human resources. Rural areas have a particular set of problems, including in transportation of goods and personnel, attracting and keeping personnel, and in communication and access to information. Ethiopia is on the way to developing a nationwide viable system for health supply chain management. However, there are still challenges. Short-term challenges include the importance of highlighting strategies and programs for human resources in health supply chain management. In the long term, commitments to financial support must be obtained. A strategy is needed for the further development and sustainability of human resources in the health supply chain in Ethiopia.

Living with Autistic Spectrum Disorder: Parental Experiences of Raising a Child with Autistic Spectrum Disorder (ASD)

ERIC Educational Resources Information Center

Glazzard, Jonathan; Overall, Katy

2012-01-01

The focus of the study was to explore parental experiences of raising a child with autistic spectrum disorder (ASD). A mixed-method approach consisting of questionnaires and semi-structured interviews was used in order to elicit parental perspectives of raising a child with ASD. Two semi-structured interviews were conducted with parents of…

Nebraska Collegiate Methods Professors' Perceptions of the Next Generation Science Standards: A Semi-Structured Interview Approach

ERIC Educational Resources Information Center

Rasmussen, Ashley B.

2017-01-01

This study utilized a semi-structured interview approach to identify how college methods professors in Nebraska are engaging pre-service K-12 teachers with the Next Generation Science Standards and to determine if this information is being carried over to Nebraska K-12 classrooms. The study attempted to address these items by answering the…

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

PubMed

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

2013-07-01

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

Illness perceptions of leprosy-cured individuals in Surinam with residual disfigurements - "I am cured, but still I am ill".

PubMed

van Haaren, Mark Ac; Reyme, Melinda; Lawrence, Maggie; Menke, Jack; Kaptein, Ad A

2017-06-01

Objective Leprosy has rarely been the subject of health psychology research despite its substantial impact. Our aim was to explore illness perceptions in patients and their health care providers in Surinam. The Common Sense Model (CSM) was the guiding theoretical model. Design Patients with biomedically cured leprosy and their health care providers completed the B-IPQ and took part in semi-structured interviews. The literature on illness perceptions in patients with leprosy was reviewed. Main outcome measures Patients' B-IPQ scores were compared with samples of patients with other (chronic) illnesses, and with health care providers completing the questionnaire as if they were visibly disfigured patients. Quotations from the semi-structured interviews were used to contextualise the illness perceptions. Results Patients' B-IPQ scores reflected the chronic nature of leprosy and were comparable with those with other chronic illnesses. Health care providers perceived leprosy to have a greater negative impact than did the patients. Perceived understanding of causes differed considerably between patients and health care providers. Conclusion Leprosy continues to be experienced as an illness with major psychological and social consequences such as stigmatisation, even after biomedical cure. Interventions that target patients, health care providers, and society at large may help reduce perceived shame and stigma. The CSM is a helpful theoretical model in studying this population.

A survey of medicinal plants used by the Deb barma clan of the Tripura tribe of Moulvibazar district, Bangladesh.

PubMed

Kabir, Mohammad Humayun; Hasan, Nur; Rahman, Md Mahfuzur; Rahman, Md Ashikur; Khan, Jakia Alam; Hoque, Nazia Tasnim; Bhuiyan, Md Ruhul Quddus; Mou, Sadia Moin; Jahan, Rownak; Rahmatullah, Mohammed

2014-02-06

The number of tribes present within Bangladesh has been estimated to approximate one hundred and fifty. Information on traditional medicinal practices, particularly of the smaller tribes and their clans is lacking. It was the objective of the study to document the tribal medicinal practices of the Deb barma clan of the Tripura tribe, which clan can be found residing in Dolusora Tripura Palli of Moulvibazar district of Bangladesh. A further objective was to determine the extent of the community households who still prefer traditional treatment to other forms of treatment, particularly allopathic treatment. Interviews of the tribal healer and the tribal community regarding their ethnomedicinal practices were carried out with the help of a semi-structured questionnaire and the guided field-walk method. All together 67 clan members were interviewed including the Headman, tribal healer, 19 Heads of households and 46 other adult members of the clan. Information on number of members of household, their age, gender, educational status, occupation of working household members and preferred mode of treatment was obtained through the semi-structured questionnaire. In the guided field-walk method, the healer took the interviewers on field-walks through areas from where he collected his medicinal plants, pointed out the plants, and described their uses. The clan had a total of 135 people distributed into 20 households and had only one traditional healer. Use of medicinal plants, wearing of amulets, and worship of the evil god 'Bura debta' constituted the traditional medicinal practices of the clan for treatment of diseases. The healer used a total of 44 medicinal plants distributed into 34 families for treatment of various ailments like pain, coughs, cold, gastrointestinal disorders, cuts and wounds, diabetes, malaria, heart disorders, and paralysis. Available scientific reports validate the use of a number of plants by the traditional healer. A number of the plants used by the clan healer had reported similar uses in Ayurveda, but differ considerably in their therapeutic uses from that reported for other tribes in Bangladesh. The present survey also indicated that in recent years the Deb barma clan members are inclining more towards allopathic medicine.

Tai chi for upper limb rehabilitation in stroke patients: the patient's perspective.

PubMed

Desrochers, Pascal; Kairy, Dahlia; Pan, Shujuan; Corriveau, Hélène; Tousignant, Michel

2017-06-01

This study aimed at exploring the perceived benefits and drawbacks of practicing tai chi, an alternative therapy that can be implemented in the community, as part of upper-limb rehabilitation following stroke. Semistructured interviews were carried out with participants with chronic stroke (>6 months). The participants took part in 16 tai chi sessions over 8 weeks. Interviews were conducted in person using an interview guide based on the theory of planned behavior (TPB), and a thematic analysis was conducted. Eight interviews were carried out with participants at various stages of motor recovery. Participants perceived a number of physical, functional, and psychological benefits. They found tai chi to be a global exercise, including both physical and mental aspects, and suggested that it can be included as part of rehabilitation for stroke patients. Many participants expressed a desire to continue practicing tai chi after completion of the study because it exceeded their expectations, among other reasons. This study can serve to guide future tai chi interventions and research on tai chi for rehabilitation in terms of the characteristics of the intervention and the various areas to assess in order to measure the overall benefits. IMPLICATIONS FOR REHABILITATION Tai chi was perceived as a good way of integrating various skills learned during rehabilitation. Despite having different functional abilities, all the participants noted various physical, functional, and psychological benefits from participating in the tai chi sessions. Tai chi seems to be a form of exercise that stroke patients would perform more long-term since all the participants in this study expressed the desire to continue practicing tai chi.

What determines successful implementation of inpatient information technology systems?

PubMed

Spetz, Joanne; Burgess, James F; Phibbs, Ciaran S

2012-03-01

To identify the factors and strategies that were associated with successful implementation of hospital-based information technology (IT) systems in US Department of Veterans Affairs (VA) hospitals, and how these might apply to other hospitals. Qualitative analysis of 118 interviews conducted at 7 VA hospitals. The study focused on the inpatient setting, where nurses are the main patient-care providers; thus, the research emphasized the impact of Computerized Patient Record System and Bar Code Medication Administration on nurses. Hospitals were selected to represent a range of IT implementation dates, facility sizes, and geography. The subjects included nurses, pharmacists, physicians, IT staff, and managers. Interviews were guided by a semi-structured interview protocol, and a thematic analysis was conducted, with initial codes drawn from the content of the interview guides. Additional themes were proposed as the coding was conducted. Five broad themes arose as factors which affected the process and success of implementation: (1) organizational stability and implementation team leadership, (2) implementation timelines, (3) equipment availability and reliability, (4) staff training, and (5) changes in work flow Overall IT implementation success in the VA depended on: (1) whether there was support for change from both leaders and staff, (2) development of a gradual and flexible implementation approach, (3) allocation of adequate resources for equipment and infrastructure, hands-on support, and deployment of additional staff, and (4) how the implementation team planned for setbacks, and continued the process to achieve success. Problems that developed in the early stages of implementation tended to become persistent, and poor implementation can lead to patient harm.

Analyzing the effectiveness of teaching and factors in clinical decision-making.

PubMed

Hsieh, Ming-Chen; Lee, Ming-Shinn; Chen, Tsung-Ying; Tsai, Tsuen-Chiuan; Pai, Yi-Fong; Sheu, Min-Muh

2017-01-01

The aim of this study is to prepare junior physicians, clinical education should focus on the teaching of clinical decision-making. This research is designed to explore teaching of clinical decision-making and to analyze the benefits of an "Analogy guide clinical decision-making" as a learning intervention for junior doctors. This study had a "quasi-experimental design" and was conducted in a medical center in eastern Taiwan. Participants and Program Description: Thirty junior doctors and three clinical teachers were involved in the study. The experimental group (15) received 1 h of instruction from the "Analogy guide for teaching clinical decision-making" every day for 3 months. Program Evaluation: A "Clinical decision-making self-evaluation form" was used as the assessment tool to evaluate participant learning efficiency before and after the teaching program. Semi-structured qualitative research interviews were also conducted. We found using the analogy guide for teaching clinical decision-making could help enhance junior doctors' self-confidence. Important factors influencing clinical decision-making included workload, decision-making, and past experience. Clinical teaching using the analogy guide for clinical decision-making may be a helpful tool for training and can contribute to a more comprehensive understanding of decision-making.

The decision-making experience of mothers selecting waterbirth.

PubMed

Wu, Chia-Jung; Chung, Ue-Lin

2003-12-01

Waterbirth has been a way of birth for 20 to 30 years abroad, while in Taiwan, only in the past three years have some women chosen water birth. This study aims to explore the decision-making experience of mothers selecting waterbirth. A phenomenological approach was employed in this study. Nine mothers who had given birth in water successfully in the midwife clinic in the past year were chosen and one-by-one, face-to-face interviews were conducted. The research tools included a basic information questionnaire, a semi-structured and open-ended interview guide, and an audio recorder to record the entire interviews. The content of the interviews was faithfully transcribed and analyzed with Giorgi's phenomenological method and Lincoln and Guba's qualitative credibility. Four main concepts concluded from the experience context of the studied women were: (1) Dissatisfaction with existing obstetric practices; (2) Demonstration of autonomy; (3) Consideration of relatives' attitude; and (4) Employing strategies to achieve goals. The result of this study can help nursing staff and the public to understand the decision-making experience of mothers selecting waterbirth, and help the contemplation of health care providers with respect to furnishing a more humanized birth environment in hospitals.

[The daily experience of the patient with an implantable cardioverter defibrillator].

PubMed

Palacios-Ceña, Domingo; Alonso-Blanco, Cristina; Cachón-Pérez, José Miguel; Alvarez-López, Cristina

2010-01-01

To describe the daily experience of patients with an automatic defibrillator (AD) implant and the adaptive changes of the patient. Qualitative and phenomenological research. Collection of data through; initially unstructured interview with half of the informants, semi-structured interviews through an open questions guide after the initial unstructured interviews and use of personal narratives of the informants. Analysis of the data using the Van Manen proposal. We analysed the interviews of 10 participants. We collected socio-demographic variables and identified the following themes, which respond to the question "How is life with an AD": It is life "with the two sides of the coin," living in constant wait and uncertainty, accepting change, developing adaptation strategies, renegotiating relationships and sexuality and it is to live transformed. The results of this study can be integrated into nurse clinical practice in areas such as valuation after discharge, changes in habits, control of treatment, notification of shocks, masking detection of symptoms and strategies that can jeopardise the bearer. Research needs to be developed that looks closer into the influence of other technological devices in people. Copyright 2009 Elsevier España, S.L. All rights reserved.

The lived experience of pediatric burn nurses following patient death.

PubMed

Kellogg, Marni B; Barker, Marianne; McCune, Nancy

2014-01-01

The purpose of this study is to describe the lived experience of pediatric burn unit nurses who have experienced the death of a patient. A qualitative phenomenological design was used for the interview and analysis. Methods were incorporated into the design to ensure reliability, consistency, and rigor. Using a semi-structured interview guide and phenomenological concepts, the investigators interviewed seven registered nurses who were employed in a pediatric burn unit. Data obtained were analyzed for common themes that emerged during examination of transcribed interviews. Four common themes of feelings were identified: 1) grief and sadness, 2) helplessness, 2) compartmentalization of feelings, and 4) lack of preparedness for dealing with situations involving the death of a pediatric patient. While nurses are emotionally supportive to patients and families, the emotional support available to nurses who are dealing with these situations is lacking. By developing individual coping strategies and seeking peer support, nurses attempt to deal with emotional situations faced in the workplace. Nurses, nurse educators, and administrators must understand the impact of nurses' grief following patient death. By understanding and validating their emotions, it is hoped that nurses will be supported in a way that will enhance a healthy professional environment and personal well-being.

Building from within: pastoral insights into community resources and assets.

PubMed

Ford, Cassandra D

2013-01-01

To explore perceptions of community pastors regarding the extent of community resources and assets in a rural, Southern, African American community. Utilizing a qualitative, descriptive design, interviews were conducted with six African American pastors. Interviews were conducted using a semi-structured interview guide based on an assets-oriented approach. Pastors discussed various resources and assets, probable within the community that may be considered as support for program development. Key themes included: (1) community strengths, (2) community support, and (3) resources for a healthy lifestyle. The church was identified, throughout the interviews, as a primary source of strength and support for community members. In this study of African American pastors, various perceptions of community resources were identified. Findings indicate that a sample, rural, Southern, African American community has a wealth of resources and assets, but additional resources related to health promotion are still necessary to produce optimal results. Specific programs to prevent chronic conditions such as cardiovascular disease can provide an effective means for addressing related health disparities. Programs implemented through churches can reach large numbers of individuals in the community and provide an important source of sustainable efforts to improve the health of African Americans. © 2013 Wiley Periodicals, Inc.

Considerations for conducting qualitative research with pediatric patients for the purpose of PRO development.

PubMed

Patel, Zabin S; Jensen, Sally E; Lai, Jin-Shei

2016-09-01

To provide an overview of methodological considerations when conducting qualitative research with pediatric patients for the purpose of patient-reported outcome measure development A literature review of qualitative methods in pediatric measure development was completed. Eight clinicians providing care to pediatric patients were interviewed for their expert input. Thematic analysis of the literature and clinician interviews was used to identify themes for consideration. Findings from the literature and expert interviews emphasized the way in which cognitive, linguistic, and social developmental factors affect pediatric patients' understanding of their condition and ability to communicate about their experiences in an interview. There was consensus among the experts that traditional semi-structured interviews with children younger than eight lack characteristics necessary to yield meaningful information about condition and symptom report because they may fail to capture children's understanding and awareness of their condition and may limit their ability to express themselves comfortably. Our findings include recommended strategies to optimize data collected in qualitative interviews with pediatric patients, including modifications to the interview process to establish rapport, construction of interview questions to ensure they are developmentally appropriate, and the use of supplementary techniques to facilitate communication. When employing qualitative methods in pediatric measure development, interview guides, methods, and length require careful tailoring to ensure the child's perspectives are captured. This may be best achieved through research performed with narrow age bands that employs flexibility in methods to allow children a comfortable way in which to communicate about their experiences.

Dissemination of effective physical activity interventions: are we applying the evidence?

PubMed Central

Ballew, Paula; Brownson, Ross C.; Haire-Joshu, Debra; Heath, Gregory W.; Kreuter, Matthew W.

2010-01-01

Background. Given sparse knowledge on dissemination, this study sought to explore key benefits, barriers and contextual factors that are perceived to be important to the adoption and implementation of the ‘Community Guide's’ evidence-based physical activity recommendations. Design. We conducted case studies in two states where extensive adoption and implementation of the Guide's recommendations have occurred and in two states where widespread dissemination has lagged. Interviews (n = 76) were semi-structured and included both quantitative and qualitative methods. Participant perceptions from the following areas were examined: (i) priority of physical activity, (ii) awareness of and ability to define the term ‘evidence-based approaches’ and (iii) awareness, adoption, facilitators, benefits, challenges and barriers to Guide adoption. Results. Key enabling factors among high capacity states included: funds and direction from the Centers for Disease Control and Prevention; leadership support; capable staff; and successful partnerships and collaborations. Restraining forces among low capacity states included: the Guide recommendations being too new; participants being too new to current job; lack of time and training on how to use the Guide recommendations; limited funds and other resources and lack of leadership. Conclusion. To be effective, we must gain an understanding of contextual factors when designing for dissemination. PMID:20156839

Acceptability of Bibliotherapy for Patients With Cancer: A Qualitative, Descriptive Study.

PubMed

Roberts, Nicole; Lee, Virginia; Ananng, Bethsheba; Körner, Annett

2016-09-01

To determine the acceptability of a self-help workbook, Mastering the Art of Coping in Good Times and Bad, for patients with cancer.
. Descriptive, qualitative.
. Participants were recruited from the psychosocial support cancer centers of two tertiary care teaching hospitals in Montreal, Quebec, Canada.
. 18 individuals diagnosed with cancer.
. A semistructured interview guide with open-ended questions was used to gather feedback from participants about the workbook. 
. 18 participants completed the interviews from which the data emerged. Two main categories were identified from the respondents' interviews regarding the acceptability of the workbook. The first category focuses on content, whereas the other focuses on recommendations. Interviewees specified the following content as most helpful. Bibliotherapy gives patients access to knowledge to help them cope and engage in their own self-management. The workbook Mastering the Art of Coping in Good Times and Bad may be an acceptable means of helping them manage their stress. 
. Bibliotherapy is not only cost-effective and easy to administer but also an acceptable minimal intervention.

Perceived motivational factors for female football players during rehabilitation after sports injury - a qualitative interview study.

PubMed

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-04-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete's motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players' motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation.

Essential Nutrition and Food Systems Components for School Curricula: Views from Experts in Iran

PubMed Central

SADEGHOLVAD, Sanaz; YEATMAN, Heather; OMIDVAR, Nasrin; PARRISH, Anne-Maree; WORSLEY, Anthony

2017-01-01

Background: This study aimed to investigate food experts’ views on important nutrition and food systems knowledge issues for education purposes at schools in Iran. Methods: In 2012, semi-structured, face-to-face or telephone interviews were conducted with twenty-eight acknowledged Iranian experts in food and nutrition fields. Participants were selected from four major provinces in Iran (Tehran, Isfahan, Fars and Gilan). Open-ended interview questions were used to identify nutrition and food systems knowledge issues, which experts considered as important to be included in school education programs. Qualitative interviews were analyzed thematically using NVivo. Results: A framework of knowledge that would assist Iranian students and school-leavers to make informed decisions in food-related areas was developed, comprising five major clusters and several sub-clusters. Major knowledge clusters included nutrition basics; food production; every day food-related practices; prevalent nutritional health problems in Iran and improvement of students’ ethical attitudes in the food domain. Conclusion: These findings provide a guide to curriculum developers and policy makers to assess current education curricula in order to optimize students’ knowledge of nutrition and food systems. PMID:28845405

Parents' experiences and the effect on the family two years after their child was admitted to a PICU-An interview study.

PubMed

Terp, Karina; Sjöström-Strand, Annica

2017-12-01

For parents, having a child admitted to a paediatric intensive care unit (PICU) is a very stressful experience filled with anxiety. Parents are often scared and traumatised. This stress can lead to PTSD. The aim was to describe parents' experiences and the effect on the family two years after their child was admitted to a paediatric intensive care unit. Ten parents were interviewed according to a semi-structured interview guide. An inductive approach was applied for the study and qualitative content analysis was used to analyse the data. The parents carried vivid memories and they were still strongly affected by the experience of having their child admitted to a paediatric intensive care unit. They could clearly recall the environment, feelings that affected them and how they felt powerless. The relationship between the parents had been strengthened. Parents, siblings and the ill child could all show symptoms of anxiety, stress and sleeping disorders. The parents valued life differently. Copyright © 2017 Elsevier Ltd. All rights reserved.

What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California.

PubMed

Sanchez-Flack, Jennifer C; Baquero, Barbara; Linnan, Laura A; Gittelsohn, Joel; Pickrel, Julie L; Ayala, Guadalupe X

2016-01-01

To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers' grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and sociocultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers.

Practical Nurses' Lived Experience of Returning to School.

PubMed

Chachula, Kathryn; Smith, Mary; Hyndman, Kathryn

2018-05-25

The lived experience of licensed practical nurses (LPNs) pursuing Bachelor of Nursing (BN) education is not commonly studied in Canada. The aim was to understand the transition experience of LPNs who bridged into a BN program. Max van Manen's phenomenological methodology was used through use of a semistructured interview guide to explore the lived experience of LPNs who pursued baccalaureate nursing education. Five themes were found: seeking advancement; stepping back into the student role; juggling work, school, and family; struggling to be understood; and seeing things differently. LPN-to-BN students have a well-developed sense of identity as nurses. These students can benefit from a specifically designed, stand-alone bridge course to situate them within a BN program.

Attitudes and beliefs regarding depression, HIV/AIDS and HIV risk-related sexual behaviors among clinically depressed African American adolescent females

PubMed Central

Brawner, Bridgette M.

2012-01-01

Individuals’ attitudes and beliefs toward behaviors are key indicators of behavioral performance. The purpose of this study was to elucidate attitudes and beliefs about depression, HIV/AIDS and HIV risk-related sexual behaviors among clinically depressed African American adolescent females and to develop an understanding of their context for HIV risk. For this descriptive qualitative inquiry, semi-structured interviews and surveys were employed (N = 24). The narratives reveal that behavioral sequelae of depression (i.e. loneliness) can produce risk for HIV. These findings may guide psychiatric nurse educators, scientists, and practitioners to modify HIV risk among clinically depressed African American adolescent females. PMID:23164403

Aging in the Shadow of Violence: A Phenomenological Conceptual Framework for Understanding Elderly Women Who Experienced Lifelong IPV.

PubMed

Band-Winterstein, Tova

2015-01-01

This article suggests a heuristic framework for understanding elderly women's "lived experience" of lifelong intimate partner violence (IPV). This framework is based on the phenomenological qualitative studies of 31 women, aged 60-83, using a semistructured interview guide. From the results, a matrix emerged built on two axes. The first axis consists of three phenomenological dimensions: suffering, a "ticking clock," and life wisdom. The second axis consists of four themes that emerged from the content analysis: loneliness, regret, being in a state of waiting, and being a living monument to perpetual victimhood. The practical implications of these phenomenological findings are then discussed.

A qualitative identification of categories of patient participation in decision-making by health care professionals and patients during surgical treatment.

PubMed

Heggland, Liv-Helen; Hausken, Kjell

2013-05-01

The aim of this article is to identify how health care professionals and patients experience patient participation in decision-making processes in hospitals. Eighteen semi-structured interviews with experts from different disciplines such as medicine and nursing in surgical departments as well as patients who have undergone surgical treatment constitute the data. By content analysis four categories of patient participation were identified: information dissemination, formulation of options, integration of information, and control. To meet the increasing demands of patient participation, this categorization with four identified critical areas for participation in decision-making has important implications in guiding information support for patients prior to surgery and during hospitalization.

Characteristics of zero-absenteeism in hospital care.

PubMed

Schreuder, J A H; Roelen, C A M; van der Klink, J J L; Groothoff, J W

2013-06-01

Literature on sickness presenteeism is emerging, but still little is known about employees who are never absent from work due to injuries or illness. Insight into the determinants and characteristics of such zero-absentees may provide clues for preventing sickness absence. To investigate the characteristics of zero-absentees, defined as employees without sickness absence over a period of 5 years. A mixed-method qualitative study comprising semi-structured interviews and focus groups for which Azjen and Fishbein's theory of planned behaviour was used as a framework. Zero-absentees working in hospital care were invited for semi-structured interviews until saturation was reached. The results of semi-structured interviews were validated in two focus groups. Of 1053 hospital employees, 47 were zero-absentees of whom 31 (66%) agreed to participate in the study. After 16 semi-structured interviews, no new insights or information were gathered from the interviews. The remaining 15 employees were invited to two (n = 8 and n = 7) focus groups. Personal attitudes and self-efficacy were more important in zero-absenteeism than social pressures of managers, colleagues or patients. Zero-absentees were found to be intrinsically motivated to try attending work when ill. In the present study population of hospital employees, we found indications that zero-absenteeism and sickness presenteeism might be different types of work attendance. Managers should realize that zero-absentees are driven by intrinsic motivation rather than social pressures to attend work.

Knowledge mobilized by a critical thinking process deployed by nursing students in practical care situations: a qualitative study.

PubMed

Lechasseur, Kathleen; Lazure, Ginette; Guilbert, Louise

2011-09-01

This paper is a report of a qualitative study of mobilization of knowledge within the critical thinking process deployed by female undergraduate nursing students in practical care situations. Holistic practice is based on variety of knowledge mobilized by a critical thinking process. Novices and, more specifically, students experience many difficulties in this regard. Therefore, a better understanding of the knowledge they mobilize in their practice is important for nurse educators. A qualitative study, guided by grounded theory, was carried out. Sixteen nursing students, registered in an undergraduate programme in an Eastern Canadian university, were recruited. Descriptions of practical care situations were obtained through explicitation interviews in 2007. A sociodemographic questionnaire, semi-structured interviews and field notes were also used. Data were analysed using an approach based on grounded theory. An additional stage of analysis involved data condensation. Various types of knowledge guide nursing students' practice. These include intrapersonal, interpersonal, perceptual, moral/ethical, experiential, practical, scientific and contextual knowledge. The mobilization of these types of knowledge is only possible when the process of critical thinking has attained a higher level, giving rise to a new knowledge that we have termed combinational constructive knowledge rather than aesthetic knowledge. Clarification of the types of knowledge guiding the practice of student nurses and of the role of critical thinking in their mobilization could lead to innovative educational strategies. The findings provide guidance for the revision and development of both academic and clinical training programmes. © 2011 Blackwell Publishing Ltd.

Involving people with dementia in developing an interactive web tool for shared decision-making: experiences with a participatory design approach.

PubMed

Span, Marijke; Hettinga, Marike; Groen-van de Ven, Leontine; Jukema, Jan; Janssen, Ruud; Vernooij-Dassen, Myrra; Eefsting, Jan; Smits, Carolien

2018-06-01

The aim of this study was at gaining insight into the participatory design approach of involving people with dementia in the development of the DecideGuide, an interactive web tool facilitating shared decision-making in their care networks. An explanatory case study design was used when developing the DecideGuide. A secondary analysis focused on the data gathered from the participating people with dementia during the development stages: semi-structured interviews (n = 23), four focus group interviews (n = 18), usability tests (n = 3), and a field study (n = 4). Content analysis was applied to the data. Four themes showed to be important regarding the participation experiences of involving people with dementia in research: valuable feedback on content and design of the DecideGuide, motivation to participate, perspectives of people with dementia and others about distress related to involvement, and time investment. People with dementia can give essential feedback and, therefore, their contribution is useful and valuable. Meaningful participation of people with dementia takes time that should be taken into account. It is important for people with dementia to be able to reciprocate the efforts others make and to feel of significance to others. Implications for Rehabilitation People with dementia can contribute meaningfully to the content and design and their perspective is essential for developing useful and user-friendly tools. Participating in research activities may contribute to social inclusion, empowerment, and quality of life of people with dementia.

Parental Explicit Heuristics in Decision-making for Children With Life-threatening Illnesses

PubMed Central

Renjilian, Chris B.; Womer, James W.; Carroll, Karen W.; Kang, Tammy I.

2013-01-01

OBJECTIVE: To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by parents of children with life-threatening illnesses when confronting and making medical decisions. METHODS: Prospective cross-sectional observational study of 69 parents of 46 children who participated in the Decision-making in Pediatric Palliative Care Study between 2006 and 2008 at the Children’s Hospital of Philadelphia. Parents were guided individually through a semistructured in-depth interview about their experiences and thoughts regarding making medical decisions on behalf of their ill children, and the transcribed interviews were qualitatively analyzed. RESULTS: All parents in our study employed explicit heuristics in interviews about decision-making for their children, with the number of identified explicit heuristics used by an individual parent ranging from tens to hundreds. The heuristics served 5 general functions: (1) to depict or facilitate understanding of a complex situation; (2) to clarify, organize, and focus pertinent information and values; (3) to serve as a decision-making compass; (4) to communicate with others about a complex topic; and (5) to justify a choice. CONCLUSIONS: Explicit heuristics played an important role in decision-making and communication about decision-making in our population of parents. Recognizing explicit heuristics in parent interactions and understanding their content and functions can aid clinicians in their efforts to partner with parents in the decision-making process. PMID:23319524

Parental explicit heuristics in decision-making for children with life-threatening illnesses.

PubMed

Renjilian, Chris B; Womer, James W; Carroll, Karen W; Kang, Tammy I; Feudtner, Chris

2013-02-01

To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by parents of children with life-threatening illnesses when confronting and making medical decisions. Prospective cross-sectional observational study of 69 parents of 46 children who participated in the Decision-making in Pediatric Palliative Care Study between 2006 and 2008 at the Children's Hospital of Philadelphia. Parents were guided individually through a semistructured in-depth interview about their experiences and thoughts regarding making medical decisions on behalf of their ill children, and the transcribed interviews were qualitatively analyzed. All parents in our study employed explicit heuristics in interviews about decision-making for their children, with the number of identified explicit heuristics used by an individual parent ranging from tens to hundreds. The heuristics served 5 general functions: (1) to depict or facilitate understanding of a complex situation; (2) to clarify, organize, and focus pertinent information and values; (3) to serve as a decision-making compass; (4) to communicate with others about a complex topic; and (5) to justify a choice. Explicit heuristics played an important role in decision-making and communication about decision-making in our population of parents. Recognizing explicit heuristics in parent interactions and understanding their content and functions can aid clinicians in their efforts to partner with parents in the decision-making process.

Hand Function and Appearance following Reconstruction for Congenital Hand Differences: A Qualitative Analysis of Children and Parents.

PubMed

Kelley, Brian P; Franzblau, Lauren E; Chung, Kevin C; Carlozzi, Noelle; Waljee, Jennifer F

2016-07-01

Congenital hand differences induce social, psychological, and functional challenges for children. However, little is known about how children perceive their outcomes after reconstructive or what concerns children have. A total of 33 children (aged 6 to 17 years) who were treated for congenital hand differences, and their parents, participated in qualitative, semistructured interviews regarding the child's hand function and appearance. Discussion focused on the influence of congenital hand differences on the child's daily activities, school, and participation in sports and music. The interviews were open format to allow for spontaneous emergence of relevant themes followed by guided questioning. The interviews were transcribed verbatim and analyzed using qualitative coding, iterative comparisons, and frequency analysis to reveal perceptions of children and parents. In this sample, 73 percent of children and parents reported difficulty with hand function. Children experienced difficulties with personal care (58 percent), school activities (30 percent), and household tasks (27 percent). Children were bothered by hand appearance (48 percent), pain (30 percent), and weakness (24 percent). Complex anomalies were associated with greater disability and limitation in sports and music. Children with congenital hand differences are concerned with the aesthetics of their hands and limitations in their ability to perform activities. Children were often discouraged by activities that their peers accomplished easily, but with increasing age demonstrated adaptive behaviors to accommodate in their "own way," suggesting the uniqueness of their limitations. Patients may benefit from early hand therapy guided toward areas of concern to enhance functional adaptation.

A qualitative study on healthcare professionals’ perceived barriers to insulin initiation in a multi-ethnic population

PubMed Central

2012-01-01

Background Nationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals’ views on barriers to starting insulin therapy in people with type 2 diabetes. Methods Healthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach. Results Insulin initiation was found to be affected by patient, healthcare professional and system factors. Patients’ barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals’ barriers include negative attitudes towards insulin therapy and the ‘legacy effect’ of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges. Conclusions Tackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds. PMID:22469132

Influence of patients' socioeconomic status on clinical management decisions: a qualitative study.

PubMed

Bernheim, Susannah M; Ross, Joseph S; Krumholz, Harlan M; Bradley, Elizabeth H

2008-01-01

Little is known about how patients' socioeconomic status (SES) influences physicians' clinical management decisions, although this information may have important implications for understanding inequities in health care quality. We investigated physician perspectives on how patients' SES influences care. The study consisted of in-depth semistructured interviews with primary care physicians in Connecticut. Investigators coded interviews line by line and refined the coding structure and interview guide based on successive interviews. Recurrent themes emerged through iterative analysis of codes and tagged quotations. We interviewed 18 physicians from varied practice settings, 6 female, 9 from minority racial backgrounds, and 3 of Hispanic ethnicity. Four themes emerged from our interviews: (1) physicians held conflicting views about the effect of patient SES on clinical management, (2) physicians believed that changes in clinical management based on the patient's SES were made in the patient's interest, (3) physicians varied in the degree to which they thought changes in clinical management influenced patient outcomes, and (4) physicians faced personal and financial strains when caring for patients of low SES. Physicians indicated that patient SES did affect their clinical management decisions. As a result, physicians commonly undertook changes to their management plan in an effort to enhance patient outcomes, but they experienced numerous strains when trying to balance what they believed was feasible for the patient with what they perceived as established standards of care.

Formative research to develop a lifestyle application (app) for African American breast cancer survivors

PubMed Central

Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Fontenot, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin

2016-01-01

Background There is a proliferation of lifestyle-oriented mobile technologies; however, few have targeted users. Through intervention mapping, investigators and community partners completed Steps 1–3 (needs assessment, formulation of change objectives, and selection of theory-based methods) of a process to develop a mobile cancer prevention application (app) for cancer prevention. The aim of this qualitative study was to complete Step 4 (intervention development) by eliciting input from African American (AA) breast cancer survivors (BCSs) to guide app development. Methods Four focus group discussions (n=60) and three individual semi-structured interviews (n=36) were conducted with AA BCSs (40–72 years of age) to assess barriers and strategies for lifestyle change. All focus groups and interviews were recorded and transcribed verbatim. Data were analyzed with NVivo qualitative data analysis software version 10, allowing categories, themes, and patterns to emerge. Results Three categories and related themes emerged from the analysis: 1) perceptions about modifiable risk factors; 2) strategies related to adherence to cancer prevention guidelines; and 3) app components to address barriers to adherence. Participant perceptions, strategies, and recommended components guided development of the app. Conclusions For development of a mobile cancer prevention app, these findings will assist investigators in targeting features that are usable, acceptable, and accessible for AA BCSs. PMID:27583307

Exploring the decision-making process in the delivery of physiotherapy in a stroke unit.

PubMed

McGlinchey, Mark P; Davenport, Sally

2015-01-01

The aim of this study was to explore the decision-making process in the delivery of physiotherapy in a stroke unit. A focused ethnographical approach involving semi-structured interviews and observations of clinical practice was used. A purposive sample of seven neurophysiotherapists and four patients participated in semi-structured interviews. From this group, three neurophysiotherapists and four patients were involved in observation of practice. Data from interviews and observations were analysed to generate themes. Three themes were identified: planning the ideal physiotherapy delivery, the reality of physiotherapy delivery and involvement in the decision-making process. Physiotherapists used a variety of clinical reasoning strategies and considered many factors to influence their decision-making in the planning and delivery of physiotherapy post-stroke. These factors included the therapist's clinical experience, patient's presentation and response to therapy, prioritisation, organisational constraints and compliance with organisational practice. All physiotherapists highlighted the importance to involve patients in planning and delivering their physiotherapy. However, there were varying levels of patient involvement observed in this process. The study has generated insight into the reality of decision-making in the planning and delivery of physiotherapy post-stroke. Further research involving other stroke units is required to gain a greater understanding of this aspect of physiotherapy. Implications for Rehabilitation Physiotherapists need to consider multiple patient, therapist and organisational factors when planning and delivering physiotherapy in a stroke unit. Physiotherapists should continually reflect upon how they provide physiotherapy, with respect to the duration, frequency and time of day sessions are delivered, in order to guide current and future physiotherapy delivery. As patients may demonstrate varying levels of participation in deciding and understanding how physiotherapy is delivered, physiotherapists need to adjust how they engage patients in the decision-making process and manage patient expectations accordingly.

Building better research partnerships by understanding how Aboriginal health communities perceive and use data: a semistructured interview study.

PubMed

Young, Christian; Tong, Allison; Sherriff, Simone; Kalucy, Deanna; Fernando, Peter; Muthayya, Sumithra; Craig, Jonathan C

2016-04-25

To describe the attitudes and beliefs of health professionals working in Aboriginal Community Controlled Health Services (ACCHS) towards the access, usage and potential value of routinely obtained clinical and research data. Face-to-face, semistructured interviews were conducted with 35 health professionals from 2 urban and 1 regional ACCHS in New South Wales. The interviews were transcribed and themes were identified using an adapted grounded theory approach. Six major themes were identified: occupational engagement (day-to-day relevance, contingent on professional capacity, emphasising clinical relevance), trust and assurance (protecting ownership, confidence in narratives, valuing local sources), motivation and empowerment (engaging the community, influencing morale, reassuring and encouraging clients), building research capacity (using cultural knowledge, promoting research aptitude, prioritising specific data), optimising service provision (necessity for sustainable services, guiding and improving services, supporting best practice), and enhancing usability (ensuring ease of comprehension, improving efficiency of data management, valuing accuracy and accessibility). Participants were willing to learn data handling procedures that could further enhance health service delivery and enable more ACCHS-led research, but busy workloads restrict these opportunities. Staff held concerns regarding the translation of research data into beneficial services, and believed that the outcome and purpose of data collection could be communicated more clearly. Promoting research partnerships, ensuring greater awareness of positive health data and the purposes of data collection, and communicating data in a user-friendly format are likely to encourage greater data use, build research capacity and improve health services within the Aboriginal community. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

‘I'll be in a safe place’: a qualitative study of the decisions taken by people with advanced cancer to seek emergency department care

PubMed Central

Henson, Lesley A; Higginson, Irene J; Daveson, Barbara A; Ellis-Smith, Clare; Koffman, Jonathan; Morgan, Myfanwy; Gao, Wei

2016-01-01

Objective To explore the decisions of people with advanced cancer and their caregivers to seek emergency department (ED) care, and understand the issues that influence the decision-making process. Design Cross-sectional qualitative study incorporating semistructured patient and caregiver interviews. Methods Between December 2014 and July 2015, semistructured interviews were conducted with 18 people with advanced cancer, all of whom had recently attended the ED of a large university teaching hospital located in south-east London; and six of their caregivers. Interviews were audio recorded, transcribed verbatim and analysed using a constant comparative approach. Padgett and Brodsky's modified version of the ‘Behavioral Model of Health Services Use’ was used as a framework to guide the study. Results Issues influencing the decision-making process included: (1) disease-related anxiety—those with greater anxiety related to their cancer diagnosis interpreted their symptoms as more severe and/or requiring immediate attention; (2) prior patterns of health-seeking behaviour—at times of crisis participants defaulted to previously used services; (3) feelings of safety and familiarity with the hospital setting—many felt reassured by the presence of healthcare professionals and monitoring of their condition; and, (4) difficulties accessing community healthcare services—especially urgently and/or out-of-hours. Conclusions These data provide healthcare professionals and policymakers with a greater understanding of how systems of care may be developed to help reduce ED visits by people with advanced cancer. In particular, our findings suggest that the number of ED visits could be reduced with greater end-of-life symptom support and education, earlier collaboration between oncology and palliative care, and with increased access to community healthcare services. PMID:27807085

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study

PubMed Central

Eisingerich, Andreas B

2016-01-01

Background Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. Objective The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. Methods We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Conclusions Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond. PMID:27777216

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study.

PubMed

El-Hilly, Abdulrahman Abdulla; Iqbal, Sheeraz Syed; Ahmed, Maroof; Sherwani, Yusuf; Muntasir, Mohammed; Siddiqui, Sarim; Al-Fagih, Zaid; Usmani, Omar; Eisingerich, Andreas B

2016-10-24

Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond.

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

PubMed Central

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

2016-01-01

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

Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences

PubMed Central

Anderson, Kevin; Burford, Oksana; Emmerton, Lynne

2016-01-01

Objective Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications (‘apps’) for consumers’ self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps. Materials and Methods ‘Health app’ was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively. Results Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26–35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers’ data. Conclusions The semi-structured interviews provided insight into usage, benefits and challenges of health monitoring using apps. Understanding the range of consumer experiences and expectations can inform design of health apps to encourage persistence in self-monitoring. PMID:27214203

How do the EMA and FDA decide which anticancer drugs make it to the market? A comparative qualitative study on decision makers' views.

PubMed

Tafuri, G; Stolk, P; Trotta, F; Putzeist, M; Leufkens, H G; Laing, R O; De Allegri, M

2014-01-01

The process leading to a regulatory outcome is guided by factors both related and unrelated to the data package, defined in this analysis as 'formal and informal factors', respectively. The aim of this qualitative study was to analyse which formal and informal factors drive the decision-making process of the European Medicines Agency (EMA) and Food and Drug Administration (FDA) regulators with regard to anticancer drugs, using in-depth semi-structured interviews with regulators of the two agencies. In line with the theory and practice of qualitative research, no set sample size was defined a priori. Respondent enrolment continued until saturation and redundancy were reached. Data were collected through means of in-depth semi-structured interviews conducted either in a face-to-face setting or via Skype(®) with each regulator. The interviews were audio-recorded and verbatim transcribed. The analysis was manually carried out on the transcribed text. Data were independently coded and categorized by two researchers. Interpretation of the findings emerged through a process of triangulation between the two. Seven EMA and six FDA regulators, who had extensive experience with making decisions about anticancer medicines, were interviewed between April and June 2012. There is an open dialogue between the FDA and EMA, with the two moving closer and exchanging information, not opinions. Differences in decision-making between the agencies may be due to a different evaluation of end points. Different interaction modalities with industry and patients represent an additional source of divergence with a potential impact on decision-making. The key message of our respondents was that the agencies manage uncertainty in a different way: unlike the EMA, the FDA has a prevailing attitude to take risks in order to guarantee quicker access to new treatments. Although formal factors are the main drivers for regulatory decisions, the influence of informal factors plays an important role in the drug evaluation process.

Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences.

PubMed

Anderson, Kevin; Burford, Oksana; Emmerton, Lynne

2016-01-01

Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications ('apps') for consumers' self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps. 'Health app' was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively. Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26-35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers' data. The semi-structured interviews provided insight into usage, benefits and challenges of health monitoring using apps. Understanding the range of consumer experiences and expectations can inform design of health apps to encourage persistence in self-monitoring.

Nurses' perceptions of a pressure ulcer prevention care bundle: a qualitative descriptive study.

PubMed

Roberts, Shelley; McInnes, Elizabeth; Wallis, Marianne; Bucknall, Tracey; Banks, Merrilyn; Chaboyer, Wendy

2016-01-01

Pressure ulcer prevention is a critical patient safety indicator for acute care hospitals. An innovative pressure ulcer prevention care bundle targeting patient participation in their care was recently tested in a cluster randomised trial in eight Australian hospitals. Understanding nurses' perspectives of such an intervention is imperative when interpreting results and translating evidence into practice. As part of a process evaluation for the main trial, this study assessed nurses' perceptions of the usefulness and impact of a pressure ulcer prevention care bundle intervention on clinical practice. This qualitative descriptive study involved semi-structured interviews with nursing staff at four Australian hospitals that were intervention sites for a cluster randomised trial testing a pressure ulcer prevention care bundle. Four to five participants were purposively sampled at each site. A trained interviewer used a semi-structured interview guide to question participants about their perceptions of the care bundle. Interviews were digitally recorded, transcribed and analysed using thematic analysis. Eighteen nurses from four hospitals participated in the study. Nurses' perceptions of the intervention are described in five themes: 1) Awareness of the pressure ulcer prevention care bundle and its similarity to current practice; 2) Improving awareness, communication and participation with the pressure ulcer prevention care bundle; 3) Appreciating the positive aspects of patient participation in care; 4) Perceived barriers to engaging patients in the pressure ulcer prevention care bundle; and 5) Partnering with nursing staff to facilitate pressure ulcer prevention care bundle implementation. Overall, nurses found the care bundle feasible and acceptable. They identified a number of benefits from the bundle, including improved communication, awareness and participation in pressure ulcer prevention care among patients and staff. However, nurses thought the care bundle was not appropriate or effective for all patients, such as those who were cognitively impaired. Perceived enablers to implementation of the bundle included facilitation through effective communication and dissemination of evidence about the care bundle; strong leadership and ability to influence staff behaviour; and simplicity of the care bundle.

Adaptation of the European Commission-recommended user testing method to patient medication information leaflets in Japan.

PubMed

Yamamoto, Michiko; Doi, Hirohisa; Yamamoto, Ken; Watanabe, Kazuhiro; Sato, Tsugumichi; Suka, Machi; Nakayama, Takeo; Sugimori, Hiroki

2017-01-01

The safe use of drugs relies on providing accurate drug information to patients. In Japan, patient leaflets called Drug Guide for Patients are officially available; however, their utility has never been verified. This is the first attempt to improve Drug Guide for Patients via user testing in Japan. To test and improve communication of drug information to minimize risk for patients via user testing of the current and revised versions of Drug Guide for Patients, and to demonstrate that this method is effective for improving Drug Guide for Patients in Japan. We prepared current and revised versions of the Drug Guide for Patients and performed user testing via semi-structured interviews with consumers to compare these versions for two guides for Mercazole and Strattera. We evenly divided 54 participants into two groups with similar distributions of sex, age, and literacy level to test the differing versions of the Mercazole guide. Another group of 30 participants were divided evenly to test the versions of the Strattera guide. After completing user testing, the participants evaluated both guides in terms of amount of information, readability, usefulness of information, and layout and appearance. Participants were also asked for their opinions on the leaflets. Response rates were 100% for both Mercazole and Strattera. The revised versions of both Guides were superior or equal to the current versions in terms of accessibility and understandability. The revised version of the Mercazole guide showed better ratings for readability, usefulness of information, and layout ( p <0.01) than did the current version, while that for Strattera showed superior readability and layout ( p <0.01). User testing was effective for evaluating the utility of Drug Guide for Patients. Additionally, the revised version had superior accessibility and understandability.

Exploring the Perceptions of Newly Credentialed Athletic Trainers as They Transition to Practice.

PubMed

Walker, Stacy E; Thrasher, Ashley B; Mazerolle, Stephanie M

2016-08-01

Research is limited on the transition to practice of newly credentialed athletic trainers (ATs). Understanding this transition could provide insight to assist employers and professional programs in developing initiatives to enhance the transition. To explore newly credentialed ATs' experiences and feelings during their transition from student to autonomous practitioner. Qualitative study. Individual phone interviews. Thirty-four ATs certified between January and September 2013 participated in this study (18 women, 16 men; age = 23.8 ± 2.1 years; work settings were collegiate, secondary school, clinic, and other). Data saturation guided the number of participants. Participants were interviewed via phone using a semistructured interview guide. All interviews were recorded and transcribed verbatim. Data were analyzed through phenomenologic reduction, with data coded for common themes and subthemes. Credibility was established via member checks, peer review, and intercoder reliability. The 3 themes that emerged from the data were (1) transition to practice preparation, (2) orientation, and (3) mentoring. Transition to practice was rarely discussed during professional preparation, but information on the organization and administration or capstone course (eg, insurance, documentation) assisted participants in their transition. Participants felt that preceptors influenced their transition by providing or hindering the number and quality of patient encounters. Participants from larger collegiate settings reported more formal orientation methods (eg, review policies, procedures manual), whereas those in secondary school, clinic/hospital, and smaller collegiate settings reported informal orientation methods (eg, independent review of policies and procedures, tours). Some participants were assigned a formal mentor, and others engaged in peer mentoring. Employers could enhance the transition to practice by providing formal orientation and mentorship. Professional programs could prepare students for the transition by discussing how to find support and mentoring and by involving preceptors who provide students with opportunities to give patient care.

[Context of pregnancy in adolescence. We starting going out and everything began then].

PubMed

de la Cuesta Benjumea, C

2001-09-01

The authors reveal the findings of an qualitative investigation on teenage pregnancy. Their data came from 21 semi-structured interviews with pregnant teenagers. The analysis of this data followed the procedures set forth in tested theories. This study reveals that the nature of the interplay a teenager who gets pregnant is that of a serious love affair in which the ideas of romantic love and the rules of that genre guide their behavior. This is the social milieu in which youths live and where they construct their identifies. Sexual relations are part of the natural course of a love affair since they link sex with love. This is not an easy love affair; it develops under unstable conditions. The aspects revealed by this study show the difficulties which surround conventional anti-conceptive practices. The authors hope this study serves as a guide, as orientation, in order that promotional and preventative compaigns become relevant, meaningful and acceptable to youths.

The Experience of Persons With Multiple Sclerosis Using MS INFoRm: An Interactive Fatigue Management Resource.

PubMed

Pétrin, Julie; Akbar, Nadine; Turpin, Karen; Smyth, Penelope; Finlayson, Marcia

2018-04-01

We aimed to understand participants' experiences with a self-guided fatigue management resource, Multiple Sclerosis: An Interactive Fatigue Management Resource ( MS INFoRm), and the extent to which they found its contents relevant and useful to their daily lives. We recruited 35 persons with MS experiencing mild to moderate fatigue, provided them with MS INFoRm, and then conducted semistructured interviews 3 weeks and 3 months after they received the resource. Interpretive description guided the analysis process. Findings indicate that participants' experience of using MS INFoRm could be understood as a process of change, influenced by their initial reactions to the resource. They reported experiencing a shift in knowledge, expectations, and behaviors with respect to fatigue self-management. These shifts led to multiple positive outcomes, including increased levels of self-confidence and improved quality of life. These findings suggest that MS INFoRm may have a place in the continuum of fatigue management interventions for people with MS.

Factors influencing when intensive care unit nurses go to the bedside to investigate patient related alarms: A descriptive qualitative study.

PubMed

Despins, Laurel A

2017-12-01

This study examines what prompts the intensive care unit (ICU) nurse to go to the patient's bedside to investigate an alarm and the influences on the nurse's determination regarding how quickly this needs to occur. A qualitative descriptive design guided data collection and analysis. Individual semi-structured interviews were conducted. Thematic analysis guided by the Patient Risk Detection Theoretical Framework was applied to the data. Four specialty intensive care units in an academic medical center. ICU nurses go the patient's bedside in response to an alarm to catch patient deterioration and avert harm. Their determination of the immediacy of patient risk and their desire to prioritize their bedside investigations to true alarms influences how quickly they proceed to the bedside. Ready visual access to physiological data and waveform configurations, experience, teamwork, and false alarms are important determinants in the timing of ICU nurses' bedside alarm investigations. Copyright © 2017 Elsevier Ltd. All rights reserved.

What makes a good voice for radio: perceptions of radio employers and educators.

PubMed

Warhurst, Samantha; McCabe, Patricia; Madill, Catherine

2013-03-01

To inform vocal training and management of voice disorders of professional radio performers in Australia by determining radio employers' and educators' qualitative perceptions on (1) what makes a good voice for radio and (2) what communication characteristics are important when employing radio performers. Radio employers and educators (n=9) participated in semistructured interviews. Interview transcripts were coded line-by-line and analyzed for qualitative themes using principles of grounded theory. Radio performers sound easy-on-the-ear, natural, and have an ability to read and produce voices that suit the station. Many of these characteristics make them sound different to radio voices in the past. Content and personality are now also more significant than voice characteristics. A multidimensional model of these characteristics is presented. The model has implications for the training and management of voice disorders in radio performers and will guide future quantitative research on the vocal features of this population. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Resilience of Vietnamese refugees: resources to cope with natural disasters in their resettled country.

PubMed

Xin, Huaibo; Aronson, Robert E; Lovelace, Kay A; Strack, Robert W; Villalba, José A

2013-08-01

Study findings suggest that refugees are more vulnerable than the general population to mental disorders from disasters. This pilot study explored the nature of Vietnamese refugees' resilience to a potential natural disaster as a first step toward improving their disaster mental health. Interviews were conducted with 20 ethnic Vietnamese and Montagnard adult refugees using a semistructured interview guide. Factors in resilience at both individual and family levels were examined. Our results indicated that these refugees had positive personalities and strong family cohesion. However, although a majority of the participants had experienced natural disasters, they lacked knowledge and specific strategies to cope with these events. The individual participants and their families lacked sufficient information, financial resources, emergency supplies, or social support for a natural disaster. Enhancing refugees' current strengths in responding to disasters, delivering them tailored emergency training, strengthening relationships between refugee service providers and refugee communities, and advocating for refugees' socioeconomic capacity building should be considered.

Motivations and Expectations of Undergraduate Nursing Students Undertaking International Clinical Placements.

PubMed

Gower, Shelley; Duggan, Ravani; Dantas, Jaya A R; Boldy, Duncan

2016-09-01

International clinical placements are common in preregistration nursing programs in Australian universities to enhance awareness of cultural needs and global health issues. Yet, little is known about the motivations and expectations of nursing students who choose to participate. Using a qualitative exploratory design, individual semistructured interviews were undertaken with 52 preregistration final-year nursing students from four Western Australian universities 2 weeks prior to departure to the developing countries of Tanzania, Thailand, the Philippines, Cambodia, and India. Data were analyzed using thematic analysis. The interviews revealed that students were motivated by cultural inquisitiveness and a desire to help. They expected to gain cultural learning, to be challenged, to be fulfilled, to experience professional growth, and to feel gratitude. Developing an understanding of culture was a crucial outcome. By understanding the impetus and personal motivations of students, educators can guide students toward a more transformative experience whereby a more multicultural perspective on health care can be developed. [J Nurs Educ. 2016;55(9):487-494.]. Copyright 2016, SLACK Incorporated.

[Financing Regional Dementia Networks in Germany: Determinants of Sustainable Healthcare Networks].

PubMed

Michalowsky, B; Wübbeler, M; Thyrian, J R; Holle, B; Gräske, J; Schäfer-Walkmann, S; Fleßa, S; Hoffmann, W

2017-12-01

Analysis of practice-based financing concepts in German dementia networks (DN); Provision of sustainable financing structures and their determinants in DN. Qualitative expert interviews with leaders of 13 DN were conducted. A semi-structured interview guide was used to analyse four main topics: Finance-related organization, cost, sources of funding and financial sustainability. DN were primarily financed by membership fees, earnings of services provided, public funds and payments by municipalities or health care providers. 63% of the DN reported a financial sustainability. Funds to support the interpersonal expanding, a mix of internal and external financing sources and investments of the municipality were determinants of a sustainable financing. Overall, DN in rural areas seemed to be disadvantaged due to a lack of potential linkable service providers. DN in urban regions are more likely able to gather sustainable funding resources. A minimum funding of 50.000 €/year for human resources coordinating the DN, seems to be a threshold for a sustainable DN. © Georg Thieme Verlag KG Stuttgart · New York.

Mexican and Mexican American women in a battered women's shelter: barriers to condom negotiation for HIV/AIDS prevention.

PubMed

Davila, Y R; Brackley, M H

1999-01-01

Anecdotal information suggests that, for Hispanic women who are involved with abusive partners, condom use request as an HIV/AIDS sexual risk-reduction behavior may expose the women to risk of both abuse and HIV/AIDS. A qualitative study explored barriers to condom negotiation for HIV/AIDS prevention among Mexican and Mexican American women in abusive relationships. A convenience sample of 14 Mexican and Mexican American women was recruited from a battered women's shelter. A demographic form, a domestic violence assessment form, and audiotaped responses to a semistructured interview guide were used to collect data. Descriptive statistics were used to describe the sample. Audiotaped interviews were transcribed verbatim and submitted to content analysis, which revealed past and present themes of physical, psychological, and sexual abuse of Mexican and Mexican American women who requested condom use by their male sexual partners. Also identified by content analysis was the influence of men's power on women's public, private, and sexual interactions.

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.

Intimate partner violence, pregnancy and the decision for abortion.

PubMed

Williams, Gail B; Brackley, Margaret H

2009-04-01

Pregnant women whose lives are affected by intimate partner violence and unintended pregnancy are often faced with the decision for abortion. In this qualitative research, the authors explored women's experiences of unintended pregnancy and intimate partner violence (IPV) from the perspective of adult pregnant women seeking abortion. Women were assessed for intimate partner violence and study inclusion by means of two IPV screening tools. The authors collected data during one-to two-hour semi-structured interviews with eight pregnant women. At the completion of the interviews, all women were assessed for safety using an assessment of danger tool. Safety planning and referrals were provided for all women. Qualitative data collection and data analysis were guided by naturalistic inquiry to identify prevalent themes. Three major themes emerged from the data: (1) It Wasn't That Bad, (2) Then It Got Worse, and (3) If I Have the Baby He'll Come Back. Descriptive statistics were used to tabulate and describe the women's responses to the three tools.

Resident challenges with daily life in Chinese long-term care facilities: A qualitative pilot study.

PubMed

Song, Yuting; Scales, Kezia; Anderson, Ruth A; Wu, Bei; Corazzini, Kirsten N

As traditional family-based care in China declines, the demand for residential care increases. Knowledge of residents' experiences with long-term care (LTC) facilities is essential to improving quality of care. This pilot study aimed to describe residents' experiences in LTC facilities, particularly as it related to physical function. Semi-structured open-ended interviews were conducted in two facilities with residents stratified by three functional levels (n = 5). Directed content analysis was guided by the Adaptive Leadership Framework. A two-cycle coding approach was used with a first-cycle descriptive coding and second-cycle dramaturgical coding. Interviews provided examples of challenges faced by residents in meeting their daily care needs. Five themes emerged: staff care, care from family members, physical environment, other residents in the facility, and personal strategies. Findings demonstrate the significance of organizational context for care quality and reveal foci for future research. Copyright © 2017 Elsevier Inc. All rights reserved.

Decreasing Damaging Effects of Stress-Bound Situations: Towards a New Model of Leadership under Stress

DTIC Science & Technology

1987-01-01

interviews encompassed a clinical interview and a critical incident interview . The clinical interview was semi-structured coaprising three aain...data. In the critical incident interview the subject was asked, first, to recall and to describe a particularly hard, difficult or threatening

"They're younger… it's harder." Primary providers' perspectives on hypertension management in young adults: a multicenter qualitative study.

PubMed

Johnson, Heather M; Warner, Ryan C; Bartels, Christie M; LaMantia, Jamie N

2017-01-03

Young adults (18-39 year-olds) have the lowest hypertension control rates among adults with hypertension in the United States. Unique barriers to hypertension management in young adults with primary care access compared to older adults have not been evaluated. Understanding these differences will inform the development of hypertension interventions tailored to young adults. The goals of this multicenter study were to explore primary care providers' perspectives on barriers to diagnosing, treating, and controlling hypertension among young adults with regular primary care. Primary care providers (physicians and advanced practice providers) actively managing young adults with uncontrolled hypertension were recruited by the Wisconsin Research & Education Network (WREN), a statewide practice-based research network. Semi-structured qualitative interviews were conducted in three diverse Midwestern clinical practices (academic, rural, and urban clinics) using a semi-structured interview guide, and content analysis was performed. Primary care providers identified unique barriers across standard hypertension healthcare delivery practices for young adults. Altered self-identity, greater blood pressure variability, and unintended consequences of medication initiation were critical hypertension control barriers among young adults. Gender differences among young adults were also noted as barriers to hypertension follow-up and antihypertensive medication initiation. Tailored interventions addressing the unique barriers of young adults are needed to improve population hypertension control. Augmenting traditional clinic structure to support the "health identity" of young adults and self-management skills are promising next steps to improve hypertension healthcare delivery.

Effects of a training in the Disability Assessment Structured Interview on the interviews of Dutch insurance physicians.

PubMed

Spanjer, Jerry; van de Mei, Sijrike; Cornelius, Bert; Brouwer, Sandra; van der Klink, Jac

2016-08-01

The Disability Assessment Structured Interview (DASI) is a semi-structured interview for assessing functional limitations of claimants in a work disability evaluation. The aim of this study is to evaluate the effect of a 3-day DASI training course on the quality of assessment interviews of insurance physicians (IPs). In a pretest-posttest study, 55 IPs employed at the Dutch National Institute for Employee Benefits Schemes completed a 3-day DASI training. Before (T0), directly after the training (T1) and after 3 months follow-up (T2), these IPs filled out questionnaires that measured knowledge, skills, attitude and self-efficacy. Furthermore, in 10 disability assessment cases interview duration, IP's satisfaction, amount of acquired information and confidence of judgement were measured. Finally, the amount of information reported was measured in three randomly selected disability assessment reports of each IP. IP's knowledge, skills and self-efficacy improved significantly after the training. The attitude of the IPs changed towards a more open attitude and structuring of the interview. Satisfaction about the interview, amount of acquired information and confidence of their judgement all increased. The DASI training improved the quality of assessment interviews of IPs. A semi-structured interview, like the DASI, can help physicians to pay more attention to activity limitations and participation in addition to medical information. Implications for Rehabilitation Experienced IPs are able to change their disability assessment interview routine after training. In determining work ability, IPs should pay more attention to claimant's activity limitations and participation in addition to medical information. A semi-structured interview as the DASI can help IPs to pay more attention to claimant's functioning. A 3-day DASI training for IPs can increase their confidence in their judgement and provides significantly more information in their assessment reports.

Can nurse teachers manage student incivility by guided democracy? A grounded theory study

PubMed Central

Rad, Mostafa; Ildarabadi, Eshagh

2017-01-01

Introduction Managing incivility in academic settings is among the basic concerns and challenges of most educational systems, including nursing education. Incivility management cannot be considered devoid of disruptive behaviors. However, incivility management is a complexphenomenon upon which few studies are conducted. Objectives The present study aims at discovering teachers and students’ experiences regarding incivility and developing an approach to manage nursing students’ incivility. Design The present study was conducted based on the qualitative research design of the grounded theory methodology. Settings This study was conducted at schools of nursing in academic settings in Iran. Participants Study participants in the present study include nurse teachers (N=20) and nursing students (N=9). Method In-depth semi-structured interviews were conducted using theoretical and purposive sampling. Constant comparative analysis was used for data analysis. Results The results include four main categories; (1) deterioration of learning; (2) dominant individual and organisational culture; (3) guided democracy; and (4) movement toward professionalism. Guided democracy is recognised as the main basic psychosocial process for incivility management. Conclusions Incivility management is pursued to help learners develop professional performance. As indicated by the results of the present study, guided democracy is an effective strategy for incivility management in nursing education. PMID:28716787

An Evaluation of Research Ethics in Undergraduate Health Science Research Methodology Programs at a South African University.

PubMed

Coetzee, Tanya; Hoffmann, Willem A; de Roubaix, Malcolm

2015-10-01

The amended research ethics policy at a South African University required the ethics review of undergraduate research projects, prompting the need to explore the content and teaching approach of research ethics education in health science undergraduate programs. Two qualitative data collection strategies were used: document analysis (syllabi and study guides) and semi-structured interviews with research methodology coordinators. Five main themes emerged: (a) timing of research ethics courses, (b) research ethics course content, (c) sub-optimal use of creative classroom activities to facilitate research ethics lectures, (d) understanding the need for undergraduate project research ethics review, and (e) research ethics capacity training for research methodology lecturers and undergraduate project supervisors. © The Author(s) 2015.

Analyzing beliefs and practices of a Mexican high school biology teacher

NASA Astrophysics Data System (ADS)

Verjovsky, Janet; Waldegg, Guillermina

2005-04-01

This article explores the beliefs and practices of a high school biology teacher through three interrelated theoretical frameworks: common knowledge, collaborative learning, and communities of practice. The data were obtained from an in-depth case study of Maria, a biology teacher from a Mexican public high school that was participating in a 4-year international science project using collaborative learning and information and communication technology. Her beliefs and practices were explored by means of questionnaires, semi-structured interviews, and nonparticipant observation of classes. Through the use of the three-component framework, the degrees of coherence between practice and beliefs that guide the teacher's daily behavior became apparent, as well as the difficulties of incorporating innovations due to institutional constraints.

What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California

PubMed Central

Sanchez-Flack, Jennifer C.; Baquero, Barbara; Linnan, Laura A.; Gittelsohn, Joel; Pickrel, Julie L.; Ayala, Guadalupe X.

2016-01-01

To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers’ grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and socio-cultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers. PMID:26800243

Patient navigation moderates emotion and information demands of cancer treatment: a qualitative analysis.

PubMed

Rousseau, Sally J; Humiston, Sharon G; Yosha, Amy; Winters, Paul C; Loader, Starlene; Luong, Vi; Schwartzbauer, Bonnie; Fiscella, Kevin

2014-12-01

Patient navigation is increasingly employed to guide patients through cancer treatment. We assessed the elements of navigation that promoted patients' involvement in treatment among patients with breast and colorectal cancer that participated in a navigation study. We conducted qualitative analysis of 28 audiotaped and transcribed semi-structured interviews of navigated and unnavigated cancer patients. Themes included feeling emotionally and cognitively overwhelmed and desire for a strong patient-navigator partnership. Both participants who were navigated and those who were not felt that navigation did or could help address their emotional, informational, and communicational needs. The benefits of logistical support were cited less often. Findings underscore the salience of personal relationships between patients and navigators in meeting patients' emotional and informational needs.

Barriers to and Methods of Help Seeking for Domestic Violence Victimization: A Comparison of Hispanic and Non-Hispanic White Women Residing in the United States.

PubMed

Bridges, Ana J; Karlsson, Marie E; Jackson, Jennifer C; Andrews, Arthur R; Villalobos, Bianca T

2018-02-01

This study examined strategies Hispanic and non-Hispanic White victims of domestic violence use to manage violence and leave their relationships. Participants ( N = 76, 41% Hispanic) completed self-report questionnaires and a semistructured interview with a language-congruent research assistant. Hispanics reported child care needs and fears of social embarrassment as barriers to leaving, while non-Hispanic Whites reported fewer social supports as a barrier. Hispanics were more likely to use legal resources for help, while non-Hispanic Whites used more informal resources. Recognizing unique barriers to leaving abusive relationships and accessing help can guide service providers and others to target vulnerable populations more effectively.

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

PubMed

Jensen, Puk; Brodersen, John

2010-06-07

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

Sexual Health Care, Sexual Behaviors and Functioning, and Female Genital Cutting: Perspectives From Somali Women Living in the United States.

PubMed

Connor, Jennifer Jo; Hunt, Shanda; Finsaas, Megan; Ciesinski, Amanda; Ahmed, Amira; Robinson, Beatrice Bean E

2016-01-01

We investigated the sexual values, attitudes, and behaviors of 30 Somali female refugees living in a large metropolitan area of Minnesota by collecting exploratory sexual health information based on the components of the sexual health model-components posited to be essential aspects of healthy human sexuality. A Somali-born bilingual interviewer conducted the semistructured interviews in English or Somali; 22 participants chose to be interviewed in Somali. Interviews were translated, transcribed, and analyzed using descriptive statistics and thematic analyses. Our study findings highlighted a sexually conservative culture that values sexual intimacy, female and male sexual pleasure, and privacy in marriage; vaginal sexual intercourse as the only sanctioned sexual behavior; and the importance of Islamic religion in guiding sexual practices. Findings related to human immunodeficiency virus (HIV) revealed HIV testing at immigration, mixed attitudes toward condom use, and moderate knowledge about HIV transmission modes. Female genital cutting (FGC) was a pervasive factor affecting sexual functioning in Somali women, with attitudes about the controversial practice in transition. We recommend that health professionals take the initiative to discuss sexual health care and safer sex, sexual behaviors/functioning, and likely challenges to sexual health with Somali women--as they may be unlikely to broach these subjects without permission and considerable encouragement.

Situating and Constructing Diversity in Semi-Structured Interviews

PubMed Central

McIntosh, Michele J.; Morse, Janice M.

2015-01-01

Although semi-structured interviews (SSIs) are used extensively in research, scant attention is given to their diversity, underlying assumptions, construction, and broad applications to qualitative and mixed-method research. In this three-part article, we discuss the following: (a) how the SSI is situated historically including its evolution and diversification, (b) the principles of constructing SSIs, and (c) how SSIs are utilized as a stand-alone research method, and as strategy within a mixed-method design. PMID:28462313

Using Multiple Interviewers in Qualitative Research Studies: The Influence of Ethic of Care Behaviors in Research Interview Settings

ERIC Educational Resources Information Center

Matteson, Shirley M.; Lincoln, Yvonna S.

2009-01-01

This study considered the methodological implications of a qualitative study that involved two research practitioners as interviewers, one male and one female, who conducted semistructured cognitive interviews with middle school students. During the reading and analysis of interview transcriptions, differences were noted between the interviewers'…

Hispanic Male’s Perspectives of Health Behaviors Related to Weight Management

PubMed Central

Garcia, David O.; Valdez, Luis A.; Hooker, Steven P.

2015-01-01

Hispanic males have the highest prevalence of overweight and obesity among men in the United States; yet are significantly underrepresented in weight loss research. The purpose of the current study was to examine Hispanic male’s perspectives of health behaviors related to weight management to refine the methodologies to deliver a gender-sensitive and culturally sensitive weight loss intervention. From October 2014 to April 2015, semistructured interviews were conducted with 14 overweight Hispanic men of ages 18 to 64 years. The interviews lasted approximately 60 minutes. Participants also completed a brief questionnaire and body weight/height were measured. Grounded in a deductive process, a preliminary codebook was developed based on the topics included in the interview guides. A thematic analysis facilitated the identification of inductive themes and the finalization of the codebook used for transcript analysis. Four overarching themes were identified: (a) general health beliefs of how diet and physical activity behaviors affect health outcomes, (b) barriers to healthy eating and physical activity, (c) motivators for change, and (d) viable recruitment and intervention approaches. Future research should examine feasible and appropriate recruitment and intervention strategies identified by Hispanic males to improve weight management in this vulnerable group. PMID:26634854

Factors related to reducing free sugar intake among white ethnic adults in the UK: a qualitative study.

PubMed

Rawahi, Said Harith Al; Asimakopoulou, Koula; Newton, Jonathon Timothy

2018-01-01

To determine the barriers and enablers to behavioural change to reduce free sugar intake related to dental caries in a sample of UK adults who identify their ethnicity as White. Qualitative study comprising semi-structured interviews of 27 participants. Interviews were recorded, transcribed and analysed using thematic analysis methods. The Capability-Opportunity-Motivation-Behaviour model (COM-B) and the Theoretical Domains Framework (TDF) were used to guide the derivation of themes. Data saturation occurred at 27 interviews. The COM-B Model and TDF domains captured various factors that may influence the consumption of free sugar. TDF elements which are reflected in the study are: Knowledge; Psychological skills; Memory, attention, and decision processes; Behavioural regulation; Physical skills; Social influence; Environmental context and resources; Social and professional role and identity; Beliefs about capabilities; Beliefs about consequence; Intentions and goals reinforcement; and Emotions. COM-B Model elements which are reflected in the study are: psychological capabilities, physical capabilities, social opportunities, physical opportunities, reflective motivation, and automatic motivation. The COM-B model and TDF framework provided a comprehensive account of the barriers and facilitators of reducing sugar intake among white ethnic groups.

Perceived motivational factors for female football players during rehabilitation after sports injury – a qualitative interview study

PubMed Central

Hildingsson, Malin; Fitzgerald, Ulrika Tranaeus; Alricsson, Marie

2018-01-01

Compliance with a rehabilitation program is significant among athletes following a sports injury. It is also one of the main factors that influence the rehabilitation process; moreover, the outcome is also influenced by the athlete’s motivation. It is primarily an autonomous motivation, resulting in rehabilitation adherence. The aim of this study was to investigate the perceived motivation of female football players during rehabilitation after a sports injury and the extent to which these motivating factors were autonomous. Qualitative interviews, based on a semistructured interview guide with injured female football players undergoing rehabilitation, were analyzed using content analysis. The motivational factors that were described were their set goals, social support as well as external and internal pressures during rehabilitation. The perceived autonomy varied somewhat but overall, they experienced external motivation; therefore, the behavior was not entirely self-determined. Results are expected to provide a better understanding of women football players’ motivation in relation to their rehabilitation; hence, physiotherapists and coaches who are part of the rehabilitation process can contribute by increasing the autonomous motivation, thus, improving the compliance and outcome of the rehabilitation. PMID:29740552

ReGAE 5: Can we improve the surgical journey for African-Caribbean patients undergoing glaucoma filtration surgery? Some preliminary findings

PubMed Central

Cross, Vinette; Shah, Peter; Glynn, Martin; Chidrawar, Shivani

2009-01-01

Aim: To explore the experiences of African-Caribbean patients who had undergone filtration surgery for advanced glaucoma. Methods: Semi-structured qualitative interviews were used to collect the data and an interview guide was developed. Participants recounted when they first became aware of a problem with their eyes and their feelings at the time. Subsequently they were probed about their subjective experiences of becoming a glaucoma patient, receiving treatment, the decision to undergo surgery, and its aftermath. The perceptions of three participants from three different generations of African-Caribbean men were selected from the larger study for presentation in this paper. Interview transcripts were subjected to narrative analysis. Results: The concept of patient-partnership was re-framed in terms of mentorship. Surgeon–patient relationships are central to developing effective coping strategies. Support to face the ordeals ahead, challenge to take on new responsibilities, and help to envision a meaningful life with glaucoma are fundamental to fostering trust and maintaining motivation to continue. Conclusions: The use of patient narratives provides a valuable a resource for enhancing communication skills and patient-centered care in the hospital eye service. PMID:19668538

Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics.

PubMed

Ganatra, B; Kalyanwala, S; Elul, B; Coyaji, K; Tewari, S

2010-01-01

We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed.

Health workers' perceptions of private-not-for-profit health facilities' organizational culture and its influence on retention in Uganda.

PubMed

Shumba, Constance Sibongile; Kielmann, Karina; Witter, Sophie

2017-12-06

An in-depth understanding of how organizational culture is experienced by health workers (HWs), and influences their decisions to leave their jobs is a fundamental, yet under-examined, basis for forming effective retention strategies. This research examined HWs' working experiences and perceptions of organisational culture within private-not-for-profit, largely mission-based hospitals, and how this influenced retention. Thirty-two HWs, including managers, in 19 health facilities in Uganda were interviewed using a semi-structured topic guide. Interview transcripts were analysed using thematic content analysis. Interviews showed that the organizational culture was predominantly hierarchical, with non-participative management styles which emphasized control and efficiency. HWs and managers held different perceptions of the organizational culture. While the managers valued results and performance, HWs valued team work, recognition and participative management. The findings of this study indicate that organizational culture influences retention of HWs in health facilities and provide a useful context to inform health care managers in the PNFP sub-sector in Uganda and similar contexts. To improve retention of HWs, a gradual shift in organizational culture will be necessary, focussing on the values, beliefs and perceptions which have the greatest influence on observable behaviour.

Expert Knowledge Influences Decision-Making for Couples Receiving Positive Prenatal Chromosomal Microarray Testing Results.

PubMed

Rubel, M A; Werner-Lin, A; Barg, F K; Bernhardt, B A

2017-09-01

To assess how participants receiving abnormal prenatal genetic testing results seek information and understand the implications of results, 27 US female patients and 12 of their male partners receiving positive prenatal microarray testing results completed semi-structured phone interviews. These interviews documented participant experiences with chromosomal microarray testing, understanding of and emotional response to receiving results, factors affecting decision-making about testing and pregnancy termination, and psychosocial needs throughout the testing process. Interview data were analyzed using a modified grounded theory approach. In the absence of certainty about the implications of results, understanding of results is shaped by biomedical expert knowledge (BEK) and cultural expert knowledge (CEK). When there is a dearth of BEK, as in the case of receiving results of uncertain significance, participants rely on CEK, including religious/spiritual beliefs, "gut instinct," embodied knowledge, and social network informants. CEK is a powerful platform to guide understanding of prenatal genetic testing results. The utility of culturally situated expert knowledge during testing uncertainty emphasizes that decision-making occurs within discourses beyond the biomedical domain. These forms of "knowing" may be integrated into clinical consideration of efficacious patient assessment and counseling.

Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada

PubMed Central

Chan, Justine; DeMelo, Margaret; Gingras, Jacqui; Gucciardi, Enza

2015-01-01

Objective. To explore how food insecurity affects individuals' ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants' experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support. PMID:26576154

A qualitative, exploratory study of nurses' decision-making when interrupted during medication administration within the Paediatric Intensive Care Unit.

PubMed

Bower, Rachel A; Coad, Jane E; Manning, Joseph C; Pengelly, Theresa A

2018-02-01

In the paediatric intensive care unit (PICU), medication administration is challenging. Empirical studies demonstrate that interruptions occur frequently and that nurses are fundamental in the delivery of medication. However, little is known about nurse's decision making when interrupted during medication administration. Therefore, the objective is to understand decision making when interrupted during medication administration within the PICU. A qualitative study incorporating non-participant observation and audio recorded semi-structured interviews. A convenience sample of ten PICU nurses were interviewed. Each interview schedule was informed by two hours of observation which involved a further 29 PICU nurses. Data was analysed using Framework Analysis. A regional PICU located in a university teaching hospital in the United Kingdom. Analysis resulted in four overarching themes: (1) Guiding the medication process, (2) Concentration, focus and awareness, (3) Influences on interruptions (4) Impact and recovery CONCLUSION: Medication administration within the PICU is an essential but complex activity. Interruptions can impact on focus and concentration which can contribute to patient harm. Decision making by PICU nurses is influenced by interruption awareness, fluctuating levels of concentration, and responding to critically ill patient and families' needs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Facilitators of Survivorship Care Among Underserved Breast Cancer Survivors: a Qualitative Study.

PubMed

Ustjanauskas, Amy E; Quinn, Gwendolyn P; Pan, Tonya M; Rivera, Maria; Vázquez-Otero, Coralia; Ung, Danielle; Roetzheim, Richard G; Laronga, Christine; Johnson, Kenneth; Norton, Marilyn; Carrizosa, Claudia; Muñoz, Dariana; Goldenstein, Marissa; Nuhaily, Sumayah; Wells, Kristen J

2017-12-01

Research investigating facilitators of survivorship care among underserved breast cancer survivors (BCS) is sparse. This study aimed to explore facilitators of survivorship care among underserved BCS within the first 5 years following chemotherapy, radiation, or surgery for breast cancer. In-depth interviews were conducted, using a semi-structured interview guide, with underserved BCS exploring survivorship care experiences. Content analysis of the verbatim transcripts was applied, and results were summarized according to themes related to facilitators of breast cancer survivorship care. Interviews were conducted with 25 BCS. Eight main themes were identified: coordination of care; positive perceptions of health care providers; communication between patient and health care providers; financial and insurance facilitators; information, classes, and programs provided; assistance provided by organizations and health care professionals; transportation facilitators; and job flexibility. This study provides a comprehensive look at facilitators of survivorship care among underserved BCS. BCS endorsed several facilitators of their survivorship care, mainly at the interpersonal, organizational, and societal level. This study adds to the research literature on catalysts of care among underserved BCS. Results from this study are currently being used to inform a patient navigation intervention to facilitate care among this population.

Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada.

PubMed

Chan, Justine; DeMelo, Margaret; Gingras, Jacqui; Gucciardi, Enza

2015-01-01

Objective. To explore how food insecurity affects individuals' ability to manage their diabetes, as narrated by participants living in a large, culturally diverse urban centre. Design. Qualitative study comprising of in-depth interviews, using a semistructured interview guide. Setting. Participants were recruited from the local community, three community health centres, and a community-based diabetes education centre servicing a low-income population in Toronto, Ontario, Canada. Participants. Twenty-one English-speaking adults with a diagnosis of diabetes and having experienced food insecurity in the past year (based on three screening questions). Method. Using six phases of analysis, we used qualitative, deductive thematic analysis to transcribe, code, and analyze participant interviews. Main Findings. Three themes emerged from our analysis of participants' experiences of living with food insecurity and diabetes: (1) barriers to accessing and preparing food, (2) social isolation, and (3) enhancing agency and resilience. Conclusion. Food insecurity appears to negatively impact diabetes self-management. Healthcare professionals need to be cognizant of resources, skills, and supports appropriate for people with diabetes affected by food insecurity. Study findings suggest foci for enhancing diabetes self-management support.

Cultural concepts of tuberculosis and gender among the general population without tuberculosis in rural Maharashtra, India.

PubMed

Atre, Sachin R; Kudale, Abhay M; Morankar, Sudhakar N; Rangan, Sheela G; Weiss, Mitchell G

2004-11-01

Gender-specific patterns of experience, meaning, and behaviour for tuberculosis (TB) require consideration to guide control programmes. To clarify concepts of gender, culture, and TB in a rural endemic population of Maharashtra, India, this study of 80 men and 80 women employed qualitative and quantitative methods of cultural epidemiology, using a locally adapted semi-structured Explanatory Model Interview Catalogue (EMIC) interviews are instruments for cultural epidemiological study of the distribution of illness-related experiences, meanings, and behaviours. This interview queried respondents without active disease about vignettes depicting a man and woman with typical features of TB. Emotional and social symptoms were frequently reported for both vignettes, but more often considered most distressing for the female vignette; specified problems included arranging marriages, social isolation, and inability to care for children and family. Job loss and reduced income were regarded most troubling for the male vignette. Men and women typically identified sexual experience as the cause of TB for opposite-sex vignettes. With wider access to information about TB, male respondents more frequently recommended allopathic doctors and specialty services. Discussion considers the practical significance of gender-specific cultural concepts of TB.

Interviewing clinicians and advocates who work with sexual assault survivors: a personal perspective on moving from quantitative to qualitative research methods.

PubMed

Ullman, Sarah E

2005-09-01

This article describes the author's personal experiences of conducting a qualitative semistructured interview study, after having done predominantly quantitative survey research in the social sciences. The author describes the process of learning how to approach conducting semistructured interviews with female advocates and clinicians who provide services to sexual assault survivors in the community. The author describes making the transition from a logical positivist deductive approach to thinking about and conducting research to a more social constructionist stance in which one learns from participants about their experiences and perspectives in narrative form to discover knowledge and develop theory inductively.

Exploring patient values in medical decision making: a qualitative study.

PubMed

Lee, Yew Kong; Low, Wah Yun; Ng, Chirk Jenn

2013-01-01

Patient decisions are influenced by their personal values. However, there is a lack of clarity and attention on the concept of patient values in the clinical context despite clear emphasis on patient values in evidence-based medicine and shared decision making. The aim of the study was to explore the concept of patient values in the context of making decisions about insulin initiation among people with type 2 diabetes. We conducted individual in-depth interviews with people with type 2 diabetes who were making decisions about insulin treatment. Participants were selected purposively to achieve maximum variation. A semi-structured topic guide was used to guide the interviews which were audio-recorded and analysed using a thematic approach. We interviewed 21 participants between January 2011 and March 2012. The age range of participants was 28-67 years old. Our sample comprised 9 women and 12 men. Three main themes, 'treatment-specific values', 'life goals and philosophies', and 'personal and social background', emerged from the analysis. The patients reported a variety of insulin-specific values, which were negative and/or positive beliefs about insulin. They framed insulin according to their priorities and philosophies in life. Patients' decisions were influenced by sociocultural (e.g. religious background) and personal backgrounds (e.g. family situations). This study highlighted the need for expanding the current concept of patient values in medical decision making. Clinicians should address more than just values related to treatment options. Patient values should include patients' priorities, life philosophy and their background. Current decision support tools, such as patient decision aids, should consider these new dimensions when clarifying patient values.

Addressing physical inactivity in Omani adults: perceptions of public health managers.

PubMed

Mabry, Ruth M; Al-Busaidi, Zakiya Q; Reeves, Marina M; Owen, Neville; Eakin, Elizabeth G

2014-03-01

To explore barriers and solutions to addressing physical inactivity and prolonged sitting in the adult population of Oman. Qualitative study involving semi-structured interviews that took place from October 2011 to January 2012. Participants were recruited through purposive sampling. Data collection and analysis was an iterative process; later interviews explored emerging themes. Interviews were audio-recorded and transcribed and continued until data saturation; this occurred by the tenth interviewee. Thematic content analysis was carried out, guided by an ecological model of health behaviour. Muscat, Oman. Ten mid-level public health managers. Barriers for physical inactivity were grouped around four themes: (i) intrapersonal (lack of motivation, awareness and time); (ii) social (norms restricting women's participation in outdoor activity, low value of physical activity); (iii) environment (lack of places to be active, weather); and (iv) policy (ineffective health communication, limited resources). Solutions focused on culturally sensitive interventions at the environment (building sidewalks and exercise facilities) and policy levels (strengthening existing interventions and coordinating actions with relevant sectors). Participants' responses regarding sitting time were similar to, but much more limited than those related to physical inactivity, except for community participation and voluntarism, which were given greater emphasis as possible solutions to reduce sitting time. Given the increasing prevalence of chronic disease in Oman and the Arabian Gulf, urgent action is required to implement gender-relevant public health policies and programmes to address physical inactivity, a key modifiable risk factor. Additionally, research on the determinants of physical inactivity and prolonged sitting time is required to guide policy makers.

Beyond Intuition: Patient Fever Symptom Experience

PubMed Central

Ames, Nancy J.; Peng, Claudia; Powers, John H.; Leidy, Nancy Kline; Miller-Davis, Claiborne; Rosenberg, Alice; VanRaden, Mark; Wallen, Gwenyth R.

2013-01-01

Context Fever is an important sign of inflammation recognized by health care practitioners and family caregivers. However, few empirical data obtained directly from patients exist to support many of the long-standing assumptions about the symptoms of fever. Many of the literature-cited symptoms, including chills, diaphoresis, and malaise, have limited scientific bases, yet they often represent a major justification for antipyretic administration. Objectives To describe the patient experience of fever symptoms for the preliminary development of a fever assessment questionnaire. Methods Qualitative interviews were conducted with 28 inpatients, the majority (86%) with cancer diagnoses, who had a recorded temperature of ≥38°C within approximately 12 hours before the interview. A semi-structured interview guide was used to elicit patient fever experiences. Thematic analyses were conducted by three independent research team members, and the data were verified through two rounds of consensus building. Results Eleven themes emerged. The participants reported experiences of feeling cold, weakness, warmth, sweating, nonspecific bodily sensations, gastrointestinal symptoms, headaches, emotional changes, achiness, respiratory symptoms, and vivid dreams/hallucinations. Conclusion Our data not only confirm long-standing symptoms of fever but also suggest new symptoms and a level of variability and complexity not captured by the existing fever literature. Greater knowledge of patients’ fever experiences will guide more accurate assessment of symptoms associated with fever and the impact of antipyretic treatments on patient symptoms in this common condition. Results from this study are contributing to the content validity of a future instrument that will evaluate patient outcomes related to fever interventions. PMID:23742739

The Lived Experiences of Persons Hospitalized for Construction of an Urgent Fecal Ostomy.

PubMed

Herlufsen, Per; Brødsgaard, Anne

The purpose of this study was to describe the lived experiences of hospital stays for patients undergoing urgent ostomy surgery. Qualitative, descriptive, phenomenological study. Six persons undergoing acute hospital admission and urgent ileostomy or colostomy surgery (either permanent or temporary) participated in the study. Participants were of Danish ethnicity and between the ages of 48 and 75 years. The research setting was the surgical department at a university hospital in the Capital Region of Denmark. Data collection and analyses were guided by a Reflective Lifeworld Research approach; this approach is based on phenomenological philosophy. Data were collected during in-depth interviews using a semistructured interview guide. Their average length was 50 minutes (range, 30-65 minutes). Interviews were digitally recorded and transcribed. Transcriptions were analyzed in 4 phases according to the principles of Reflective Lifeworld Research. The phenomenon we labeled "lived experiences of acute hospitalization with construction of an urgent unplanned fecal ostomy" comprised 4 constituents: (1) undergoing unexpected bodily changes, (2) partnership with professional caregivers, (3) experience of vulnerability, and (4) a lack of continuity. These constituents can be described as a number of challenges due to both hospitalization and ostomy creation. We found that individuals experience a number of challenges due to acute hospitalization and urgent construction of a fecal ostomy. These challenges are due to the unexpected bodily changes and interpersonal and organizational conditions. Nurses should be aware of not only the physical implications of urgent creation of a fecal ostomy but also the individual and psychological implications of this event.

The psychiatric interview: validity, structure, and subjectivity.

PubMed

Nordgaard, Julie; Sass, Louis A; Parnas, Josef

2013-06-01

There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews that are historically rooted in logical positivism and behaviorism. These theoretical approaches marked decisively the so-called "operational revolution in psychiatry" leading to the creation of DSM-III. This paper attempts to examine the theoretical assumptions that underlie the use of a fully structured psychiatric interview. We address the ontological status of pathological experience, the notions of symptom, sign, prototype and Gestalt, and the necessary second-person processes which are involved in converting the patient's experience (originally lived in the first-person perspective) into an "objective" (third person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform faithful distinctions in this particular domain, we need a more adequate approach, that is, an approach that is guided by phenomenologically informed considerations. Our theoretical discussion draws upon clinical examples derived from structured and semi-structured interviews. We conclude that fully structured interview is neither theoretically adequate nor practically valid in obtaining psycho-diagnostic information. Failure to address these basic issues may have contributed to the current state of malaise in the study of psychopathology.

Assessing quality of a worksite health promotion programme from participants' views: findings from a qualitative study in Malaysia.

PubMed

Liau, Siow-Yen; Hassali, Mohamed-Azmi A; Shafie, Asrul A; Ibrahim, Mohamed-Izham M

2014-02-01

An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme. To explore the participants' perceptions of the quality and effectiveness of the 'Love Your Heart Programme'. A qualitative study using semi-structured interviews with a purposive sample of participants of the 'Love Your Heart' programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio-recorded, transcribed verbatim and analysed using the principles of grounded theory. A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the 'Road to a Healthy Heart' booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them. In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme. © 2011 John Wiley & Sons Ltd.

Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

PubMed

Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

2016-03-22

Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of optimal care, implementation of effective systemic approaches should be considered.

A survey of medicinal plants used by the Deb barma clan of the Tripura tribe of Moulvibazar district, Bangladesh

PubMed Central

2014-01-01

Background The number of tribes present within Bangladesh has been estimated to approximate one hundred and fifty. Information on traditional medicinal practices, particularly of the smaller tribes and their clans is lacking. It was the objective of the study to document the tribal medicinal practices of the Deb barma clan of the Tripura tribe, which clan can be found residing in Dolusora Tripura Palli of Moulvibazar district of Bangladesh. A further objective was to determine the extent of the community households who still prefer traditional treatment to other forms of treatment, particularly allopathic treatment. Methods Interviews of the tribal healer and the tribal community regarding their ethnomedicinal practices were carried out with the help of a semi-structured questionnaire and the guided field-walk method. All together 67 clan members were interviewed including the Headman, tribal healer, 19 Heads of households and 46 other adult members of the clan. Information on number of members of household, their age, gender, educational status, occupation of working household members and preferred mode of treatment was obtained through the semi-structured questionnaire. In the guided field-walk method, the healer took the interviewers on field-walks through areas from where he collected his medicinal plants, pointed out the plants, and described their uses. Results The clan had a total of 135 people distributed into 20 households and had only one traditional healer. Use of medicinal plants, wearing of amulets, and worship of the evil god ‘Bura debta’ constituted the traditional medicinal practices of the clan for treatment of diseases. The healer used a total of 44 medicinal plants distributed into 34 families for treatment of various ailments like pain, coughs, cold, gastrointestinal disorders, cuts and wounds, diabetes, malaria, heart disorders, and paralysis. Conclusions Available scientific reports validate the use of a number of plants by the traditional healer. A number of the plants used by the clan healer had reported similar uses in Ayurveda, but differ considerably in their therapeutic uses from that reported for other tribes in Bangladesh. The present survey also indicated that in recent years the Deb barma clan members are inclining more towards allopathic medicine. PMID:24502444

Our flesh is here but our soul stayed there: A qualitative study on resource loss due to war and displacement among internally-displaced women in the Republic of Georgia.

PubMed

Seguin, Maureen; Lewis, Ruth; Amirejibi, Tinatin; Razmadze, Mariam; Makhashvili, Nino; Roberts, Bayard

2016-02-01

Losses experienced by conflict-affected civilians in low and middle income countries is a relatively unexplored area. The aim of our paper is to explore the concept of resource loss in the accounts of internally displaced women in Georgia. We use Hobfoll's Conservation of Resources (COR) theory to guide our approach by examining the loss of objects, personal characteristics, conditions, and energies. Semi-structured interviews were conducted on 42 purposively-selected Georgian women residing in internally displaced persons settlements during fieldwork in Georgia from December 2012 to February 2013. Line-by-line open-coding was conducted on translated and transcribed interviews using Nvivo. The conservation of resources theory was utilised to guide the 'mapping' of the relationships between losses which occurred in the post-conflict period. War-related trauma led to the loss of property, which caused the loss of livelihood and subsequent loss of social networks and mental and physical health. The mental and physical health losses, along with the loss of livelihood, constituted a loss spiral in which losses in one area perpetuated on-going losses in the other areas. Interventions at supporting livelihoods are needed in order to address the cascade of losses resulting from war. Copyright © 2016 Elsevier Ltd. All rights reserved.

Self-Reported Pediatric Measures of Physical Activity, Sedentary Behavior and Strength Impact for PROMIS®: Conceptual Framework

PubMed Central

Tucker, Carole A.; Bevans, Katherine B.; Teneralli, Rachel E.; Smith, Ashley Wilder; Bowles, Heather R; Forrest, Christopher B.

2014-01-01

Purpose Children's physical activity (PA) levels are commonly assessed in pediatric clinical research, but rigorous self-report assessment tools for children are scarce, and computer adaptive test implementations are rare. Our objective was to improve pediatric self-report measures of activity using semi-structured interviews with experts and children for conceptualization of a child-informed framework. Methods Semi-structured interviews were conducted to conceptualize physical activity, sedentary behaviors, and strengthening activities. We performed systematic literature reviews to identify item-level concepts used to assess these 3 domains. Results We developed conceptual frameworks for each domain using words and phrases identified by children as relevant. Conclusions Semi-structured interview methods provide valuable information of children's perspectives and the ways children recall previous activities. Conceptualized domains of physical activity are based on the literature and expert views that also reflect children's experiences and understanding providing a basis for pediatric self-report instruments. PMID:25251789

Parenting around child snacking: development of a theoretically-guided, empirically informed conceptual model.

PubMed

Davison, Kirsten K; Blake, Christine E; Blaine, Rachel E; Younginer, Nicholas A; Orloski, Alexandria; Hamtil, Heather A; Ganter, Claudia; Bruton, Yasmeen P; Vaughn, Amber E; Fisher, Jennifer O

2015-09-17

Snacking contributes to excessive energy intakes in children. Yet factors shaping child snacking are virtually unstudied. This study examines food parenting practices specific to child snacking among low-income caregivers. Semi-structured interviews were conducted in English or Spanish with 60 low-income caregivers of preschool-aged children (18 non-Hispanic white, 22 African American/Black, 20 Hispanic; 92% mothers). A structured interview guide was used to solicit caregivers' definitions of snacking and strategies they use to decide what, when and how much snack their child eats. Interviews were audio-recorded, transcribed verbatim and analyzed using an iterative theory-based and grounded approach. A conceptual model of food parenting specific to child snacking was developed to summarize the findings and inform future research. Caregivers' descriptions of food parenting practices specific to child snacking were consistent with previous models of food parenting developed based on expert opinion [1, 2]. A few noteworthy differences however emerged. More than half of participants mentioned permissive feeding approaches (e.g., my child is the boss when it comes to snacks). As a result, permissive feeding was included as a higher order feeding dimension in the resulting model. In addition, a number of novel feeding approaches specific to child snacking emerged including child-centered provision of snacks (i.e., responding to a child's hunger cues when making decisions about snacks), parent unilateral decision making (i.e., making decisions about a child's snacks without any input from the child), and excessive monitoring of snacks (i.e., monitoring all snacks provided to and consumed by the child). The resulting conceptual model includes four higher order feeding dimensions including autonomy support, coercive control, structure and permissiveness and 20 sub-dimensions. This study formulates a language around food parenting practices specific to child snacking, identifies dominant constructs, and proposes a conceptual framework to guide future research.

PATIENT NAVIGATION MODERATES EMOTION AND INFORMATION DEMANDS OF CANCER TREATMENT: A QUALITATIVE ANALYSIS

PubMed Central

Rousseau, Sally J.; Humiston, Sharon G.; Yosha, Amy; Winters, Paul C.; Loader, Starlene; Luong, Vi; Schwartzbauer, Bonnie; Fiscella, Kevin

2014-01-01

Purpose Patient navigation is increasingly employed to guide patients through cancer treatment. We assessed the elements of navigation that promoted patients’ involvement in treatment among patients with breast and colorectal cancer that participated in a navigation study. Methods We conducted qualitative analysis of 28 audiotaped and transcribed semi-structured interviews of navigated and un-navigated cancer patients. Results Themes included feeling emotionally and cognitively overwhelmed and desire for a strong patient-navigator partnership. Both participants who were navigated and those who were not felt that navigation did or could help address their emotional, informational, and communicational needs. The benefits of logistical support were cited less often. Conclusions Findings underscore the salience of personal relationships between patients and navigators in meeting patients’ emotional and informational needs. PMID:24890503

“This is Not Who I Want to be:” Experiences of Opioid-Dependent Youth Before, and During, Combined Buprenorphine and Behavioral Treatment

PubMed Central

Moore, Sarah K.; Guarino, Honoria; Marsch, Lisa A.

2018-01-01

Novel, qualitative data were collected from youth in treatment for opioid dependence (2009–2010) regarding their experiences with opioid dependence and combined behavioral–pharmacological treatment. Urban youth participants were recruited from a larger randomized controlled trial examining the relative efficacy of two tapers of buprenorphine–naloxone, combined with behavioral treatment (ages 13–24 eligible). Twenty-two youth participated in 1- to 1.5-hour semi-structured interviews. A grounded theory approach guided the analysis. The results have the potential to inform the development of efficacious treatments for this growing, yet understudied, group of youth. Study implications and limitations are noted, and future research is prescribed. (NIDA #1R01 DA018297). PMID:24041131

76 FR 13412 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

...) Screening questionnaire--used to recruit research participants for the needs assessment interviews...) Needs assessment interviews--consisting of semi-structured interviews with non-users of the Health IT... those persons that ``screen-in'' will complete the demographics section). The needs assessment will be...

Harm reduction and cessation efforts and interest in cessation resources among survivors of smoking-related cancers

PubMed Central

Berg, Carla J.; Carpenter, Matthew J.; Jardin, Bianca; Ostroff, Jamie S.

2013-01-01

Purpose Despite the well-established risks associated with persistent smoking, many cancer survivors who were active smokers at the time of cancer diagnosis continue to smoke. In order to guide the development of tobacco cessation interventions for cancer survivors, a better understanding is needed regarding post-diagnosis quitting efforts. Thus, we examined quitting and reduction efforts and interest in cessation resources among cancer survivors who self-identified as current smokers at the time of diagnosis. Methods We conducted analyses of survey participants (n=54) who were current smokers at the time of cancer diagnosis and were continued smokers at the time of assessment. We also conducted semi-structured interviews (n=21) among a subset of those who either continued to smoke or quit smoking post cancer diagnosis. Results Among our survey participants, 22.2% had ever used behavioral cessation resources and 66.7% had use pharmacotherapy, while 62.8% had interest in future use of behavioral cessation resources and 75.0% had interest in pharmacotherapy. The majority reported some quitting efforts including making quit attempts, using cessation medications, and reducing their daily cigarette consumption. Semi-structured interview data revealed various strategies used to aid in smoking reduction and cessation as well as variability in preferences for cessation resources. Conclusions Cancer patients who smoke following diagnosis often engage in smoking reduction and cessation-related behaviors, which may reflect their motivation to reduce their smoking-related risks. They also report high interest in cessation resources. Thus, it is important to explore the acceptability and effectiveness of different cessation intervention components among this group. PMID:23307036

Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort.

PubMed

Mushaphi, Lindelani Fhumudzani; Mahopo, Tjale Cloupas; Nesamvuni, Cebisa Noxolo; Baloyi, Brenda; Mashau, Ellen; Richardson, Jeniata; Dillingham, Rebecca; Guerrant, Richard; Ambikapathi, Ramya; Bessong, Pascal

2017-09-01

There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non-breast milk liquids and solids by the second month of child's life. Common reasons for introducing non-breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended.

"Where It Falls Apart": Barriers to Retention in HIV Care in Latino Immigrants and Migrants.

PubMed

Levison, Julie H; Bogart, Laura M; Khan, Iman F; Mejia, Dianna; Amaro, Hortensia; Alegría, Margarita; Safren, Steven

2017-09-01

Latino immigrants in the United States are disproportionately affected by HIV. Barriers to consistent attendance (retention) in HIV primary care constrain opportunities for HIV treatment success, but have not been specifically assessed in this population. We conducted semistructured interviews with 37 HIV-infected Latinos (aged ≥18 years and born in Puerto Rico or a Latin American Spanish-speaking country) and 14 HIV providers in metropolitan Boston (total n = 51). The Andersen Model of Healthcare Utilization informed a semistructured interview guide, which bilingual research staff used to explore barriers to HIV care. We used thematic analysis to explore the processes of retention in care. Six ubiquitous themes were perceived to influence HIV clinic attendance: (1) stigma as a barrier to HIV serostatus disclosure; (2) social support as a safety net during negative life circumstances; (3) unaddressed trauma and substance use leading to interruption in care; (4) a trusting relationship between patient and provider motivating HIV clinic attendance; (5) basic unmet needs competing with the perceived value of HIV care; and (6) religion providing a source of hope and optimism. Cultural subthemes were the centrality of family (familismo), masculinity (machismo), and trusting relationships (confianza). The timing of barriers was acute (e.g., eviction) and chronic (e.g., family conflict). These co-occurring and dynamic constellation of factors affected HIV primary care attendance over time. HIV-infected Latino immigrants and migrants experienced significant challenges that led to interruptions in HIV care. Anticipatory guidance to prepare for these setbacks may improve retention in HIV care in this population.

Perceptions of urgency: defining the gap between what physicians and nurses perceive to be an urgent issue.

PubMed

Quan, S D; Morra, D; Lau, F Y; Coke, W; Wong, B M; Wu, R C; Rossos, P G

2013-05-01

Through our research into the design and evaluation of technology systems to improve the quality and safety of clinical communication, we have discovered that physicians and nurses differ in perspective regarding clinical prioritization and desirable response times. This has a number of important consequences including unnecessary interruptions, escalating conflict and deterioration in interprofessional relationships. Understanding the differing perspectives on clinical prioritization, or the gap in perceived urgency, may improve interprofessional relationships. We conducted a mixed-methods study utilizing both qualitative (semi-structured interviews) and quantitative (surveys) methods to determine the gap between perceived urgency among physicians and nurses. The survey comprised of real messages extracted from the clinical communication system that was implemented. Physicians and nurses reviewed the messages and assigned an urgency level to each. The semi-structured interviews used open-ended questions to act as a guide to highlight key themes of interest. Thematic analysis, frequency tabulation, and triangulation were used to analyze the data. Although the surveys demonstrated concordance between physicians and nurses when independently ranking the urgency of clinical messages (kappa=0.66 SE 0.15), agreement was only fair in comparison to the urgency identified by the original nurse who sent the message (kappa=0.22 SE 0.18). We hypothesize that clinical context has a major role in defining urgency and may explain this finding. The survey data was triangulated with the semi-structured interview data and it was determined that the desired response time significantly impacted the sender's message prioritization. For example, shift changes and anxious family members were associated with discordant prioritizations. This study demonstrated that the perceived communication urgency gap between sending nurses and receiving physicians was primarily related to timeframe and context, not clinical condition. Most disagreement occurred when nurses used urgent messaging for time sensitive but not clinically urgent issues in an effort to expedite the resolution of their issue by the physicians. These results indicate the need for clinical communication systems to incorporate decision support around both clinical prioritization and expected response time in their design. Effective interprofessional communication is essential to the provision of safe, quality-based healthcare; these results highlight some of the sociotechnical aspects of health information technology implementation that must be considered. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Understanding what matters most to people with multiple myeloma: a qualitative study of views on quality of life

PubMed Central

2014-01-01

Background Multiple myeloma is an incurable haematological cancer that affects physical, psychological and social domains of quality of life (QOL). Treatment decisions are increasingly guided by QOL issues, creating a need to monitor QOL within clinical practice. The development of myeloma-specific QOL questionnaires has been limited by a paucity of research to fully characterise QOL in this group. Aims of the present study are to (1) explore the issues important to QOL from the perspective of people with multiple myeloma, and (2) explore the views of patients and clinical staff on existing QOL questionnaires and their use in clinical practice. Methods The ‘Issues Interviews’ were semi-structured qualitative interviews to explore the issues important to QOL in a purposive sample of myeloma patients (n = 20). The ‘Questionnaire Interviews’ were semi-structured qualitative interviews in a separate purposive sample of myeloma patients (n = 20) to explore views on existing QOL questionnaires and their clinical use. Two patient focus groups (n = 7, n = 4) and a focus group of clinical staff (n = 6) complemented the semi-structured interviews. Thematic content analysis resulted in the development of a theoretical model of QOL in myeloma. Results Main themes important to QOL were Biological Status, Treatment Factors, Symptoms Status, Activity & Participation, Emotional Status, Support Factors, Expectations, Adaptation & Coping and Spirituality. Symptoms had an indirect effect on QOL, only affecting overall QOL if they impacted upon Activity & Participation, Emotional Status or Support Factors. This indirect relationship has implications for the design of QOL questionnaires, which often focus on symptom status. Health-service factors emerged as important but are often absent from QOL questionnaires. Sexual function was important to patients and difficult for clinicians to discuss, so inclusion in clinical QOL tools may flag hidden problems and facilitate better care. Patients and staff expressed preferences for questionnaires to be no more than 2 pages long and to include a mixture of structured and open questions to focus the goals of care on what is most important to patients. Conclusion Existing QOL questionnaires developed and validated for use in myeloma do not capture all that is important to patients and may not be well suited to clinical use. PMID:25005145

Can nurse teachers manage student incivility by guided democracy? A grounded theory study.

PubMed

Rad, Mostafa; Karimi Moonaghi, Hossein; Ildarabadi, Eshagh

2017-07-17

Managing incivility in academic settings is among the basic concerns and challenges of most educational systems, including nursing education. Incivility management cannot be considered devoid of disruptive behaviors. However, incivility management is a complexphenomenon upon which few studies are conducted. The present study aims at discovering teachers and students' experiences regarding incivility and developing an approach to manage nursing students' incivility. The present study was conducted based on the qualitative research design of the grounded theory methodology. This study was conducted at schools of nursing in academic settings in Iran. Study participants in the present study include nurse teachers (N=20) and nursing students (N=9). In-depth semi-structured interviews were conducted using theoretical and purposive sampling. Constant comparative analysis was used for data analysis. The results include four main categories; (1) deterioration of learning; (2) dominant individual and organisational culture; (3) guided democracy; and (4) movement toward professionalism. Guided democracy is recognised as the main basic psychosocial process for incivility management. Incivility management is pursued to help learners develop professional performance. As indicated by the results of the present study, guided democracy is an effective strategy for incivility management in nursing education. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

"New Choices" for women with addictions: perceptions of program participants

PubMed Central

Sword, Wendy; Niccols, Alison; Fan, Aimei

2004-01-01

Background Substance use in pregnancy is a major public health problem. It can have profound effects on pregnancy outcomes, and childhood health and development. Additionally, women who use substances have their own health-related issues. Although intervention is important, these women often have difficulty using traditional systems of care. The New Choices program is a centralized, multi-sector approach to service delivery that has attempted to overcome barriers to care by offering one-stop shopping in a supportive environment. As part of an evaluation of this program designed for women who are pregnant and/or parenting young children, interviews were conducted with participants to gain insight into their experiences in New Choices and perceptions of any changes attributed to program involvement. Methods A qualitative, exploratory design was used to guide data collection and analysis. Four women participated in a focus group interview and seven women agreed to individual interviews over the course of the program evaluation (N = 11). A semi-structured interview guide was used to explore women's experiences in New Choices and their perceptions of the program and its impact. The interview data were analyzed using NVivo software and an inductive approach to data analysis. Results The emergent themes captured women's motivations for attending New Choices, benefits of participation, and overall quality of the program. Children were the primary motivating factor for program enrollment. Perceived benefits included decreased substance use, improved maternal health, enhanced opportunity for employment, increased access to other resources, enhanced parenting skills, and improved child behaviour and development. Women highly valued the comprehensive and centralized approach to service delivery that provided a range of informal and formal supports. Conclusions Interview findings endorse the appropriateness and potential efficacy of a collaborative, centralized approach to service provision for women with substance use issues. Although the findings provide insight into an alternative model of service delivery for women with addictions, future research is needed to evaluate the effectiveness of the intervention. Research also is needed to determine which program components or constellation of components contribute to desired outcomes, and to learn more about processes that underlie changes in behaviour. PMID:15086957

Nursing attitudes toward patients with substance use disorders in pain.

PubMed

Morgan, Betty D

2014-03-01

The problem of inadequate pain management in hospitals is well documented. Patients who have substance use disorders (SUD) have many medical problems and are often in pain as a result of these problems. Nurses often lack knowledge of appropriate treatment of both pain and SUD, and have been identified as having negative attitudes toward patients with SUD. The negative attitudes may affect the quality of care delivered to patients with problems of pain and SUD. The purpose of this study was to identify and explore nurses' attitudes toward hospitalized patients with SUD who are in pain, to expand the knowledge about nurses' attitudes and interactions with patients with SUD in pain, and to generate theory that will contribute to a greater understanding of the problem. Grounded theory methodology was used to interview hospital-based nurses who work with patients with SUD who are in pain. Individual interviews, using a semistructured interview guide, were conducted with 14 nurses who worked with this population. Additionally, an expert addictions nurse was interviewed at the end of the study to validate the findings. Interviews were analyzed and coded with the use of grounded theory concepts. A model illustrating the categories and their relationships was developed based on the theory generated as a result of the study. The implications for nursing practice, education, research, and policy are discussed. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Residents' perceptions of their own sadness--a qualitative study in Norwegian nursing homes.

PubMed

Iden, Kristina Riis; Ruths, Sabine; Hjørleifsson, Stefan

2015-03-08

Mood symptoms are highly prevalent among frail old people residing in nursing homes. Systematic diagnostics of depression is scarce, and treatment is not always in accordance with best evidence. The distinction between non-pathological sadness and depression may be challenging, and we know little of the older peoples' perspectives. The aim of this qualitative interview study was to explore residents' perceptions of their own sadness. We performed individual, semi-structured interviews with twelve older people residing in nursing homes with no dementia. The interview guide comprised questions on what made the informants sad and what prevented sadness. We recorded, transcribed verbatim and analysed the interviews using systematic text condensation. The interviews revealed three main themes. I. Decay and loss of agency. The informants perceived their sadness to be caused by loss of health and functional ability, reliance on long-term care, dysfunctional technical aids and poor care. II. Loneliness in the middle of the crowd. Loss of family and friends, and lack of conversations with staff members and fellow patients were also sources of sadness. III. Relating and identity. The informants kept sadness at bay through: acceptance and re-orientation to their current life situation, maintaining narratives about their identity and belonging, and religiosity. Nursing home nurses and doctors should identify and respond to sadness that is a rational response to manageable causes. Further, identifying and supporting residents' resources and coping strategies is a salutogenetic approach that may alleviate sadness.

International perspectives on sharing clinical data with patients.

PubMed

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

2016-02-01

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

Residents' experiences of relationships with nurses in community-based supported housing - a qualitative study based on Giorgi's method of analysis and self psychology.

PubMed

Rønning, Solrun Brenk; Bjørkly, Stål

2017-01-01

One of the prioritizations in the World Health Organization's (WHO) Mental Health Action Plan 2013-2020 is the provision of community mental health and social care services, such as supported housing. The ongoing process of such deinstitutionalization has raised issues concerning the impact on users' quality of life. The purpose of this study was to explore how residents in supported housing experience receiving professional help and how they perceived their relationships with nurses. The second aim was to investigate the relevance of Giorgi's method of analysis and self psychology in analyzing these experiences. Four residents were interviewed individually. The interviews were based on a semi-structured interview guide and analyzed by Giorgi's method of analysis. Relations were interpreted within self psychology. The residents reported that they not only felt safe in the community but also felt a greater awareness of wanting to appear normal. They seemed to have an easier daily life and felt that the personnel met their selfobject needs when routines allowed for it. Professional awareness of empathic attunement and selfobject roles might enhance residents' self-cohesiveness. The interviews were analyzed by Giorgi's method of analysis, and the use of clinical concepts from self psychology was chosen to achieve a more dynamic understanding of the participants' relational experiences and needs in supported housing.

The experiences of health-related quality of life in patients with nonspecific symptoms who undergo a diagnostic evaluation for cancer: a qualitative interview study.

PubMed

Moseholm, Ellen; Lindhardt, Bjarne Oerskov; Rydahl-Hansen, Susan

2017-09-01

The diagnostic phase of cancer can affect health-related quality of life (HRQoL). The aim of this study was to investigate how patients with nonspecific symptoms experience HRQoL while undergoing diagnostic evaluations for cancer. Twenty-one participants who had completed a fast-track evaluation for possible cancer at one of three hospitals in the Capital Region, Denmark were interviewed 2-4 weeks after completing diagnostic evaluations. The interviews were semi-structured and were supported by an interview guide based on the same themes as in The European Organisation for Research and Treatment of Cancer Quality of Life questionnaire (EORCT-QLQ-C30). Data analysis was based on qualitative content analysis by Krippendorff. The analysis generated six categories: symptoms, physical-, role-, emotional-, cognitive- and social functioning, and the diagnostic fast-track experience. From these categories, a main theme was identified: Health-related quality of life is not solely affected by the diagnostic process. The results provide a comprehensive understanding of HRQoL in the diagnostic phase of possible cancer, which can be used not only to enhance evidence-based care, but also in the interpretation of the EORTC-QLQ-C30 scores. Psycho-social support with a focus on individual informational needs during the diagnostic phase may be warranted. © 2016 Nordic College of Caring Science.

A human factors systems approach to understanding team-based primary care: a qualitative analysis

PubMed Central

Mundt, Marlon P.; Swedlund, Matthew P.

2016-01-01

Background. Research shows that high-functioning teams improve patient outcomes in primary care. However, there is no consensus on a conceptual model of team-based primary care that can be used to guide measurement and performance evaluation of teams. Objective. To qualitatively understand whether the Systems Engineering Initiative for Patient Safety (SEIPS) model could serve as a framework for creating and evaluating team-based primary care. Methods. We evaluated qualitative interview data from 19 clinicians and staff members from 6 primary care clinics associated with a large Midwestern university. All health care clinicians and staff in the study clinics completed a survey of their communication connections to team members. Social network analysis identified key informants for interviews by selecting the respondents with the highest frequency of communication ties as reported by their teammates. Semi-structured interviews focused on communication patterns, team climate and teamwork. Results. Themes derived from the interviews lent support to the SEIPS model components, such as the work system (Team, Tools and Technology, Physical Environment, Tasks and Organization), team processes and team outcomes. Conclusions. Our qualitative data support the SEIPS model as a promising conceptual framework for creating and evaluating primary care teams. Future studies of team-based care may benefit from using the SEIPS model to shift clinical practice to high functioning team-based primary care. PMID:27578837

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

PubMed Central

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

2017-01-01

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

Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hosptal

PubMed Central

Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M.

2015-01-01

Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused group discussion. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0. Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education and adolescent awareness about existence of friendly health services offered were significantly associated with utilization at p<0.05. Long queues, unfavorable working hours and lack of money negatively affected consumption of AFHS.The study concluded that the utilization of health services among the adolescents was low largely due to unfriendliness of the health care providers at health facilities and lack of awareness of AFHS services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of AFHS and ensure that the recommendations of Adolescent Package of care is implemented fully with good evaluation strategies in place. Laborious awareness drives to sensitize the adolescents about the available services through rigorous health education and increased involvement of both parents/guardians and teachers to scale up implementation are also recommended. PMID:26153176

Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hospital.

PubMed

Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M

2015-03-25

Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused group discussion. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0. Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education and adolescent awareness about existence of friendly health services offered were significantly associated with utilization at p<0.05. Long queues, unfavorable working hours and lack of money negatively affected consumption of AFHS. The study concluded that the utilization of health services among the adolescents was low largely due to unfriendliness of the health care providers at health facilities and lack of awareness of AFHS services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of AFHS and ensure that the recommendations of Adolescent Package of care is implemented fully with good evaluation strategies in place. Laborious awareness drives to sensitize the adolescents about the available services through rigorous health education and increased involvement of both parents/guardians and teachers to scale up implementation are also recommended.

Use of Evidence in the Implementation of Social Programs: A Qualitative Study from Chile.

PubMed

Flores, Rodrigo; Naranjo, Carola; Hein, Andreas

2016-01-01

Through this qualitative, empirical study the authors aim to explore and describe the sources of knowledge that are used to guide intervention practice by social workers in Chile. Particular attention was paid to factors that may facilitate or hinder the use of research-based evidence to guide social interventions design, implementation, and outcome evaluation. In order to explore these issues, 25 semi-structured interviews with social workers from Chilean social service non-profit organizations were conducted. The main findings suggest that social workers do not use research-based evidence to support their social interventions due to various personal organizational constraints (e.g., lack of time, lack of access to resources for disseminating evidence, lack of English command). In addition, no evaluation processes of social programs which will support evidence-based effectiveness could be found. One key barrier to support use of evidence and evidence production may be related to the fact that most non-governmental organizations maintain a hierarchical and vertical relationship with state agencies (program design, oversight, and funding) for social program development.

Social knowledge and the construction of drinking water preference.

PubMed

Soares, Ana Carolina Cordeiro; Carmo, Rose Ferraz; Bevilacqua, Paula Dias

2017-10-01

The analytical categories of Health Surveillance territorialization and daily life guided the design of this study, which aimed to understand from the methodological framework of qualitative research the factors involved in the use of individual supply solutions (ISS) as drinking water sources. We conducted semi-structured interviews with residents of 22 households set at a municipality in the Zona da Mata Mineira. Statements were fully transcribed, processed through content analysis and interpreted based on the psychosocial theory of social representations. It was possible to apprehend the social and affective components of social representations. The social component characterized by the representation of water from IWSS ISS water as clean and of good quality seemed to drive or justify the "resistance" of individuals to use water from public supply. The affective component referred to the use of IWSS water from ISS as a return to and protection of individuals' origins, a way to strengthen respondents' identity. The results pointed out that people's perceptions and demands might guide actions aimed to stimulate trust in the use of public system water and the choice of this source of supply, contributing to health protection.

A purposeful Yet Nonimposing Approach: How Japanese Home Care Nurses Establish Relationships With Older Clients and Their Families.

PubMed

Iwasaki, Takako; Yamamoto-Mitani, Noriko; Sato, Kana; Yumoto, Yoshie; Noguchi-Watanabe, Maiko; Ogata, Yasuko

2017-11-01

Relationship development is crucial to nursing practice with families. However, little is known about the process of building relationships with multiple family members in home care settings and in various cultures. The objective of this study was to explore the experiences of home care nurses about how they established relationships with older clients and their families in Japan. Grounded theory was used to guide the research. Twenty-three expert home care nurses participated in semistructured interviews concerning their family nursing practice. The establishment of relationships with clients/family members was based on a purposeful yet nonimposing approach composed of four aspects: keeping a mindful distance from the family, not being a threat to family life, being a comfortable neighbor, and gaining trust as a competent nurse. Through a purposeful nonimposing approach, Japanese home care nurses promoted and nurtured nurse-family relationships and became involved in the life of the family. These findings provide a useful foundation to guide practice with families and grow knowledge about the process of establishing relationships with multiple family members in home settings.

The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

PubMed Central

2014-01-01

Background The potential of clinical practice guidelines has not been realized due to inconsistent adoption in clinical practice. Optimising intrinsic characteristics of guidelines (e.g., its wording and format) that are associated with uptake (as perceived by their end users) may have potential. Using findings from a realist review on guideline uptake and consultation with experts in guideline development, we designed a conceptual version of a future tool called Guideline Implementability Tool (GUIDE-IT). The tool will aim to involve family physicians in the guideline development process by providing a process to assess draft guideline recommendations. This feedback will then be given back to developers to consider when finalizing the recommendations. As guideline characteristics are best assessed by end-users, the objectives of the current study were to explore how family physicians perceive guideline implementability, and to determine what components should comprise the final GUIDE-IT prototype. Methods We conducted a qualitative study with family physicians inToronto, Ontario. Two experienced investigators conducted one-hour interviews with family physicians using a semi-structured interview guide to 1) elicit feedback on perceptions on guideline implementability; 2) to generate a discussion in response to three draft recommendations; and 3) to provide feedback on the conceptual GUIDE-IT. Sessions were audio taped and transcribed verbatim. Data collection and analysis were guided by content analyses. Results 20 family physicians participated. They perceived guideline uptake according to facilitators and barriers across 6 categories of guideline implementability (format, content, language, usability, development, and the practice environment). Participants’ feedback on 3 draft guideline recommendations were grouped according to guideline perception, cognition, and agreement. When asked to comment on GUIDE-IT, most respondents believed that the tool would be useful, but urged to involve “regular” or community family physicians in the process, and suggested that an online system would be the most efficient way to deliver it. Conclusions Our study identified facilitators and barriers of guideline implementability from the perspective of community and academic family physicians that will be used to build our GUIDE-IT prototype. Our findings build on current knowledge by showing that family physicians perceive guideline uptake mostly according to factors that are in the control of guideline developers. PMID:24476491

Designing for health in school buildings: between research and practice.

PubMed

Kirkeby, Inge Mette; Jensen, Bjarne Bruun; Larsen, Kristian; Kural, René

2015-05-01

To investigate the kinds of knowledge practitioners use when planning and designing for health in school buildings. Twelve semi-structured qualitative interviews were conducted with architects, teachers and officials to investigate use of knowledge in the making of school buildings. Practitioners drew on many kinds and sources of knowledge, but in particular they made use of concepts, examples or pictures or thought-provoking knowledge. However, the interviews indicate a number of hurdles for efficient knowledge sharing between research and practice: (1) a considerable discrepancy between kinds of knowledge used by practice and knowledge traditionally produced by research; (2) research-knowledge and practice-knowledge form two circuits and the flow from one circuit to the other is weak; (3) practitioners' knowledge was often based on experience and therefore person-dependent. It makes the knowledge vulnerable. Special attention has to be paid by research to concepts and principles to guide the decision-making in practice. Further is recommended to consider new kinds of collaboration between researchers and practitioners. © 2015 the Nordic Societies of Public Health.

Quantitative and qualitative testing of DARWeb: An online self-guided intervention for children with functional abdominal pain and their parents.

PubMed

Nieto, Rubén; Boixadós, Mercè; Hernández, Eulàlia; Beneitez, Imma; Huguet, Anna; McGrath, Patrick

2018-06-01

The main objective of this study was to preliminary explore the effects of DARWeb on different outcomes. A Quasi-experimental, one-group, pretest-posttest design was used. Parents and children were asked to complete questionnaires and questions (separately) about quality of life, abdominal pain severity, and satisfaction. Semi-structured interviews with families were also performed. This study focuses on 17 families. Results showed that parent's ratings of children's abdominal pain severity were significantly lower after finishing the intervention and at the 3-month follow-up, and quality of life scores had increased significantly after 3 months. From children's ratings, mean abdominal pain severity scores were significantly lower after the intervention compared to the preintervention assessment. Both parents and children were quite satisfied with the intervention. In qualitative interviews, families suggested that DARWeb helped them to give less importance to pain and to learn coping strategies. In conclusion, this study showed the potential usefulness of DARWeb for children with functional abdominal pain and for their parents.

Global meaning in people with spinal cord injury: Content and changes

PubMed Central

Littooij, Elsbeth; Widdershoven, Guy A.M.; Stolwijk-Swüste, Janneke M.; Doodeman, Suzan; Leget, Carlo J.W.; Dekker, Joost

2016-01-01

Background After spinal cord injury (SCI), people are confronted with abrupt discontinuity in almost all areas of life, leading to questions on how to live a meaningful life again. Global meaning refers to basic ideas and goals that guide people in giving meaning to their lives, in specific situations. Little is known about global meaning relating to SCI and whether global meaning changes after SCI. Purpose The purpose of this study was twofold: (i) to explore the content of global meaning of people with SCI, and (ii) to explore whether or not global meaning changes after SCI. Methods In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed according to the method of grounded theory. Results (i) Five aspects of global meaning were found: core values, relationships, worldview, identity and inner posture. (ii) Overall, little change in the content of global meaning was found after SCI; specific aspects of global meaning were foregrounded after SCI. Conclusion Five aspects of global meaning were found in people with SCI. Global meaning seems hardly subject to change. PMID:25615571

A Conceptual Framework for the Evaluation of Emergency Risk Communications

PubMed Central

Lin, Leesa; Gamhewage, Gaya M.

2017-01-01

Objectives. To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). Methods. The framework proposed is based on a systematic review of the scientific literature (2001–2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. Results. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees’ data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Conclusions. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies. PMID:28892436

Enhanced Patient-Centred Care: Physiotherapists' Perspectives on the Impact of International Clinical Internships on Canadian Practice.

PubMed

Mesaroli, Giulia; Bourgeois, Anne-Marie; McCurry, Ellen; Condren, Allison; Petropanagos, Peter; Fraser, Michelle; Nixon, Stephanie A

2015-01-01

To explore the perspectives of physiotherapists who participated in an international clinical internship (ICI) in low- or middle-income countries (LMICs) during their physiotherapy (PT) training in a Canadian PT programme regarding the ICI's impact on their PT practice in Canada. This qualitative descriptive study used in-depth semi-structured interviews. Data were organized using NVivo; inductive and deductive coding were used to analyze data and develop broader themes. The 13 practising Canadian physiotherapists interviewed described three enhanced capacities: (1) critical reflection on culture, values and practice; (2) communication skills; and (3) creativity and resourcefulness. These capacities were perceived to transfer to Canadian practice by enhancing participants' ability to deliver patient-centred care, specifically through an enhanced understanding of patients' values and social determinants of health, regardless of the Canadian setting or patient population. For PT students considering an ICI, the study findings provide insight into the perceived impact of ICIs on Canadian practice. For PT academic programmes, the findings can guide decisions on the extent of investment in ICIs as learning opportunities that will enhance practice in Canada.

A Conceptual Framework for the Evaluation of Emergency Risk Communications.

PubMed

Savoia, Elena; Lin, Leesa; Gamhewage, Gaya M

2017-09-01

To articulate a conceptual framework in support of evaluation activities in emergency risk communications (ERC). The framework proposed is based on a systematic review of the scientific literature (2001-2016) combined with data derived from a series of semistructured interviews with experts and practitioners in ERC, and it is designed to support local, national, and international public health organizations in implementing evaluation studies in ERC. We identified a list of ERC outcomes from the full-text review of 152 articles and categorized these into 3 groups, depending upon the level at which the outcome was measured: (1) information environment, (2) population, and (3) public health system. We analyzed interviewees' data from 18 interviews to identify practices and processes related to the effectiveness of ERC and included these as key structural components and processes in the developed evaluation framework. Researchers and public health practitioners interested in the evaluation of ERC can use the conceptual framework described in this article to guide the development of evaluation studies and methods for assessing communication outcomes related to public health emergencies.

Understanding the social and community support networks of American Indian women cancer survivors.

PubMed

Burnette, Catherine E; Liddell, Jessica; Roh, Soonhee; Lee, Yeon-Shim; Lee, Hee Yun

2018-04-02

Cancer is the leading cause of death among American Indian and Alaska Native (AI/AN) women, and although cancer disparities among AI women are alarming, there is little research focused on the topic of social support and cancer treatment and outcomes. A community advisory board was used to develop and administer the project, and a qualitative descriptive study methodology was used. This research was conducted in partnership with two community-based hospitals in the Northern Plains. The sample included 43 AI female cancer survivors who were interviewed with a semi-structured interview guide. The data were analyzed using content analysis. Emergent themes revealed that AI cancer survivors' non-familial support systems included friends (n = 12), support groups (n = 6), churches (n = 10), co-workers (n = 5), communities (n = 4), support from health practitioners (n = 3) and additional forms of support. Results indicate that survivors' networks are diverse, and support broad prevention programs that reach out to churches, community groups, and online forums. These sources of supports can be enhanced through sustainable community-based infrastructures.

Children's experiences of dental anxiety.

PubMed

Morgan, Annie G; Rodd, Helen D; Porritt, Jenny M; Baker, Sarah R; Creswell, Cathy; Newton, Tim; Williams, Chris; Marshman, Zoe

2017-03-01

Dental anxiety is common among children. Although there is a wealth of research investigating childhood dental anxiety, little consideration has been given to the child's perspective. This qualitative study sought to explore with children their own experiences of dental anxiety using a cognitive behavioural therapy assessment model. Face-to-face, semi-structured interviews were conducted with dentally anxious children aged 11-16 years. The Five Areas model was used to inform the topic guide and analysis. Data were analysed using a framework approach. In total, 13 children were interviewed. Participants described their experiences of dental anxiety across multiple dimensions (situational factors and altered thoughts, feelings, physical symptoms, and behaviours). Participants placed considerable value on communication by dental professionals, with poor communication having a negative influence on dental anxiety and the dentist-patient relationship. This study confirms the Five Areas model as an applicable theoretical model for the assessment of childhood dental anxiety. Children provided insights about their own dental anxiety experiences that have not previously been described. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Optimizing the utility of military injury surveillance systems: a qualitative study within the Australian Defence Force.

PubMed

McKinnon, Adam D; Ozanne-Smith, Joan; Pope, Rodney

2009-05-01

Injury prevention guided by robust injury surveillance systems (ISS's) can effectively reduce military injury rates, but ISS's depend on human interaction. This study examined experiences and requirements of key users of the Australian Defence Force (ADF) ISS to determine whether the operation of the ISS was optimal, whether there were any shortcomings, and if so, how these shortcomings might be addressed. Semistructured interviews were conducted with 18 Australian Defence Department participants located throughout Australia. Grounded theory methods were used to analyze data by developing an understanding of processes and social phenomena related to injury surveillance systems within the military context. Interviews were recorded and professionally transcribed and information contained in the transcripts was analyzed using NVivo. Key themes relating to the components of an injury surveillance system were identified from the analysis. A range of processes and sociocultural factors influence the utility of military ISS's. These are discussed in detail and should be considered in the future design and operation of military ISS's to facilitate optimal outcomes for injury prevention.

The Imperative of Solving Nurses' Usability Problems With Health Information Technology.

PubMed

Staggers, Nancy; Elias, Beth L; Makar, Ellen; Alexander, Gregory L

2018-04-01

Health information technology (IT) usability issues are a key concern for nurse executives and nurses. The aims of this study are to understand usability pain points faced by nurses regarding the use of health IT, identify their impact and importance, discuss responsibilities, and develop possible solutions to improve the health IT-user experience for nurses. Twenty-seven experts were interviewed including nursing leaders, informaticists, executives, engineers, researchers, and human factors experts across acute care, long-term care, and vendor settings. Semistructured questions guided the interviews, and content analysis was used to identify themes. Four themes emerged: 1) user experience pain points, 2) importance of the issues, 3) the responsibility gap, and 4) acting on usability issues. Nurses continue to endure significant health IT-usability issues that negatively impact patients, nurses, and healthcare organizations. Solutions include enhancing the voice of nursing at the national and local levels, creating a digital strategy for nursing, providing incentives to improve usability in health IT, and accelerating the understanding of nurses' work intended to inform and translate nurses' work into health IT design.

Researchers’ Perceptions of the Ethical Implications of Pharmacogenomics Research with Children

PubMed Central

Avard, D.; Silverstein, T.; Sillon, G.; Joly, Y.

2009-01-01

Background This paper presents the results of an exploratory qualitative study that assesses Canadian pediatric researchers’ perceptions of a pre-selected group of ethical issues raised by pharmacogenomics research with children. Methods As a pilot study, we conducted semi-structured telephone interviews with Canadian pediatric pharmacogenomic researchers. The interviews were guided by the following themes: (1) benefits and risks of inclusion, (2) the consent/assent process, and (3) the return of research results. Results Issues about assent, consent, risks and benefits, as well as the communication of results were addressed by the respondents. Some issues, such as the unique vulnerability of children, the long term privacy concerns associated with biobanking, additional core elements that need to be discussed and included in the consent/assent forms, as well as the challenges of communicating research results in a pediatric research were not explicitly identified by the respondents. Conclusion Further consideration should be given to address the ethical challenges of including children in pharmacogenomics research. This exploratory study indicates that further guidance is needed if children are to be protected and yet benefit from such research. PMID:19204423

An exploratory study of the socio-cultural risk influences for cigarette smoking among Southern Nigerian youth.

PubMed

Egbe, Catherine O; Petersen, Inge; Meyer-Weitz, Anna; Oppong Asante, Kwaku

2014-11-22

The increase in smoking prevalence in developing countries including Nigeria has been mainly blamed on the aggressive marketing strategies of big tobacco companies. There is a paucity of research on other socio-cultural risk factors for smoking among the youth. The main objective of this study is to explore and describe socio-cultural risk factors influencing cigarette smoking among the youth in Southern Nigeria. A total of 27 respondents (5 community leaders, 4 political analysts and 18 young cigarette smokers) were interviewed using a semi-structured interview guide. Interpretative Phenomenological Analysis (IPA) was used to analyse the data. Social-cultural practices fuelling early usage and exposure of children to cigarettes and the promotional activities of tobacco companies were identified as possible factors influencing youth's smoking behaviour in Southern Nigeria. Tobacco control policies should include cultural interventions to modify current traditional practices and social norms which fuel the use of tobacco in the society. Such interventions must target specific groups, subpopulations and subcultures more exposed to the cultural risk influences for smoking.

A qualitative study of Australians' opinions about personally controlled electronic health records.

PubMed

Lehnbom, Elin C; McLachlan, Andrew; Brien, Jo-Anne E

2012-01-01

A personally controlled electronic health record (PCEHR) system is being implemented in Australia. Every Australian that wants a PCEHR will be able to opt-in from July 2012. To explore the opinions of Australian consumers and healthcare providers about the PCEHR. In this qualitative study, consumers and healthcare providers were interviewed using a semi-structured interview guide. Perceived benefits identified by participants regarding the PCEHR included instant access to clinical information, and safer and more efficient healthcare delivery. The risk of unauthorised access and breaches of privacy were some of the perceived drawbacks. Although consumers seemed unwilling to opt-in to have a PCEHR, the vast majority of healthcare providers were positive towards this development and predicted better and safer healthcare as a result. Consumers and healthcare providers appeared uniformed about the imminent PCEHR. The wide-spread unwillingness among participants to opt-in to have a PCEHR could potentially jeopardise successful implementation and uptake of this system. A well-designed system without security glitches and with individualised information from trusted healthcare providers regarding the benefits of having a PCEHR appears critical in engaging consumer opt-in.

An Expert Map of Gambling Risk Perception.

PubMed

Spurrier, Michael; Blaszczynski, Alexander; Rhodes, Paul

2015-12-01

The purpose of the current study was to investigate the moderating or mediating role played by risk perception in decision-making, gambling behaviour, and disordered gambling aetiology. Eleven gambling expert clinicians and researchers completed a semi-structured interview derived from mental models and grounded theory methodologies. Expert interview data was used to construct a comprehensive expert mental model 'map' detailing risk-perception related factors contributing to harmful or safe gambling. Systematic overlapping processes of data gathering and analysis were used to iteratively extend, saturate, test for exception, and verify concepts and emergent themes. Findings indicated that experts considered idiosyncratic beliefs among gamblers result in overall underestimates of risk and loss, insufficient prioritization of needs, and planning and implementation of risk management strategies. Additional contextual factors influencing use of risk information (reinforcement and learning; mental states, environmental cues, ambivalence; and socio-cultural and biological variables) acted to shape risk perceptions and increase vulnerabilities to harm or disordered gambling. It was concluded that understanding the nature, extent and processes by which risk perception predisposes an individual to maintain gambling despite adverse consequences can guide the content of preventative educational responsible gambling campaigns.

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

ERIC Educational Resources Information Center

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

2011-01-01

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

An Investigation of the Nontechnical Skills Required to Maximize the Safety and Productivity of U.S. Navy Divers

DTIC Science & Technology

2005-04-01

experience. The critical incident interview uses recollection of a specific incident as its starting point and employs a semistructured interview format...context assessment, expectancies, and judgments. The four sweeps in the critical incident interview include: Sweep 1 - Prompting the interviewee to

Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries.

PubMed

Broda, Anja; Bieber, Anja; Meyer, Gabriele; Hopper, Louise; Joyce, Rachael; Irving, Kate; Zanetti, Orazio; Portolani, Elisa; Kerpershoek, Liselot; Verhey, Frans; Vugt, Marjolein de; Wolfs, Claire; Eriksen, Siren; Røsvik, Janne; Marques, Maria J; Gonçalves-Pereira, Manuel; Sjölund, Britt-Marie; Woods, Bob; Jelley, Hannah; Orrell, Martin; Stephan, Astrid

2017-08-03

As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.

Barriers to physical activity: qualitative data on caregiver-daughter perceptions and practices.

PubMed

Gordon-Larsen, Penny; Griffiths, Paula; Bentley, Margaret E; Ward, Dianne S; Kelsey, Kristine; Shields, Kenitra; Ammerman, Alice

2004-10-01

There is little research on household and physical environment barriers to physical activity, particularly in minority populations at high risk for obesity and inactivity. Few studies include data on caregiver and daughter dyads. Formative data were used to develop intervention strategies and pathways for the Girls Rule! obesity prevention intervention, in under-studied high-risk pre-adolescents. Participants included 12 African-American girls (mean age 7.8 years) and their 11 primary female caregivers (mean age 41.8 years)--eight mother-daughter dyads and three grandmother-granddaughter dyads--for a total of 51 interviews across 23 participants interviewed from April to October 2000.A qualitative approach was used for 51 semistructured in-depth interviews with 11 dyads (female caregiver and girl), consisting of up to three interviews per respondent (mean=2.4 interviews per respondent). Interviews were transcribed, coded, and systematically analyzed between January 2002 and January 2003 to identify recurrent patterns and themes related to physical activity. Findings indicate clear preference of the girls for sedentary, rather than active, behaviors. Caregivers were unaware of the amount of TV viewed and found positive benefits of TV viewing, including safe supervision of their daughters. Barriers to physical activity include perceived lack of affordable and accessible recreation facilities and low caregiver motivation. Potential intervention strategies identified by respondents include walking for exercise and transportation and several low-cost, favored physical activities, such as hopscotch, jumping rope, and dance. These findings point toward several physical activity and obesity intervention strategies that can guide obesity prevention efforts.

Exploring Patient Values in Medical Decision Making: A Qualitative Study

PubMed Central

Lee, Yew Kong; Low, Wah Yun; Ng, Chirk Jenn

2013-01-01

Background Patient decisions are influenced by their personal values. However, there is a lack of clarity and attention on the concept of patient values in the clinical context despite clear emphasis on patient values in evidence-based medicine and shared decision making. The aim of the study was to explore the concept of patient values in the context of making decisions about insulin initiation among people with type 2 diabetes. Methods and Findings We conducted individual in-depth interviews with people with type 2 diabetes who were making decisions about insulin treatment. Participants were selected purposively to achieve maximum variation. A semi-structured topic guide was used to guide the interviews which were audio-recorded and analysed using a thematic approach. We interviewed 21 participants between January 2011 and March 2012. The age range of participants was 28–67 years old. Our sample comprised 9 women and 12 men. Three main themes, ‘treatment-specific values’, ‘life goals and philosophies’, and ‘personal and social background’, emerged from the analysis. The patients reported a variety of insulin-specific values, which were negative and/or positive beliefs about insulin. They framed insulin according to their priorities and philosophies in life. Patients’ decisions were influenced by sociocultural (e.g. religious background) and personal backgrounds (e.g. family situations). Conclusions This study highlighted the need for expanding the current concept of patient values in medical decision making. Clinicians should address more than just values related to treatment options. Patient values should include patients’ priorities, life philosophy and their background. Current decision support tools, such as patient decision aids, should consider these new dimensions when clarifying patient values. PMID:24282518

An ethnobotanical survey of medicinal plants of Laos toward the discovery of bioactive compounds as potential candidates for pharmaceutical development

PubMed Central

Soejarto, D.D.; Gyllenhaal, C.; Kadushin, M.R.; Southavong, B.; Sydara, K.; Bouamanivong, S.; Xaiveu, M.; Zhang, H.-J.; Franzblau, S.G.; Tan, Ghee T.; Pezzuto, J.M.; Riley, M.C.; Elkington, B.G.; Waller, D.P.

2012-01-01

Context An ethnobotany-based approach in the selection of raw plant materials to study was implemented. Objective To acquire raw plant materials using ethnobotanical field interviews as starting point to discover new bioactive compounds from medicinal plants of the Lao People’s Democratic Republic. Methods Using semi-structured field interviews with healers in the Lao PDR, plant samples were collected, extracted, and bio-assayed to detect bioactivity against cancer, HIV/AIDS, TB, malaria. Plant species demonstrating activity were recollected and the extracts subjected to a bioassay-guided isolation protocol to isolate and identify the active compounds. Results Field interviews with 118 healers in 15 of 17 provinces of Lao PDR yielded 753 collections (573 species) with 955 plant samples. Of these 955, 50 extracts demonstrated activity in the anticancer, 10 in the anti-HIV, 30 in the anti-TB, and 52 in the antimalarial assay. Recollection of actives followed by bioassay-guided isolation processes yielded a series of new and known in vitro-active anticancer and antimalarial compounds from 5 species. Discussion Laos has a rich biodiversity, harboring an estimated 8000–11,000 species of plants. In a country highly dependent on traditional medicine for its primary health care, this rich plant diversity serves as a major source of their medication. Conclusions Ethnobotanical survey has demonstrated the richness of plant-based traditional medicine of Lao PDR, taxonomically and therapeutically. Biological assays of extracts of half of the 955 samples followed by in-depth studies of a number of actives have yielded a series of new bioactive compounds against the diseases of cancer and malaria. PMID:22136442

Engaging Stakeholders in Patient-Centered Outcomes Research Regarding School-Based Sealant Programs.

PubMed

Chi, Donald L; Milgrom, Peter; Gillette, Jane

2018-02-01

Purpose: The purpose of this study was to use qualitative methods to describe the key lessons learned during the stakeholder engagement stage of planning a randomized clinical trial comparing outcomes of silver diamine fluoride (SDF) as an alternative to pit-and-fissure sealants in a school-based delivery system. Methods: Eighteen caregivers and community-based stakeholders with involvement in the school-based sealant program Sealants for Smiles from the state of Montana, were recruited for this qualitative study. United States (U.S.) Patient-Centered Outcomes Research Institute (PCORI) methodology standards were used to develop two semi-structured interview guides consisting of 6 questions. One interview guide was used for telephone interviews with caregivers and the second was used for a stakeholder focus group. Content analytic methods were used to analyze the data. Results: All participants believed that a study comparing SDF and sealants was clinically relevant. Non-caregiver stakeholders agreed with the proposed primary outcome of the study (caries prevention) whereas caregivers also emphasized the importance of child-centered outcomes such as minimizing dental anxiety associated with dental care. Stakeholders described potential concerns associated with SDF such as staining and perceptions of safety and discussed ways to address these concerns through community engagement, appropriate framing of the study, proper consent procedures, and ongoing safety monitoring during the trial. Finally, stakeholders suggested dissemination strategies such as direct communication of findings through professional organizations and encouraging insurance plans to incentivize SDF use by reimbursing dental providers. Conclusions: Involving key stakeholders in early planning is essential in developing patient-centered research questions, outcomes measures, study protocols, and dissemination plans for oral health research involving a school-based delivery system. Copyright © 2018 The American Dental Hygienists’ Association.

Adapting qualitative research strategies to technology savvy adolescents.

PubMed

Mason, Deanna Marie; Ide, Bette

2014-05-01

To adapt research strategies involving adolescents in a grounded theory qualitative research study by conducting email rather than face-to-face interviews. Adolescent culture relies heavily on text-based communication and teens prefer interactions mediated through technology. Traditional qualitative research strategies need to be rethought when working with adolescents. Adapting interviewing strategies to electronic environments is timely and relevant for researching adolescents. Twenty three adolescents (aged 16-21) were interviewed by email. A letter of invitation was distributed. Potential participants emailed the researcher to convey interest in participating. If the inclusion criteria were met, email interviews were initiated. Participants controlled the interviews through their rate of response to interview questions. A grounded theory methodology was employed. Initial contact with participants reiterated confidentiality and the ability to withdraw from the study at any time. Interviews began with the collection of demographic information and a broad opening based on a semi-structured interview guide. All data were permissible, including text, photos, music, videos or outside media, for example YouTube. The participant was allowed to give direction to the interview after initial questions were posed. Email interviews continued until saturation was reached in the data. Participants were enthusiastic about email interviewing. Attrition did not occur. Email interviewing gave participants more control over the research, decreased power differentials between the adolescent and researcher, allowed the study to be adapted to cultural, linguistic and developmental needs, and maintained confidentiality. As participants said that email communication was slow and they preferred instant messaging, replication in faster-paced media is recommended. Repetition in face-to-face settings is warranted to evaluate how technology may have influenced the findings. Implications for practice/research Adolescents' use of the internet and their preference for textbased communication makes a compelling support for modifying traditional face-to-face qualitative investigations to reflect these changing contextual conditions.

"They Have to Adapt to Learn": Surgeons' Perspectives on the Role of Procedural Variation in Surgical Education.

PubMed

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2016-01-01

Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons' perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents. This qualitative study used a grounded theory-based analysis of observational and interview data. Observational data were collected in 3 tertiary care teaching hospitals in Ontario, Canada. Semistructured interviews explored potential procedural variations arising during the observations and prompts from an iteratively refined guide. Ongoing data analysis refined the theoretical framework and informed data collection strategies, as prescribed by the iterative nature of grounded theory research. Our sample included 99 hours of observation across 45 cases with 14 surgeons. Semistructured, audio-recorded interviews (n = 14) occurred immediately following observational periods. Surgeons endorsed the use of intersurgeon procedural variations to teach residents about adapting to the complexity of surgical practice and the norms of surgical culture. Surgeons suggested that residents' efforts to identify thresholds of principle and preference are crucial to professional development. Principles that emerged from the study included the following: (1) knowing what comes next, (2) choosing the right plane, (3) handling tissue appropriately, (4) recognizing the abnormal, and (5) making safe progress. Surgeons suggested that learning to follow these principles while maintaining key aspects of surgical culture, like autonomy and individuality, are important social processes in surgical education. Acknowledging intersurgeon variation has important implications for curriculum development and workplace-based assessment in surgical education. Adapting to intersurgeon procedural variations may foster versatility in surgical residents. However, the existence of procedural variations and their active use in surgeons' teaching raises questions about the lack of attention to this form of complexity in current workplace-based assessment strategies. Failure to recognize the role of such variations may threaten the implementation of competency-based medical education in surgery. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

PubMed Central

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2017-01-01

OBJECTIVE Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons’ perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents. DESIGN AND SETTING This qualitative study used a grounded theory-based analysis of observational and interview data. Observational data were collected in 3 tertiary care teaching hospitals in Ontario, Canada. Semistructured interviews explored potential procedural variations arising during the observations and prompts from an iteratively refined guide. Ongoing data analysis refined the theoretical framework and informed data collection strategies, as prescribed by the iterative nature of grounded theory research. PARTICIPANTS Our sample included 99 hours of observation across 45 cases with 14 surgeons. Semistructured, audio-recorded interviews (n = 14) occurred immediately following observational periods. RESULTS Surgeons endorsed the use of intersurgeon procedural variations to teach residents about adapting to the complexity of surgical practice and the norms of surgical culture. Surgeons suggested that residents’ efforts to identify thresholds of principle and preference are crucial to professional development. Principles that emerged from the study included the following: (1) knowing what comes next, (2) choosing the right plane, (3) handling tissue appropriately, (4) recognizing the abnormal, and (5) making safe progress. Surgeons suggested that learning to follow these principles while maintaining key aspects of surgical culture, like autonomy and individuality, are important social processes in surgical education. CONCLUSIONS Acknowledging intersurgeon variation has important implications for curriculum development and workplace-based assessment in surgical education. Adapting to intersurgeon procedural variations may foster versatility in surgical residents. However, the existence of procedural variations and their active use in surgeons’ teaching raises questions about the lack of attention to this form of complexity in current workplace-based assessment strategies. Failure to recognize the role of such variations may threaten the implementation of competency-based medical education in surgery. PMID:26705062

'I'll be in a safe place': a qualitative study of the decisions taken by people with advanced cancer to seek emergency department care.

PubMed

Henson, Lesley A; Higginson, Irene J; Daveson, Barbara A; Ellis-Smith, Clare; Koffman, Jonathan; Morgan, Myfanwy; Gao, Wei

2016-11-02

To explore the decisions of people with advanced cancer and their caregivers to seek emergency department (ED) care, and understand the issues that influence the decision-making process. Cross-sectional qualitative study incorporating semistructured patient and caregiver interviews. Between December 2014 and July 2015, semistructured interviews were conducted with 18 people with advanced cancer, all of whom had recently attended the ED of a large university teaching hospital located in south-east London; and six of their caregivers. Interviews were audio recorded, transcribed verbatim and analysed using a constant comparative approach. Padgett and Brodsky's modified version of the 'Behavioral Model of Health Services Use' was used as a framework to guide the study. Issues influencing the decision-making process included: (1) disease-related anxiety-those with greater anxiety related to their cancer diagnosis interpreted their symptoms as more severe and/or requiring immediate attention; (2) prior patterns of health-seeking behaviour-at times of crisis participants defaulted to previously used services; (3) feelings of safety and familiarity with the hospital setting-many felt reassured by the presence of healthcare professionals and monitoring of their condition; and, (4) difficulties accessing community healthcare services-especially urgently and/or out-of-hours. These data provide healthcare professionals and policymakers with a greater understanding of how systems of care may be developed to help reduce ED visits by people with advanced cancer. In particular, our findings suggest that the number of ED visits could be reduced with greater end-of-life symptom support and education, earlier collaboration between oncology and palliative care, and with increased access to community healthcare services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

New Possibilities in Life with Type 2 Diabetes: Experiences from Participating in a Guided Self-Determination Programme in General Practice.

PubMed

Karlsen, Bjørg; Rasmussen Bruun, Bettina; Oftedal, Bjørg

2018-01-01

Research suggests that guided self-determination programmes can support self-management of diabetes by empowering self-determined goal setting and competence building. As most research in this area has focused on people with type 1 diabetes, knowledge is lacking on how adults with type 2 diabetes mellitus experience participation in such programmes. This study reports the modelling phase of a complex intervention design that explored the experiences of adults with type 2 diabetes who participated in a nurse-led guided self-determination programme in general practice and examines how the programme affected patients' motivation to self-manage diabetes. The qualitative design with semistructured interviews included 9 adults with type 2 diabetes who participated in the programme. Qualitative content analysis was used to analyse the data. The findings indicate that the participants experienced new life possibilities after participating in the programme, which seemed to have a positive influence on their motivation for self-management. Through reflections about how to live with diabetes, the participants reinterpreted their life with diabetes by gradually developing a closer relationship with the disease, moving towards acceptance. The fact that dialogue with the nurses was seen to be on an equal footing helped support the participants to become more self-determined.

Understanding male cancer patients' barriers to participating in cancer rehabilitation.

PubMed

Handberg, C; Lomborg, K; Nielsen, C V; Oliffe, J L; Midtgaard, J

2015-11-01

The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors representing seven cancer types. Data were generated through a 5-month fieldwork study comprising participant observations, semi-structured individual interviews and informal conversations. The analyses revealed two overarching findings shedding light on male cancer survivors' barriers to rehabilitation: 'Fear of losing control' and 'Striving for normality'. While 'Fear of losing control' signified what the men believed rehabilitation would invoke: 'Reduced manliness', 'Sympathy and dependency' and 'Confrontation with death', 'Striving for normality' was based on what the men believed rehabilitation would hinder: 'Autonomy and purpose', 'Solidarity and fellowship' and 'Forget and move on'. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation. The findings can guide practice to develop research-based rehabilitation approaches focused on preserving control and normality. Further empirical evidence is needed to: (1) explore the conduct of health professionals' towards male cancer patients and (2) address gender inequalities in cancer rehabilitation. © 2015 John Wiley & Sons Ltd.

Emergency medical service attitudes toward geriatric prehospital care and continuing medical education in geriatrics.

PubMed

Peterson, Lars-Kristofer N; Fairbanks, Rollin J; Hettinger, Aaron Z; Shah, Manish N

2009-03-01

To understand the opinions of emergency medical service (EMS) providers regarding their ability to care for older adults, the domains of geriatric medicine in which they need more training, and the modality through which continuing education could be best delivered. Qualitative study using key informant interviews. Prehospital EMS system in Rochester, New York. EMS providers, EMS instructors and administrators, emergency physicians, and geriatricians. Semistructured interviews were conducted using an interview guide that addressed knowledge and skill deficiencies, recommendations for improvement of geriatrics continuing education, and delivery methods of education. Participant responses were generally congruous despite the diverse backgrounds, and redundancy was achieved rapidly. All participants perceived a deficit in EMS education on the care of older adults, particularly related to communications with patients and skilled nursing facility staff. All desired more geriatric continuing education for EMS providers, especially in communications and psychosocial issues. Education was desired in various modalities. Further geriatric continuing education for EMS providers is needed. Some specific topics relate to medical issues, but a large proportion involve communications and psychosocial issues. Education should be delivered in a variety of modalities to meet the needs of the EMS community. Emerging on-line video technologies may bridge the gap between learners preferring classroom-based modailities and those preferring self-study modules.

Hollywood on tobacco: how the entertainment industry understands tobacco portrayal.

PubMed

Shields, D L; Carol, J; Balbach, E D; McGee, S

1999-01-01

To determine how people in the California-based entertainment industry think about the portrayal of tobacco use in movies and on television. Specifically, to explore who decides when to include tobacco in a project; how that decision is made; what issues are considered; what messages are intended; whether and how the issue of second-hand smoke is considered; and what advocacy methods might be useful in influencing future decisions about tobacco portrayal. Qualitative in-depth interviews of entertainment industry personnel,with a semi-structured interview protocol to guide the interview. 54 subjects drawn from a convenience sample of writers, actors, directors, producers, studio executives, and others involved in the film industry. Hollywood is heterogeneous with varying perspectives on rates of tobacco use portrayal; intentionality of the decision to use and the necessity to portray tobacco use; and its degree of acceptance of responsibility for influencing societal smoking. Tobacco depiction may originate with the writer, actor, or director and is included most frequently to elucidate character or portray reality. On-camera smoking is influenced by actors' off-camera tobacco use. The research presented can help advocates better understand the norms and values of those working within the entertainment industry and thereby assist them in creating more effective change strategies.

The experiences of people with diabetes-related lower limb amputation at the Komfo Anokye Teaching Hospital (KATH) in Ghana.

PubMed

Amoah, Vida Maame Kissiwaa; Anokye, Reindolf; Acheampong, Enoch; Dadson, Helina Rubby; Osei, Mary; Nadutey, Alberta

2018-01-24

Lower limb amputation not only causes major disfigurement, but renders people less mobile and at risk of loss of independence. Yet with appropriate rehabilitation, many people can learn to walk or function again and live high quality lives. This study sought to explore the experiences of patients with diabetes-related lower limb amputation at the Komfo Anokye Teaching Hospital. An exploratory study design was adopted using a qualitative approach and a purposive sampling to select 10 participants for the study. A semi-structured interview guide was used with an in-depth face-to-face interview. The interview was tape-recorded with an audio recorder while notes were taken in addition to the audio recording. There were varying degrees of experiences ranging from physical as well as psychological and economic challenges. Amputees had to cope with playing entirely new roles after the amputation. They also experienced some economic challenges which were as a result of their inability to work. Some of the amputees consoled themselves with the fact that, despite their condition, they were better than other people. Others believed that whatever happened was Gods doing and nothing could be done about it. This self-consolation and the belief in God helped them to cope.

Factors influencing perceived sustainability of Dutch community health programs.

PubMed

Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

2015-09-01

We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Graduates' Perceptions of Learning Affordances in Longitudinal Integrated Clerkships: A Dual-Institution, Mixed-Methods Study.

PubMed

Latessa, Robyn A; Swendiman, Robert A; Parlier, Anna Beth; Galvin, Shelley L; Hirsh, David A

2017-09-01

The authors explored affordances that contribute to participants' successful learning in longitudinal integrated clerkships (LICs). This dual-institutional, mixed-methods study included electronic surveys and semistructured interviews of LIC graduates who completed their core clinical (third) year of medical school. These LIC graduates took part in LICs at Harvard Medical School from 2004 to 2013 and the University of North Carolina School of Medicine-Asheville campus from 2009 to 2013. The survey questions asked LIC graduates to rate components of LICs that they perceived as contributing to successful learning. A research assistant interviewed a subset of study participants about their learning experiences. The authors analyzed aggregate data quantitatively and performed a qualitative content analysis on interview data. The graduates reported multiple affordances that they perceive contributed to successful learning in their LIC. The most reported components included continuity and relationships with preceptors, patients, place, and peers, along with integration of and flexibility within the curriculum. As LIC models grow in size and number, and their structures and processes evolve, learners' perceptions of affordances may guide curriculum planning. Further research is needed to investigate to what degree and by what means these affordances support learning in LICs and other models of clinical education.

[Returning students' perspectives on adjusting to medical graduate school in Korea: an interview study].

PubMed

Park, So Youn; Kwon, Oh Young; Yoon, Tai Young

2015-03-01

The recent trend of switching from medical graduate school to medical school in Korea raises questions about the adjustments that students must make in medical education. We examined the perceptions of medical graduate students with regard to their adaptation in medical education. Sixteen semistructured, in-depth interviews were administered to medical graduate students who received their first degrees in foreign countries. The interviews addressed their perceptions of their experience in medical graduate school and on how well they adjusted to medical education. Students perceived their adaptation to medical graduate school in two dimensions: academic achievement and cultural adjustment. In academic achievement, a limited student-teacher relationship was recognized by students. Students tended to be passive in the classroom due to an uncomfortable atmosphere. They also reported witnessing culture shock in relation to the paucity of information on entrance into medical graduate school. Freshmen voiced many difficulties in adjusting to the unique culture in medical graduate school, in contrast to upper classmen. However, only 32% of students experienced helpful mentoring for their problems. Students' perspectives should guide all decisions made about medical education in an altered educational system.Self-regulated learning and a good mentoring program can help prepare students for medical education and professional life.

On understanding the nature of interpersonal conflict between coaches and athletes.

PubMed

Wachsmuth, Svenja; Jowett, Sophia; Harwood, Chris G

2018-09-01

Conflict is a part of coach-athlete relationships and should be carefully considered as it can have effects on the quality of coaching and the level of performance. Despite its practical relevance, there is a dearth of research around coach-athlete conflict. Therefore, the current study aimed to explore the characteristics and topics of conflict, as well as coaches and athletes' emotional, cognitive and behavioural experiences during conflict. A total of 22 independent coaches and athletes participated in semi-structured interviews evolving around the nature of interpersonal conflict. After all interviews were transcribed, a deductive-inductive content analysis was conducted. This was guided by the interview schedule as well as the by the conceptual framework of conflict in sport relationships (Wachsmuth, Jowett, & Harwood, 2017). Data were divided into five main categories: Conflict characteristics and conflict topics, as well as conflict cognitions, emotions, and behaviours. Findings highlighted the variety of ways in which participants understood and interpreted interpersonal conflict and how their impressions of conflict influenced its evolving process. Considering the participants' cognitive, emotional and behavioural expressions of conflict, it became apparent that conflict can be described through uncertain, escalating and problem-orientated responses. Practical applications concerning (mal-) adaptive responses to conflict are discussed. (199/200).

The President Clinton crisis and the Starr report: children's perceptions and parents' awareness.

PubMed

Kelley, B R; Beauchesne, M A; Babington, L M; Christensen, M H; Patsdaughter, C A

1999-01-01

The media have suggested that the President Clinton crisis, as publicized by the Starr Report, has had detrimental effects on school-age children. Parents, too, have been concerned that their children are confused about the presidential controversies involving dishonesty, mistrust, betrayal, infidelity, and misuse of authority. The purpose of this study was to explore the perceptions and reactions of school-age children to information surrounding the President Clinton situation, as well as parents' perceptions of their children's knowledge and reactions. A descriptive, qualitative design was used in this study. Data collection took place during the 2-week period following publication of the 1998 Starr Report. Fifty-one parents and 67 school-age children were interviewed using semi-structured interview guides with 5 open-ended questions addressing the President Clinton situation. Major themes that emerged from children's interviews were lying, getting caught, infidelity, and role modeling. Parents' awareness of their children's knowledge regarding the President Clinton situation varied; few were aware of the depth of knowledge their children had, nor had they discussed this situation with their children. Findings have relevance for nurse practitioners as they support parents in listening to and talking with their children about tough issues such as morality and sexuality in the context of real life events.

Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: A qualitative study.

PubMed

Ho, Siew Ching; Jacob, Sabrina Anne; Tangiisuran, Balamurugan

2017-01-01

One of the major challenges in treating major depressive disorder (MDD) is patients' non-adherence to medication. This study aimed to explore the barriers and facilitators of patients' adherence to antidepressants among outpatients with MDD. Semi-structured and individual in-depth interviews were conducted among patients with MDD who were taking antidepressants, in the psychiatric clinic of a government-run hospital in Malaysia. Participants were purposively sampled from different genders and ethnicities. Interviews were conducted using a validated topic guide, and responses were audio-recorded, transcribed verbatim, checked, and analyzed using the grounded theory approach. A total of 30 patients were interviewed. Forty different themes and sub-themes were identified which were conceptually divided into two distinct categories related to barriers and facilitators to adherence. The barriers were: patient-specific, medication-specific, healthcare provision and system, social-cultural, and logistics. The facilitators were: having insight, perceived health benefits, regular activities, patient-provider relationship, reminders, and social support networks. Patient-specific barriers and medication side effects were the major challenges for adhering to treatment. Perceived health benefits and having insight on the need for treatment were the most frequently cited facilitators. Targeted interventions should be developed to address the key barriers, and promote measures to facilitate adherence in this group of patients.

A Swedish interview study: parents' assessment of risks in home births.

PubMed

Lindgren, Helena; Hildingsson, Ingegerd; Rådestad, Ingela

2006-03-01

to describe home-birth risk assessment by parents. interviews using a semi-structured interview guide. Data were analysed using a phenomenological approach. independent midwifery practices in Sweden. five couples who had had planned home births. the parents had a fundamental trust that the birth would take place without complications, and they experienced meaningfulness in the event itself. Risks were considered to be part of a complex phenomenon that was not limited to births at home. This attitude seems to be part of a lifestyle that has a bearing on how risks experienced during the birth were handled. Five categories were identified as counterbalancing the risk of possible complications: (1) trust in the woman's ability to give birth; (2) trust in intuition; (3) confidence in the midwife; (4) confidence in the relationship; and (5) physical and intellectual preparation. although the parents were conscious of the risk of complications during childbirth, a fundamental trust in the woman's independent ability to give birth was central to the decision to choose a home birth. Importance was attached to the expected positive effects of having the birth at home. knowledge of parents' assessment can promote an increased understanding of how parents-to-be experience the risks associated with home birth.

Perceived barriers to completing an e-learning program on evidence-based medicine.

PubMed

Gagnon, Marie-Pierre; Légaré, France; Labrecque, Michel; Frémont, Pierre; Cauchon, Michel; Desmartis, Marie

2007-01-01

The Continuing Professional Development Center of the Faculty of Medicine at Laval University offers an internet-based program on evidence-based medicine (EBM). After one year, only three physicians out of the 40 who willingly paid to register had completed the entire program. This descriptive study aimed to identify physicians' beliefs regarding their completion of this online program. Using theoretical concepts from the Theory of Planned Behaviour, a semi-structured telephone interview guide was developed to assess respondents' attitudes, perceived subjective norms, perceived obstacles and facilitating conditions with respect to completing this internet-based program. Three independent reviewers performed content analysis of the interview transcripts to obtain an appropriate level of reliability. Findings were shared and organised according to theoretical categories of beliefs. A total of 35 physicians (88% response rate) were interviewed. Despite perceived advantages to completing the internet-based program, barriers remained, especially those related to physicians' perceptions of time constraints. Lack of personal discipline and unfamiliarity with computers were also perceived as important barriers. This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME) program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.

Attitudes and barriers towards HIV screening: A qualitative study of people living with HIV/AIDS (PLWHA) in Malaysia.

PubMed

Ahmed, Syed Imran; Syed Sulaiman, Syed Azhar; Hassali, Mohamed Azmi; Thiruchelvam, Kaeshaelya; Hasan, Syed Shahzad; Lee, Christopher Kc

2017-09-01

Understanding patients' perspective towards HIV screening in Malaysia is pivotal to explore challenges faced by these individuals. This would be beneficial for developing local plans to improve the health-seeking behaviours among population at risk of HIV/AIDS. A qualitative research methodology was adopted to explore HIV/AIDS patients' views about disease screening. A semi-structured interview guide was used for in-depth patient interviews. All interviews were audio-recorded and were subjected to a standard content analysis framework for data analysis. Most patients were positive about screening and the value of knowing about their status early. However, fear of social stigma, discrimination, lack of support system and lack of public understanding were identified as major concerns affecting their willingness to be screened. They were concerned about mandatory screening being implemented without improvement in support system and public education. Reluctance to seek HIV screening is an important factor contributing to transmission in developing countries. In the Malaysian context, efforts should be made to strengthen screening strategies especially in the most-at-risk populations to monitor the epidemic and target prevention strategies. In a multicultural context, HIV preventive strategies must include disease awareness, including measure to tackle barriers towards screening.

Home care packages: insights into the experiences of older people leading up to the introduction of consumer directed care in Australia.

PubMed

Day, Jenny; Taylor, Ann Clare Thorington; Summons, Peter; Van Der Riet, Pamela; Hunter, Sharyn; Maguire, Jane; Dilworth, Sophie; Bellchambers, Helen; Jeong, Sarah; Haydon, Gunilla; Harris, Margaret; Higgins, Isabel

2017-04-01

This paper reports phase one, conducted from March to June 2015, of a two-phase, qualitative descriptive study designed to explore the perceptions and experiences of older people before and after the introduction of consumer directed care (CDC) to home care packages (HCP) in Australia. Eligible consumers with a local HCP provider were mailed information about the study. Data collection occurred before the introduction of CDC and included face-to-face, in-depth interviews, summaries of interviews, field notes and reflective journaling. Semi-structured questions and 'emotional touchpoints' relating to home care were used to guide the interview conversation. Line-by-line data analysis, where significant statements were highlighted and clustered to reveal emergent themes, was used. Five older people, aged 81 to 91 years, participated in the study. The four emergent themes were: seeking quality and reciprocity in carer relationships; patchworking services; the waiting game; and technology with utility. Continuity of carers was central to the development of a trusting relationship and perceptions of care quality among older consumers. Care coordinators and workers should play a key role in ensuring older people receive timely information about CDC and their rights and responsibilities. Participants' use of contemporary technologies suggests opportunities to improve engagement of HCP clients in CDC.

Perception of Barriers to the Diagnosis and Receipt of Treatment for Neuropsychiatric Disturbances After Traumatic Brain Injury.

PubMed

Albrecht, Jennifer S; O'Hara, Lyndsay M; Moser, Kara A; Mullins, C Daniel; Rao, Vani

2017-12-01

To explore perceptions of barriers and facilitators to the diagnosis and receipt of treatment for neuropsychiatric disturbances (NPDs) after traumatic brain injury (TBI). Qualitative study using semistructured interviews and focus groups. A clinic specializing in the treatment of TBI NPDs, an urban trauma center, and a large urban academic hospital. A sample (N=33) of health care providers (n=10) who treat individuals with TBI, persons with TBI (n=18), and caregivers (n=5). Not applicable. Topic guides for the interviews and focus groups were guided by previous literature, clinical experience, and the goals of the project and focused on the 3 most common TBI NPDs: depression, anxiety, and posttraumatic stress disorder. The interviews and focus groups were audio-recorded and transcribed verbatim. We performed a conventional content analysis on the transcripts and grouped concepts into overall themes, incorporating feedback from stakeholders. Patient education, insurance, provider type, time since TBI, caregiver support, and recognition or screening for TBI NPDs were the most frequently mentioned barriers or facilitators to the diagnosis and treatment of TBI NPDs by both interview and focus group participants. We grouped these and other frequently mentioned concepts into 3 broad themes: education, access, and support. Each of these themes is explored in depth and supported with direct quotations. This study explored patient, caregiver, and health care provider and identified barriers and facilitators to the diagnosis and receipt of treatment for TBI NPDs. Barriers included poor provider education on TBI NPDs and limited access to care due to lack of insurance, transportation, and income. Facilitators included patient education on TBI NPDs and strong caregiver support. Future studies should develop and pilot interventions aimed at quality of care that address the identified barriers and facilitators. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Exploring the Perceptions of Newly Credentialed Athletic Trainers as They Transition to Practice

PubMed Central

Walker, Stacy E.; Thrasher, Ashley B.; Mazerolle, Stephanie M.

2016-01-01

Context: Research is limited on the transition to practice of newly credentialed athletic trainers (ATs). Understanding this transition could provide insight to assist employers and professional programs in developing initiatives to enhance the transition. Objective: To explore newly credentialed ATs' experiences and feelings during their transition from student to autonomous practitioner. Design: Qualitative study. Setting: Individual phone interviews. Patients or Other Participants: Thirty-four ATs certified between January and September 2013 participated in this study (18 women, 16 men; age = 23.8 ± 2.1 years; work settings were collegiate, secondary school, clinic, and other). Data saturation guided the number of participants. Data Collection and Analysis: Participants were interviewed via phone using a semistructured interview guide. All interviews were recorded and transcribed verbatim. Data were analyzed through phenomenologic reduction, with data coded for common themes and subthemes. Credibility was established via member checks, peer review, and intercoder reliability. Results: The 3 themes that emerged from the data were (1) transition to practice preparation, (2) orientation, and (3) mentoring. Transition to practice was rarely discussed during professional preparation, but information on the organization and administration or capstone course (eg, insurance, documentation) assisted participants in their transition. Participants felt that preceptors influenced their transition by providing or hindering the number and quality of patient encounters. Participants from larger collegiate settings reported more formal orientation methods (eg, review policies, procedures manual), whereas those in secondary school, clinic/hospital, and smaller collegiate settings reported informal orientation methods (eg, independent review of policies and procedures, tours). Some participants were assigned a formal mentor, and others engaged in peer mentoring. Conclusions: Employers could enhance the transition to practice by providing formal orientation and mentorship. Professional programs could prepare students for the transition by discussing how to find support and mentoring and by involving preceptors who provide students with opportunities to give patient care. PMID:27710092

Isolated thoughts and feelings and unsolved concerns: adolescents' and parents' perspectives on living with type 1 diabetes - a qualitative study using visual storytelling.

PubMed

Castensøe-Seidenfaden, Pernille; Teilmann, Grete; Kensing, Finn; Hommel, Eva; Olsen, Birthe Susanne; Husted, Gitte Reventlov

2017-10-01

To explore and describe the experiences of adolescents and their parents living with type 1 diabetes, to identify their needs for support to improve adolescents' self-management skills in the transition from child- to adulthood. Adolescents with type 1 diabetes often experience deteriorating glycaemic control and distress. Parents are important in adolescents' ability to self-manage type 1 diabetes, but they report anxiety and frustrations. A better understanding of the challenges adolescents and parents face, in relation to the daily self-management of type 1 diabetes, is important to improve clinical practice. A qualitative explorative study using visual storytelling as part of individual interviews. A purposive sample of nine adolescents and their parents (seven mothers, six fathers) took photographs illustrating their experiences living with type 1 diabetes. Subsequently, participants were interviewed individually guided by participants' photographs and a semistructured interview guide. Interviews were analysed using thematic analysis. Four major themes were consistent across adolescents and their parents: (1) striving for safety, (2) striving for normality, (3) striving for independence and (4) worrying about future. Although adolescents and parents had same concerns and challenges living with type 1 diabetes, they were experienced differently. Their thoughts and feelings mostly remained isolated and their concerns and challenges unsolved. The concerns and challenges adolescents and their parents face in the transition from child- to adulthood are still present despite new treatment modalities. Parents are fundamental in supporting the adolescents' self-management-work; however, the parties have unspoken concerns and challenges. Healthcare providers should address the parties' challenges and concerns living with type 1 diabetes to diminish worries about future including fear of hypoglycaemia, the burden of type 1 diabetes and the feeling of being incompetent in diabetes self-management. It is important to focus on supporting both adolescents and their parents, and to provide a shared platform for communication. © 2016 John Wiley & Sons Ltd.

What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway.

PubMed

Gjestsen, Martha Therese; Wiig, Siri; Testad, Ingelin

2017-09-07

To identify contextual factors at different organisational levels to guide the implementation of an assistive living technology intervention in Norwegian primary home care. A single embedded case study design was carried out in an urban municipality in Western Norway to get an overview of key contextual factors from the municipality's perspective. The data collection was based on a triangulation of methods involving document analysis, semi-structured individual interviews and focus group interviews to get a broad insight when preparing for an intervention. Data were collected on three levels of the healthcare system: (1) national policy documents and regulations (macro), (2) five individual interviews with senior managers and municipal strategy documents (meso) and (3) two focus group interviews with nurses and nurse managers in direct patient care (micro). The Model for Understanding Success in Quality framework was used as a guide in the data analysis. The main contextual factors identified were external motivators and project sponsorship (macro level); leadership, workforce focus and maturity (meso level);and motivation to change and maturity (micro level). Strategies developed in policy documents affected upper management in the municipality, but healthcare personnel at the micro level were not so familiar with strategies and emphasis on assistive living technologies. Healthcare personnel in our study were motivated to use technological solutions, but lack of data infrastructure and resource availability hindered this. Aligning interests across multiple stakeholders remain a challenge when planning for an assistive living technology intervention in primary care. In the studied municipality, integration of technological solutions into healthcare services was more a vision than a reality because of a low level of organisational readiness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Attitudes and characteristics of health professionals working in Aboriginal health.

PubMed

Wilson, Annabelle M; Magarey, Anthea M; Jones, Michelle; O'Donnell, Kim; Kelly, Janet

2015-01-01

There is an unacceptable gap in health status between Aboriginal and non-Aboriginal people in Australia. Linked to social inequalities in health and political and historical marginalisation, this health gap must be urgently addressed. It is important that health professionals, the majority of whom in Australia are non-Aboriginal, are confident and equipped to work in Aboriginal health in order to contribute towards closing the health gap. The purpose of this study was to explore the attitudes and characteristics of non-Aboriginal health professionals working in Aboriginal health. The research was guided and informed by a social constructionist epistemology and a critical theoretical approach. It was set within a larger healthy eating and physical activity program delivered in one rural and one metropolitan community in South Australia from 2005 to 2010. Non-Aboriginal staff working in the health services where the program was delivered and who had some experience or an interest working in Aboriginal health were invited to participate in a semi-structured interview. Dietitians working across South Australia (rural and metropolitan locations) were also invited to participate in an interview. Data were coded into themes that recurred throughout the interview and this process was guided by critical social research. Thirty-five non-Aboriginal health professionals participated in a semi-structured interview about their experiences working in Aboriginal health. The general attitudes and characteristics of non-Aboriginal health professionals were classified using four main groupings, ranging from a lack of practical knowledge ('don't know how'), a fear of practice ('too scared'), the area of Aboriginal health perceived as too difficult ('too hard') and learning to practice regardless ('barrier breaker'). Workers in each group had different characteristics including various levels of willingness to work in the area; various understandings of Australia's historical relationship with Aboriginal peoples; varying awareness of their own cultural identity and influence on working with Aboriginal people; and different levels of (dis)comfort expressed in discussions about social, political and intercultural issues that impact on the healthcare encounter. These groupings can be used to assist non-Aboriginal health professionals to reflect on their own levels of confidence, attitudes, characteristics, experiences, approaches and assumptions to Aboriginal health, as an important precursor to further practice and development in Aboriginal health. By encouraging self-reflection of non-Aboriginal health professionals about where their experiences, characteristics and confidence lie, the groupings presented in this paper can be used to encourage non-Aboriginal health professionals, rather than Aboriginal clients or workers, to be the focus for change and deliver health care that is more acceptable to patients and clients, hence influencing health service delivery. The groupings presented can also begin to enable discussions between all health professionals about working together in Aboriginal health.

Thematic Analysis of the Effectiveness of an Inpatient Mindfulness Group for Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Yildiran, Hatice; Holt, Rachel R.

2015-01-01

The study focused on the effectiveness of group mindfulness for people with intellectual disabilities in an assessment and treatment unit. Six participants with mild or moderate intellectual disabilities were interviewed using semi-structured interviews. The interviews focused on identifying the benefits and difficulties of using mindfulness. The…

The Relationship Quality Interview: Evidence of Reliability, Convergent and Divergent Validity, and Incremental Utility

ERIC Educational Resources Information Center

Lawrence, Erika; Barry, Robin A.; Brock, Rebecca L.; Bunde, Mali; Langer, Amie; Ro, Eunyoe; Fazio, Emily; Mulryan, Lorin; Hunt, Sara; Madsen, Lisa; Dzankovic, Sandra

2011-01-01

Relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention has been paid to the assessment of relationship quality. The present study introduces the Relationship Quality Interview (RQI), a semistructured, behaviorally anchored individual interview.…

Tough Teens: The Methodological Challenges of Interviewing Teenagers as Research Participants

ERIC Educational Resources Information Center

Bassett, Raewyn; Beagan, Brenda L.; Ristovski-Slijepcevic, Svetlana; Chapman, Gwen E.

2008-01-01

Encouraging a teenager to have a conversation in a semistructured research interview is fraught with difficulties. The authors discuss the methodological challenges encountered when interviewing adolescents of European Canadian, African Canadian, and Punjabi Canadian families who took part in the Family Food Decision-Making Study in two regions of…

Examining the Diet of Post-Migrant Hispanic Males Using the Precede-Proceed Model: Predisposing, Reinforcing, and Enabling Dietary Factors

ERIC Educational Resources Information Center

Castellanos, Diana Cuy; Downey, Laura; Graham-Kresge, Susan; Yadrick, Kathleen; Zoellner, Jamie; Connell, Carol L.

2013-01-01

Objective: To examine socio-environmental, behavioral, and predisposing, reinforcing, and enabling (PRE) factors contributing to post-migration dietary behavior change among a sample of traditional Hispanic males. Design: In this descriptive study, semistructured interviews, a group interview, and photovoice, followed by group interviews, were…

Understanding the Lives and Challenges of Women in Poverty after TANF.

PubMed

Hildebrandt, Eugenie

2016-08-01

Welfare Reform has caused a dramatic change in the lives and health of single mothers living in poverty. This qualitative study explored the health and socioeconomic lives of 22 community-dwelling women in poverty in the years after they were terminated from the current work-based welfare program intended to move women from welfare to work and independence. The instruments were a semistructured interview guide, the HANES General Well-Being Schedule, and a demographic data form. Data were analyzed using multistage narrative analysis and descriptive statistics. These primary source data showed participants had multiple barriers that precede or follow poverty. Their voices of how they survive are a rich source of data to assist providers and policy makers in devising evidence-based solutions for reducing poverty in America. © The Author(s) 2016.

Healthcare Professionals' Attitudes to Rehabilitation Programming for Male Cancer Survivors.

PubMed

Handberg, Charlotte; Midtgaard, Julie; Nielsen, Claus Vinther; Thorne, Sally; Lomborg, Kirsten

The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. Ethnographic fieldwork was conducted, consisting of participant observation and nine semistructured focus group interviews with 58 hospital HCPs. Using interpretive description methodology with symbolic interaction as a theoretical framework, data were collected through fieldwork in three oncology wards in Denmark. Attitudes about both gender and rehabilitation were identified as overarching obstructions within hospital HCP conduct toward promoting men's participation in cancer rehabilitation. Gender and rehabilitation perceptions formed barriers in this context, suggesting that male cancer survivors' rehabilitation outcomes may be compromised by HCP attitudes and conduct. These findings provide insight into approaches to guide HCPs to take responsibility for rehabilitation and to take gender into account in their work.

Foundations of Intervention Research in Instrumental Practice

PubMed Central

Hatfield, Johannes L.; Lemyre, Pierre-Nicolas

2016-01-01

The goals of the present study are to evaluate, implement, and adapt psychological skills used in the realm of sports into music performance. This research project also aims to build foundations on how to implement future interventions to guide music students on how to optimize practice toward performance. A 2-month psychological skills intervention was provided to two students from the national music academy's bachelor program in music performance to better understand how to adapt and construct psychological skills training programs for performing music students. The program evaluated multiple intervention tools including the use of questionnaires, performance profiling, iPads, electronic practice logs, recording the perceived value of individual and combined work, as well as the effectiveness of different communication forms. Perceived effects of the intervention were collected through semi-structured interviews, observations, and logs. PMID:26834660

Critically appraising qualitative research: a guide for clinicians more familiar with quantitative techniques.

PubMed

Kisely, Stephen; Kendall, Elizabeth

2011-08-01

Papers using qualitative methods are increasingly common in psychiatric journals. This overview is an introduction to critically appraising a qualitative paper for clinicians who are more familiar with quantitative methods. Qualitative research uses data from interviews (semi-structured or unstructured), focus groups, observations or written materials. Data analysis is inductive, allowing meaning to emerge from the data, rather than the more deductive, hypothesis centred approach of quantitative research. This overview compares and contrasts quantitative and qualitative research methods. Quantitative concepts such as reliability, validity, statistical power, bias and generalisability have qualitative equivalents. These include triangulation, trustworthiness, saturation, reflexivity and applicability. Reflexivity also shares features of transference. Qualitative approaches include: ethnography, action-assessment, grounded theory, case studies and mixed methods. Qualitative research can complement quantitative approaches. An understanding of both is useful in critically appraising the psychiatric literature.

Social organization and control of tuberculosis: the experience of a Brazilian town.

PubMed

Bulgarelli, Alexandre Favero; Villa, Tereza Cristina Scatena; Pinto, Ione Carvalho

2013-01-01

This study was aimed at analyzing the participation of a committee formed by representatives of the community in tuberculosis control based on a participatory management model. This is a Case Study involving a tuberculosis committee with data collected through semi-structured interviews conducted with nine individuals. The data, organized through the Association of Ideas Map technique, were analyzed based on the Social Constructionism perspective. The participation of the Tuberculosis Committee studied was shown to be effective and associated with aspects articulated according to the measures taken by the social parties involved in the committee, culminating with assistances inserted into certain parts of the town's co-management. It was concluded that the reality of this case study shows that relationships among civil society can guide the management model in the search for effective processes of tuberculosis control.

Career mentoring needs of youths in foster care: voices for change.

PubMed

Hudson, Angela L

2013-05-01

Adolescents with a history of foster care placement are more likely to become homeless, have mental illness, become parents too early in life, or become incarcerated within the juvenile justice/prison system. In addition, a low percentage of young adults, who formerly were in foster care, complete vocational training or higher education. This was a qualitative study, using focus group methodology. Four focus group sessions were conducted with youth living in foster care. The purpose was to obtain their perceptions about mentoring. Focus groups comprised six to eight youths per group and were guided by a semi-structured interview guide. A total of 27 youth in foster care participated in focus group interviews. Mean age was 16.4 (SD = 0.68) years. Youth participants were very knowledgeable about mentoring programs for at-risk youth, along with negative psychosocial outcomes experienced by former foster youth. However, they remarked that they are given few opportunities for career mentoring. The overall themes that emerged from narrative data were needing and finding authority figures, hooking up with a career mentor, and deserving the good life. Career mentoring is an affordable and feasible intervention for child welfare agencies. This could lead to more motivated and prepared youth living in foster care for vocational training or higher education. Learning opportunities from a career mentor may be a lifeline for preventing negative psychosocial outcomes for foster youth, reward achievement goals, and improve overall quality of life in emerging adulthood. © 2013 Wiley Periodicals, Inc.

Ethnomedicinal plants of the Bauri tribal community of Moulvibazar District, Bangladesh.

PubMed

Das, Protiva Rani; Islam, Md Tabibul; Mostafa, Mohd Nabil; Rahmatullah, Mohammed

2013-01-01

Bangladesh reportedly has more than 100 tribal communities; however, documentation of their medicinal practices is markedly absent. The aim of the present study was to conduct an ethnomedicinal survey among the little known Bauri tribe of Bangladesh, whose tribal medicinal practices are yet to be documented. The survey was carried out among the Bauri tribal community of Purbo Tila village in Moulvibazar District. The community is believed to be the only Bauri community in the country and had four tribal healers who continue their traditional medicinal practices. Interviews of the healers were carried out with the help of a semi-structured questionnaire and the guided field-walk method where the healers took the interviewers on guided field-walks through areas from where they collected their medicinal plants. Here they identified the plants and described their uses. The Bauri healers were observed to use 40 different plant species and one bird species for treatment of ailments such as fever, respiratory tract disorders, pain, gastrointestinal disorders, eye problems like cataract and conjunctivitis, jaundice, abscess, cardiovascular disorders, urinary problems, paralysis, dog bite, snake bite, helminthiasis, lesions on the tongue or lips and piles. Leaves were the major plant part used and constituted 38.3% of total uses followed by fruits at 14.9%. A review of the relevant scientific literature showed that a number of medicinal plants used by the Bauri healers possess pharmacological activities, which were in line with the traditional uses, thus validating their use by the Bauri tribe.

Lived experience of blood glucose self-monitoring among pregnant women with gestational diabetes mellitus: a phenomenological research.

PubMed

Youngwanichsetha, Sununta; Phumdoung, Sasitorn

2017-10-01

To explore and describe lived experience of blood glucose self-monitoring among pregnant Thai women with gestational diabetes mellitus. Self-monitoring of blood glucose is an essential practice among pregnant women with diabetes to prevent complications in pregnancy and the newborn infant. Phenomenological research was employed to understand lived experiences in glycemic control. Thirty participants were approached and interviewed using a semistructured interview guides. Qualitative data were analysed following Colaizzi's method. The findings revealed three themes: being worried about diabetes and blood testing, trying to control it and being patient for the child. Their worry comprised three dimensions: (1) wondering about the impacts of diabetes on the child, (2) concern about maternal health and (3) being worried about doing blood test. Trying to control diabetes was composed of three dimensions: (1) learning to test blood glucose, (2) being afraid of elevated blood sugar and (3) being aware of what to eat. Being patient for the child was composed of three dimensions: (1) overcoming food desires, (2) tolerating the fingerprick pain and (3) satisfaction with the outcomes. Women with gestational diabetes experienced being worried and afraid regarding blood glucose self-monitoring; however, they could overcome and tolerate this with some difficulties. These findings can be used to guide nursing practice in assessment of perception and response towards blood glucose self-monitoring in order to improve achievement of a good glycaemic control among pregnant women with gestational diabetes mellitus. © 2016 John Wiley & Sons Ltd.

Pregnant womens' concerns when invited to a randomized trial: a qualitative case control study.

PubMed

Oude Rengerink, Katrien; Logtenberg, Sabine; Hooft, Lotty; Bossuyt, Patrick M; Mol, Ben Willem

2015-09-04

Pregnant women were excluded from clinical trials until the 1990s, but the Food and Drug Administration nowadays allows--and even encourages--responsible inclusion of pregnant women in trials with adequate safety monitoring. Still, randomized trials in pregnant women face specific enrolment challenges. Previous studies have focused on barriers to trial participation in studies that had failed to recruit sufficient participants. Our aim was to identify barriers and motivators for participation in a range of clinical trials being conducted in the Netherlands, regardless of recruitment performance. We performed a qualitative case control study in women who had been asked in 2010 to participate in one of eight clinical trials during pregnancy or shortly after giving birth. Both participants and non-participants of these clinical trials were invited for a face-to-face interview that addressed motives for participation and non-participation. We started the interview in an open fashion, asking the women for their main motive for participation or non-participation. When no new information emerged in this open part, we continued with a semi-structured interview, guided by a topic list. Transcripts of the interviews were analysed using a constant-comparative approach. Two researchers identified barriers and facilitators for participation, conjoined into main themes. Of 28 women invited for the interview, 21 agreed to be interviewed (12 participants and 9 non-participants). For 5 of the 12 participants, contribution to scientific research was their main motive, while 5 had participated because the intervention seemed favorable and was not available outside the trial. Key motives for non-participation (n = 9) were a negative association or a dislike of the intervention, either because it might do harm (n = 6) or for practical reasons (n = 3). Combining the open and topic list guided interviews we constructed seven main themes that influence the pregnant women's decision to participate: external influence, research and healthcare, perception own situation, study design, intervention, information and counselling, and uncertainty. Among seven main themes that influence pregnant women's decision to participate, uncertainty about scientific research or the intervention was reported to be of considerable importance. Measures should be taken to habituate pregnant women more to scientific research, and further evaluation of opt-out consent deserves attention.

The convergence of personality disorder diagnoses across different methods among monolingual (Spanish-speaking only) Hispanic patients in substance use treatment.

PubMed

Samuel, Douglas B; Añez, Luis M; Paris, Manuel; Grilo, Carlos M

2014-04-01

Methods for diagnosing personality disorders (PDs) within clinical settings typically diverge from those used in treatment research. Treatment groups in research studies are routinely diagnosed using semistructured interviews or self-report questionnaires, yet these methods show poor agreement with clinical diagnoses recorded in medical charts or assigned by treating clinicians, reducing the potential for evidence-based practice. Furthermore, existing research has been limited by focusing on primarily White and English-speaking participants. Our study extended prior research by comparing 4 independent methods of PD diagnosis, including self-report questionnaire, semistructured interview, chart diagnoses, and ratings by treating clinicians, within a clinical series of 130 monolingual (Spanish only) Hispanic persons (69% male; M age 37.4), in treatment for substance use. The authors examined the convergence of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) PD diagnoses across these methods. PD diagnoses appeared infrequently within medical charts but were diagnosed at higher levels by independent treating clinicians, self-report questionnaires, and semistructured interviews. Nonetheless, diagnostic concordance between clinical diagnoses and the other methods were poor (κ < .20). Convergence of PD diagnoses across diagnostic methods for Spanish-speaking Hispanic persons are comparable to other groups allaying concerns about cross-cultural application of PD diagnoses. Additionally, the results of this study echo previous research in suggesting that clinicians' PD diagnoses overlap little with self-report questionnaires or semistructured diagnostic interviews and suggest that PDs are underdiagnosed using standard diagnostic approaches. Implications for the clinical application of empirically supported research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort

PubMed Central

Mushaphi, Lindelani Fhumudzani; Mahopo, Tjale Cloupas; Nesamvuni, Cebisa Noxolo; Baloyi, Brenda; Mashau, Ellen; Richardson, Jeniata; Dillingham, Rebecca; Guerrant, Richard; Ambikapathi, Ramya; Bessong, Pascal

2018-01-01

Background There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. Objective To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. Methods Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. Results Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non–breast milk liquids and solids by the second month of child’s life. Common reasons for introducing non–breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. Conclusion Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended. PMID:28958169

Clinicians' Perspectives on Managing Symptom Clusters in Advanced Cancer: A Semistructured Interview Study.

PubMed

Dong, Skye T; Butow, Phyllis N; Agar, Meera; Lovell, Melanie R; Boyle, Frances; Stockler, Martin; Forster, Benjamin C; Tong, Allison

2016-04-01

Managing symptom clusters or multiple concurrent symptoms in patients with advanced cancer remains a clinical challenge. The optimal processes constituting effective management of symptom clusters remain uncertain. To describe the attitudes and strategies of clinicians in managing multiple co-occurring symptoms in patients with advanced cancer. Semistructured interviews were conducted with 48 clinicians (palliative care physicians [n = 10], oncologists [n = 6], general practitioners [n = 6], nurses [n = 12], and allied health providers [n = 14]), purposively recruited from two acute hospitals, two palliative care centers, and four community general practices in Sydney, Australia. Transcripts were analyzed using thematic analysis and adapted grounded theory. Six themes were identified: uncertainty in decision making (inadequacy of scientific evidence, relying on experiential knowledge, and pressure to optimize care); attunement to patient and family (sensitivity to multiple cues, prioritizing individual preferences, addressing psychosocial and physical interactions, and opening Pandora's box); deciphering cause to guide intervention (disaggregating symptoms and interactions, flexibility in assessment, and curtailing investigative intrusiveness); balancing complexities in medical management (trading off side effects, minimizing mismatched goals, and urgency in resolving severe symptoms); fostering hope and empowerment (allaying fear of the unknown, encouraging meaning making, championing patient empowerment, and truth telling); and depending on multidisciplinary expertise (maximizing knowledge exchange, sharing management responsibility, contending with hierarchical tensions, and isolation and discontinuity of care). Management of symptom clusters, as both an art and a science, is currently fraught with uncertainty in decision making. Strengthening multidisciplinary collaboration, continuity of care, more pragmatic planning of clinical trials to address more than one symptom, and training in symptom cluster management are required. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Patterns of Knowledge Construction

ERIC Educational Resources Information Center

Chang, Bo

2018-01-01

The purpose of this study was to identify knowledge construction patterns in a local learning community. Observation, documents, and semistructured interviews were employed to collect data. Twenty learners were interviewed. Data were analyzed inductively using the constant comparative method. Five major patterns--radiation, circulation,…

Establishing oral health promoting behaviours in children - parents' views on barriers, facilitators and professional support: a qualitative study.

PubMed

Duijster, Denise; de Jong-Lenters, Maddelon; Verrips, Erik; van Loveren, Cor

2015-12-10

The prevention of childhood dental caries relies on adherence to key behaviours, including twice daily tooth brushing with fluoride toothpaste and reducing the consumption of sugary foods and drinks. The aim of this qualitative study was to explore parents' perceptions of barriers and facilitators that influence these oral health behaviours in children. A further objective was to explore parents' views on limitations and opportunities for professional support to promote children's oral health. Six focus group interviews were conducted, including a total of 39 parents of 7-year old children, who were recruited from paediatric dental centres in The Netherlands. Interviews were held with Dutch parents of low and high socioeconomic status and parents from Turkish and Moroccan origin. Focus group interviews were conducted on the basis of a pre-tested semi-structured interview guide and topic list. Content analysis was employed to analyse the data. Analysis of interview transcripts identified many influences on children's oral health behaviours, operating at child, family and community levels. Perceived influences on children's tooth brushing behaviour were primarily located within the direct family environment, including parental knowledge, perceived importance and parental confidence in tooth brushing, locus of control, role modelling, parental monitoring and supervision, parenting strategies and tooth brushing routines and habituation. The consumption of sugary foods and drinks was influenced by both the direct family environment and factors external to the family, including the school, the social environment, commercials and television, supermarkets and affordability of foods. Parents raised several suggestions for professional oral health support, which included the provision of clear and consistent oral health information using a positive approach, dietary regulations at school and a multidisciplinary approach among dental professionals, child health centres and other institutions in providing parental support. In conclusion, this qualitative study provided detail regarding parental views on the influences on children oral health behaviours and their opinions on what further support is needed to promote children's dental health. Parents' suggestions for professional oral health support can guide the development or improvement of caries preventive interventions.

Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.

PubMed

Garg, Sachin K; Lyles, Courtney R; Ackerman, Sara; Handley, Margaret A; Schillinger, Dean; Gourley, Gato; Aulakh, Veenu; Sarkar, Urmimala

2016-02-06

Text messaging is an affordable, ubiquitous, and expanding mobile communication technology. However, safety net health systems in the United States that provide more care to uninsured and low-income patients may face additional financial and infrastructural challenges in utilizing this technology. Formative evaluations of texting implementation experiences are limited. We interviewed safety net health systems piloting texting initiatives to study facilitators and barriers to real-world implementation. We conducted telephone interviews with various stakeholders who volunteered from each of the eight California-based safety net systems that received external funding to pilot a texting-based program of their choosing to serve a primary care need. We developed a semi-structured interview guide based partly on the Consolidated Framework for Implementation Research (CFIR), which encompasses several domains: the intervention, individuals involved, contextual factors, and implementation process. We inductively and deductively (using CFIR) coded transcripts, and categorized themes into facilitators and barriers. We performed eight interviews (one interview per pilot site). Five sites had no prior texting experience. Sites applied texting for programs related to medication adherence and monitoring, appointment reminders, care coordination, and health education and promotion. No site texted patient-identifying health information, and most sites manually obtained informed consent from each participating patient. Facilitators of implementation included perceived enthusiasm from patients, staff and management belief that texting is patient-centered, and the early identification of potential barriers through peer collaboration among grantees. Navigating government regulations that protect patient privacy and guide the handling of protected health information emerged as a crucial barrier. A related technical challenge in five sites was the labor-intensive tracking and documenting of texting communications due to an inability to integrate texting platforms with electronic health records. Despite enthusiasm for the texting programs from the involved individuals and organizations, inadequate data management capabilities and unclear privacy and security regulations for mobile health technology slowed the initial implementation and limited the clinical use of texting in the safety net and scope of pilots. Future implementation work and research should investigate how different texting platform and intervention designs affect efficacy, as well as explore issues that may affect sustainability and the scalability.

Reshould I Take More MIS Courses? Implications from Interviews with Business Recruiters

ERIC Educational Resources Information Center

He, Jun; Guo, Yi Maggie

2015-01-01

It is important for MIS educators to have a good understanding of what IT knowledge and skills are required in business. In this study, 103 open job positions in the Midwestern United States were investigated via semi-structured interviews with hiring companies. The interviews with key business recruiters suggest that IT knowledge and skills are…

A Four-Year Follow-Up of Means-End Outcomes from Outdoor Adventure Programs

ERIC Educational Resources Information Center

Goldenberg, Marni; Soule, Katherine E.

2015-01-01

Means-end theory was used to analyze differences in outcomes from original interviews and follow-up interviews occurring four years after Outward Bound (OB) and National Outdoor Leadership School (NOLS) 2006 course participation. In 2006, a semi-structured, in-person interview was conducted after participants (N = 510) completed their course. In…

Receiving Video-Based Feedback in Elite Ice-Hockey: A Player's Perspective

ERIC Educational Resources Information Center

Nelson, Lee J.; Potrac, Paul; Groom, Ryan

2014-01-01

The aim of this paper was to provide some rich insights into how an elite ice-hockey player responded to his coaches' pedagogical delivery of video-based feedback sessions. Data for this study were gathered through a series of in-depth, semi-structured interviews and a reflective log relating to those interviews. The interviews were transcribed…

A Systemic-Based Interview Guide: Its Validity and Economy in Comparison with an Unstructured Interview Approach--Experimental Results

ERIC Educational Resources Information Center

Kubinger, Klaus D.; Wiesflecker, Sabine; Steindl, Renate

2008-01-01

An interview guide for children and adolescents, which is based on systemic therapy, has recently been added to the collection of published instruments for psychological interviews. This article aims to establish the amount of information gained during a psychological investigation using the Systemic-based Interview Guide rather than an intuitive,…

Families’ Priorities Regarding Hospital-to-Home Transitions for Children With Medical Complexity

PubMed Central

O’Brien, Emily R.; Leslie, Laurel K.; Lindenauer, Peter K.; Mangione-Smith, Rita M.

2017-01-01

BACKGROUND: National health care policy recommends that patients and families be actively involved in discharge planning. Although children with medical complexity (CMC) account for more than half of pediatric readmissions, scalable, family-centered methods to effectively engage families of CMC in discharge planning are lacking. We aimed to systematically examine the scope of preferences, priorities, and goals of parents of CMC regarding planning for hospital-to-home transitions and to ascertain health care providers’ perceptions of families’ transitional care goals and needs. METHODS: We conducted semistructured interviews with parents and health care providers at a tertiary care hospital. Interviews were continued until thematic saturation was reached. Interviews were audio recorded, transcribed verbatim, and analyzed to identify emergent themes via a general inductive approach. RESULTS: Thirty-nine in-depth interviews were conducted, including 23 with family caregivers of CMC and 16 with health care providers. Families’ priorities, preferences, and goals for hospital-to-home transitions aligned with 7 domains: effective engagement with health care providers, respect for families’ discharge readiness, care coordination, timely and efficient discharge processes, pain and symptom control, self-efficacy to support recovery and ongoing child development, and normalization and routine. These domains also emerged in interviews with health care providers, although there were minor differences in themes discussed. CONCLUSIONS: Although CMC have diverse transitional care needs, their families’ priorities, preferences, and goals aligned with 7 domains that bridged their hospital admission with reestablishment of a home routine. This research provides essential foundational data to engage families in discharge planning, guiding the operationalization of national health policy recommendations. PMID:27940509

Pharmacists' experiences and attitudes regarding generic drugs and generic substitution: two sides of the coin.

PubMed

Olsson, Erika; Kälvemark Sporrong, Sofia

2012-12-01

Generic drug substitution reduces costs for medicines, but the downsides include unintentional double medication, confusion and anxiety among patients. Information from pharmacists affects patients' experiences of substitution with generic drugs. The aim of this study was to explore experiences and attitudes to generic substitution among Swedish community pharmacists. An interview guide was developed. Semi-structured interviews with community pharmacists were conducted and transcribed verbatim. Analysis was inductive; extracts from the transcripts were compared and combined to form themes and subcategories. Pharmacists from a heterogeneous convenience sample of pharmacies were interviewed until data saturation had been achieved. Sixteen pharmacists were interviewed. Three main themes and twelve subcategories were identified, with the main themes being the role of the pharmacist, pharmacists' concerns regarding patients, and the generic drug. Pharmacists found it positive that generic substitution decreases the costs for pharmaceuticals but also emphasized that the switch can confuse and worry patients, which could result in less benefit from treatment. Respondents claimed that generic substitution has changed the focus in the pharmacist-patient meeting towards economics and regulations. According to the interviewed pharmacists generic substitution is not primarily an issue of generic versus brand-name products, but concerns above all the challenges that the switch implies for patients and pharmacists. To prevent known confusion and concerns among patients it is important that community pharmacists acquire the necessary tools and knowledge to manage this situation; pharmacists themselves as well as pharmacy owners and authorities share responsibility for this. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Focus Groups in Elderly Ophthalmologic Patients: Setting the Stage for Quantitative Preference Elicitation.

PubMed

Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Stock, Stephanie

2016-02-01

Patients suffering from age-related macular degeneration (AMD) are rarely actively involved in decision-making, despite facing preference-sensitive treatment decisions. This paper presents a qualitative study to prepare quantitative preference elicitation in AMD patients. The aims of this study were (1) to gain familiarity with and learn about the special requirements of the AMD patient population for quantitative data collection; and (2) to select/refine patient-relevant treatment attributes and levels, and gain insights into preference structures. Semi-structured focus group interviews were performed. An interview guide including preselected categories in the form of seven potentially patient-relevant treatment attributes was followed. To identify the most patient-relevant treatment attributes, a ranking exercise was performed. Deductive content analyses were done by two independent reviewers for each attribute to derive subcategories (potential levels of attributes) and depict preference trends. The focus group interviews included 21 patients. The interviews revealed that quantitative preference surveys in this population will have to be interviewer assisted to make the survey feasible for patients. The five most patient-relevant attributes were the effect on visual function [ranking score (RS): 139], injection frequency (RS: 101), approval status (RS: 83), side effects (RS: 79), and monitoring frequency (RS: 76). Attribute and level refinement was based on patients' statements. Preference trends and dependencies between attributes informed the quantitative instrument design. This study suggests that qualitative research is a very helpful step to prepare the design and administration of quantitative preference elicitation instruments. It especially facilitated familiarization with the target population and its preferences, and it supported attribute/level refinement.

Exploring the disclosure decisions made by physiotherapists with a specific learning difficulty.

PubMed

Yeowell, G; Rooney, J; Goodwin, P C

2018-06-01

To explore the disclosure decisions made in the workplace by physiotherapy staff with a specific learning difficulty (SpLD). An exploratory qualitative design was used, which was informed by the social model of disability. The research was undertaken in North West England. It is presented according to the Consolidated Criteria for Reporting Qualitative Research. A purposive sample of eight physiotherapists recognised as having a SpLD were recruited. All participants had studied on one of two programmes at a university in England between 2004-2012. Their NHS workplace experience was from across the UK. In-depth, semi-structured interviews were undertaken within the university setting or via telephone. Interviews lasted 40 to 70minutes and were digitally recorded. An interview guide was used to direct the interview. Interview data were transcribed verbatim and analysed using thematic analysis. Four participants were female. The mean number of years qualified as a physiotherapist was 4.5years (SD=2.27). Three themes were identified: 'Disclosing during the workplace application'; 'Positive about disabled people scheme'; 'Disclosing in the workplace'. Disclosure of dyslexia is a selective process and is a central dilemma in the lives of individuals who have a concealable stigmatised identity. As a consequence, physiotherapy staff with dyslexia may choose to conceal their disability and not disclose to their employer. In order for staff with dyslexia to get the support they need in the workplace, disclosure is recommended. A number of recommendations have been made to facilitate the disclosure process. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

A pilot study of a family cognitive adaptation training guide for individuals with schizophrenia.

PubMed

Kidd, Sean A; Kerman, Nick; Ernest, Debbie; Maples, Natalie; Arthur, Cicely; de Souza, Sara; Kath, Jennifer; Herman, Yarissa; Virdee, Gursharan; Collins, April; Velligan, Dawn

2018-06-01

There is a paucity of accessible, evidence-based tools for caregivers of individuals with schizophrenia. This study examines changes in the self-assessed and caregiver-assessed outcomes of people with schizophrenia after exposure to a cognitive adaptation training (CAT) guide that addressed pragmatic, in-home approaches to offset the cognitive impacts of the illness. This study examined the 4-month, pre-post outcomes of a CAT guide, as compared with a popular, general manual, for families of individuals with schizophrenia. A total of 17 caregiver-supported individual dyads completed all measures, having been randomized to either a CAT-guide group or a support-manual group. Measures included medication adherence, adaptive functioning, quality of life, and caregiver burden. Semistructured interviews assessed use and utility questions. Caregiver-assessed improvements in community functioning with medium-high effect sizes were observed in both study conditions. Self-report ratings by supported individuals did not change from baseline to 4 months and no change was observed in medication adherence or quality of life for either condition. Caregiver-burden ratings significantly declined with a large effect size, again with no difference as a function of manual type. These findings suggest that there is some promise in providing families with evidence-based information in manual form. Further research informed by this study's findings should include assessments of whether and how environmental cognitive supports can be of specific benefit to families affected by schizophrenia. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Caregiver Input to Optimize the Design of a Pediatric Care Planning Guide for Rehabilitation: Descriptive Study

PubMed Central

Lim, Heather K; Corden, Marya E

2017-01-01

Background Caregiver input has informed the design of a valid electronic patient-reported outcome (PRO) measure for use in pediatric rehabilitation. This proxy assessment may be further developed to expedite and enhance patient-centered care planning processes, but user input is first needed to finalize the core requirements that will guide its design. Objective The objective of this study was to examine the feasibility of a stepwise process for building on a baseline assessment of young children's participation in activities to develop a care plan relevant to pediatric rehabilitation. Methods A cross-sectional descriptive study design was employed using qualitative methods. Data were collected via Web-based technology and by telephone. Twenty-five caregivers of young children (9 with developmental delays, 16 without delays) and between 1 and 7 years were recruited from a subsample of parents who had previously enrolled in a Web-based validation of a PRO on children’s participation and provided consent for future contact. Each caregiver completed a demographic questionnaire and Young Children’s Participation and Environment Measure (YC-PEM) online, followed by a 20- to 60-min semistructured and audiotaped phone interview to review and build upon PRO results as summarized in an electronic report. Interview data were content coded to the interview guide and reviewed by multiple research staff to estimate feasibility according to stepwise completion rates, perceptions of difficulty in step completion, and perceptions of overall utility. Results Half of the participants in the final study sample (N=25) fully completed a stepwise process of building on their baseline PRO assessment to develop an initial care plan for their child. In most cases, similar stepwise completion rates and trends in the approaches taken for step completion were found regardless of the child’s disability status. However, more parents of children with disabilities reported difficulties in rank ordering their priorities for change and identified child-focused strategies for goal attainment. Nearly 77% (19/25) of users were willing to use the process to develop and communicate intervention priorities and strategies with professionals, family, and friends. Conclusions Results informed revisions to the care planning guide before usability and feasibility testing of an initial Web-based prototype that is now underway. PMID:29066421

A Qualitative Description of Chronic Neck Pain has Implications for Outcome Assessment and Classification

PubMed Central

MacDermid, Joy C.; Walton, David M.; Bobos, Pavlos; Lomotan, Margaret; Carlesso, Lisa

2016-01-01

Background: Neck pain is common, but few studies have used qualitative methods to describe it. Purpose: To describe the quality, distribution and behavior of neck pain. Methods: Sixteen people (15 females; mean age = 33 years (range = 20-69)) with neck pain >3 months were interviewed using a semi-structured guide. Interview data were recorded and transcribed verbatim. Descriptive content analysis was performed by two authors. Participants then completed an electronic descriptive pain tool, placing icons (word and icon descriptors to describe quality) on anatomic diagrams to identify location of pain, and intensity ratings at each location. This data was triangulated with interviews. Results: Aching pain and stiffness in the posterior neck and shoulder region were the most common pain complaints. All patients reported more than one pain quality. Associated headache was common (11/16 people); but varied in location and pain quality; 13/16 reported upper extremity symptoms. Neuropathic characteristics (burning) or sensory disturbance (numbness/tingling) occurred in some patients, but were less common. Activities that involved lifting/carrying and psychological stress were factors reported as exacerbating pain. Physical activity was valued as essential to function, but also instigated exacerbations. Concordance between the structured pain tool and interviews enhanced trustworthiness of our results. Integrating qualitative findings with a previous classification system derived a 7-axis neck pain classification: source/context, sample subgroup, distribution, duration, episode pattern, pain/symptom severity, disability/participation restriction. Conclusions: Qualitative assessment and classification should consider the multiple dimensions of neck pain. PMID:28217199

Korean American women's beliefs about breast and cervical cancer and associated symbolic meanings.

PubMed

Lee, Eunice E; Tripp-Reimer, Toni; Miller, Arlene M; Sadler, Georgia R; Lee, Shin-Young

2007-05-01

To explore Korean American women's symbolic meanings related to their breasts and cervix, to examine attitudes and beliefs about breast and cervical cancer, and to find relationships between the participants' beliefs and their cancer screening behaviors. Descriptive, qualitative analysis. Southwestern United States. 33 Korean-born women at least 40 years of age. In-depth, face-to-face, individual interviews were conducted in Korean. A semistructured interview guide was used to ensure comparable core content across all interviews. Transcribed and translated interviews were analyzed using descriptive content analysis. Breast cancer, cervical cancer, cancer screening, beliefs, and Korean American women. Korean American women's symbolic meaning of their breasts and cervix are closely related to their past experiences of bearing and rearing children. Negative life experiences among older Korean American women contributed to negative perceptions about cervical cancer. Having information about cancer, either correct or incorrect, and having faith in God or destiny may be barriers to obtaining screening tests. Korean American women's symbolic meanings regarding their breasts and cervix, as well as their beliefs about breast cancer and cervical cancer and cancer screening, are associated with their cultural and interpersonal contexts. Their beliefs or limited knowledge appear to relate to their screening behaviors. Interventions that carefully address Korean American women's beliefs about breast cancer and cervical cancer as well as associated symbolic meanings may increase their cancer screening behaviors. Clinicians should consider Korean American women's culture-specific beliefs and representations as well as their life experiences in providing care for the population.

Swedish healthcare providers' perceptions of preconception expanded carrier screening (ECS)-a qualitative study.

PubMed

Matar, A; Kihlbom, U; Höglund, A T

2016-07-01

Reproductive autonomy, medicalization, and discrimination against disabled and parental responsibility are the main ongoing ethical debates concerning reproductive genetic screening. To examine Swedish healthcare professionals' views on preconception expanded carrier screening (ECS), a qualitative study involving academic and clinical institutions in Sweden was conducted in September 2014 to February 2015. Eleven healthcare professionals including clinicians, geneticists, a midwife, and a genetic counselor were interviewed in depth using a semi-structured interview guide. The questionnaire was constructed after reviewing the main literature and meetings with relevant healthcare providers. The interviews were recorded, transcribed verbatim, and content analyzed for categories and subcategories. Participants nurtured many ethical and non-ethical concerns regarding preconception ECS. Among the ethical concerns were the potential for discrimination, medicalization, concerns with prioritization of healthcare resources, and effects on reproductive freedom. The effects of implementation of preconception ECS, its stakeholders, regulations, and motivation are some of non-ethical concerns. These concerns, if not addressed, may affect the uptake and usage of carrier screening within Swedish healthcare system. As this is a qualitative study with a small non-random sample size, the findings cannot be generalized. The participants had little to no working experience with expanded screening panels. Moreover, the interviews were conducted in English, a second language for the participants, which might have limited the expression of their views. However, the authors claim that the findings may be pertinent to similar settings in other Scandinavian countries.

Women's experiences of planning a vaginal breech birth in Australia.

PubMed

Homer, Caroline Se; Watts, Nicole P; Petrovska, Karolina; Sjostedt, Chauncey M; Bisits, Andrew

2015-04-11

In many countries, planned vaginal breech birth (VBB) is a rare event. After the Term Breech Trial in 2000, VBB reduced and caesarean section for breech presentation increased. Despite this, women still request VBB. The objective of this study was to explore the experiences and decision-making processes of women who had sought a VBB. A qualitative study using descriptive exploratory design was undertaken. Twenty-two (n = 22) women who planned a VBB, regardless of eventual mode of birth were recruited. The women had given birth at one of two maternity hospitals in Australia that supported VBB. In-depth, semi-structured interviews using an interview guide were conducted. Interviews were analysed thematically. Twenty two women were interviewed; three quarters were primiparous (n = 16; 73%). Nine (41%) were already attending a hospital that supported VBB with the remaining women moving hospitals. All women actively sought a vaginal breech birth because the baby remained breech after an external cephalic version - 12 had a vaginal birth (55%) and 10 (45%) a caesarean section after labour commenced. There were four main themes: Reacting to a loss of choice and control, Wanting information that was trustworthy, Fighting the system and seeking support for VBB and The importance of 'having a go' at VBB. Women seeking a VBB value clear, consistent and relevant information in deciding about mode of birth. Women desire autonomy to choose vaginal breech birth and to be supported in their choice with high quality care.

A qualitative study of pharmacists' perceptions of, and recommendations for improvement of antibiotic use in Qatar.

PubMed

Black, Emily; Cartwright, Andrea; Bakharaiba, Sumaia; Al-Mekaty, Eman; Alsahan, Dima

2014-08-01

Use of antibiotics has been correlated with increasing rates of resistance. Pharmacists are ideally positioned as front line health care providers to limit indiscriminate antibiotic use and promote the safe and effective administration of these medications. The aim of this project was to assess pharmacists' opinions relating to antibiotic utilization in the community setting. Doha, Qatar. Community and primary care pharmacists were invited to participate in one of three focus groups or a semi-structured interview at Qatar University or at their site of employment. A total of 22 community and primary care pharmacists participated in this study. Interviews were facilitated using a focus group guide, were recorded, and later transcribed. Transcripts were reviewed for recurring themes and coded using Nvivo software for qualitative research. Pharmacists' perceptions. Five major themes emerged from a series of focus groups and interviews. Themes which recurred across interview groups included: misconceptions and inappropriate practices by patients and healthcare providers, currently implemented strategies, perceived barriers, ways to overcome perceived barriers, and targets for improvement of antibiotic use in Qatar. The greatest need, as identified by pharmacists in this study was increased knowledge of the general population about appropriate antibiotic use through various educational interventions. Pharmacists report a number of misconceptions and inappropriate practices relating to antibiotic use in Qatar by patients and healthcare providers. Education to improve knowledge of appropriate antibiotic use is needed. Despite recognition of these issues, barriers are preventing pharmacists from implementing strategies to improve antibiotic use in Qatar.

'…a one stop shop in their own community': Medical abortion and the role of general practice.

PubMed

Newton, Danielle; Bayly, Chris; McNamee, Kathleen; Bismark, Marie; Hardiman, Annarella; Webster, Amy; Keogh, Louise

2016-12-01

The introduction to Australia of modern medical abortion methods, which require less specialist expertise and equipment than the more traditional surgical methods, have brought an as yet unrealised potential to improve access to abortion services. To investigate the potential for expanding the role of general practice in the provision of medical abortion in Victoria. In 2015, in-depth interviews were conducted with 19 experts in abortion service provision in Victoria. A semi-structured interview schedule was used to guide the interviews. Interviews were transcribed verbatim and transcripts analysed thematically. Participants were largely very supportive of the provision of early medical abortion in general practice as a way of increasing abortion access for women, particularly in rural and regional communities. Access to abortion was seen as an essential component of women's comprehensive health care and therefore general practitioners (GPs) were perceived as ideally placed to provide this service. However, this would require development and implementation of new service models, careful consideration of GP and nurse roles, strengthening of partnerships with other health professionals and services in the community, and enhanced training, support and mentoring for clinicians. The application of these findings by relevant health services and agencies has the potential to increase provision of medical abortion services in general practice settings, better meeting the health-care needs of women seeking this service. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

National policy-makers speak out: are researchers giving them what they need?

PubMed Central

Hyder, Adnan A; Corluka, Adrijana; Winch, Peter J; El-Shinnawy, Azza; Ghassany, Harith; Malekafzali, Hossein; Lim, Meng-Kin; Mfutso-Bengo, Joseph; Segura, Elsa; Ghaffar, Abdul

2011-01-01

The objective of this empirical study was to understand the perspectives and attitudes of policy-makers towards the use and impact of research in the health sector in low- and middle-income countries. The study used data from 83 semi-structured, in-depth interviews conducted with purposively selected policy-makers at the national level in Argentina, Egypt, Iran, Malawi, Oman and Singapore. The interviews were structured around an interview guide developed based on existing literature and in consultation with all six country investigators. Transcripts were processed using a thematic-analysis approach. Policy-makers interviewed for this study were unequivocal in their support for health research and the high value they attribute to it. However, they stated that there were structural and informal barriers to research contributing to policy processes, to the contribution research makes to knowledge generally, and to the use of research in health decision-making specifically. Major findings regarding barriers to evidence-based policy-making included poor communication and dissemination, lack of technical capacity in policy processes, as well as the influence of the political context. Policy-makers had a variable understanding of economic analysis, equity and burden of disease measures, and were vague in terms of their use in national decisions. Policy-maker recommendations regarding strategies for facilitating the uptake of research into policy included improving the technical capacity of policy-makers, better packaging of research results, use of social networks, and establishment of fora and clearinghouse functions to help assist in evidence-based policy-making. PMID:20547652

A human factors systems approach to understanding team-based primary care: a qualitative analysis.

PubMed

Mundt, Marlon P; Swedlund, Matthew P

2016-12-01

Research shows that high-functioning teams improve patient outcomes in primary care. However, there is no consensus on a conceptual model of team-based primary care that can be used to guide measurement and performance evaluation of teams. To qualitatively understand whether the Systems Engineering Initiative for Patient Safety (SEIPS) model could serve as a framework for creating and evaluating team-based primary care. We evaluated qualitative interview data from 19 clinicians and staff members from 6 primary care clinics associated with a large Midwestern university. All health care clinicians and staff in the study clinics completed a survey of their communication connections to team members. Social network analysis identified key informants for interviews by selecting the respondents with the highest frequency of communication ties as reported by their teammates. Semi-structured interviews focused on communication patterns, team climate and teamwork. Themes derived from the interviews lent support to the SEIPS model components, such as the work system (Team, Tools and Technology, Physical Environment, Tasks and Organization), team processes and team outcomes. Our qualitative data support the SEIPS model as a promising conceptual framework for creating and evaluating primary care teams. Future studies of team-based care may benefit from using the SEIPS model to shift clinical practice to high functioning team-based primary care. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents.

PubMed

Osilla, Karen Chan; Kennedy, David P; Hunter, Sarah B; Maksabedian, Ervant

2016-09-07

Social networks play positive and negative roles in the lives of homeless people influencing their alcohol and/or other drug (AOD) and HIV risk behaviors. We developed a four-session computer-assisted social network motivational interviewing intervention for homeless adults transitioning into housing. We examined the acceptability of the intervention among staff and residents at an organization that provides permanent supportive housing through iterative rounds of beta testing. Staff were 3 men and 3 women who were residential support staff (i.e., case managers and administrators). Residents were 8 men (7 African American, 1 Hispanic) and 3 women (2 African American, 1 Hispanic) who had histories of AOD and HIV risk behaviors. We conducted a focus group with staff who gave input on how to improve the delivery of the intervention to enhance understanding and receptivity among new residents. We conducted semi-structured qualitative interviews and collected self-report satisfaction data from residents. Three themes emerged over the course of the resident interviews. Residents reported that the intervention was helpful in discussing their social network, that seeing the visualizations was more impactful than just talking about their network, and that the intervention prompted thoughts about changing their AOD use and HIV risk networks. This study is the first of its kind that has developed, with input from Housing First staff and residents, a motivational interviewing intervention that targets both the structure and composition of one's social network. These results suggest that providing visual network feedback with a guided motivational interviewing discussion is a promising approach to supporting network change. ClinicalTrials.gov Identifier NCT02140359.

Semi-structured Interview Measure of Stigma (SIMS) in psychosis: Assessment of psychometric properties.

PubMed

Wood, Lisa; Burke, Eilish; Byrne, Rory; Enache, Gabriela; Morrison, Anthony P

2016-10-01

Stigma is a significant difficulty for people who experience psychosis. To date, there have been no outcome measures developed to examine stigma exclusively in people with psychosis. The aim of this study was develop and validate a semi-structured interview measure of stigma (SIMS) in psychosis. The SIMS is an eleven item measure of stigma developed in consultation with service users who have experienced psychosis. 79 participants with experience of psychosis were recruited for the purposes of this study. They were administered the SIMS alongside a battery of other relevant outcome measures to examine reliability and validity. A one-factor solution was identified for the SIMS which encompassed all ten rateable items. The measure met all reliability and validity criteria and illustrated good internal consistency, inter-rater reliability, test retest reliability, criterion validity, construct validity, sensitivity to change and had no floor or ceiling effects. The SIMS is a reliable and valid measure of stigma in psychosis. It may be more engaging and acceptable than other stigma measures due to its semi-structured interview format. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

“She’s a dog at the end of the day”: Guide dog owners’ perspectives on the behaviour of their guide dog

PubMed Central

Craigon, Peter J.; Hobson- West, Pru; England, Gary C. W.; Whelan, Chantelle; Lethbridge, Emma; Asher, Lucy

2017-01-01

A guide dog is a domestic dog (Canis familiaris) that is specifically educated to provide mobility support to a blind or visually impaired owner. Current dog suitability assessments focus on behavioural traits, including: trainability, reactivity or attention to environmental stimuli, low aggressiveness, fearfulness and stress behaviour, energy levels, and attachment behaviour. The aim of this study was to find out which aspects of guide dog behaviour are of key importance to guide dog owners themselves. Sixty-three semi-structured interview surveys were carried out with guide dog owners. Topics included the behaviour of their guide dog both within and outside their working role, and also focused on examples of behaviour which might be considered outside a guide dog owner’s typical expectations. Both positive and negative examples and situations were covered. This allowed for the discovery of new perspectives and emerging themes on living and working with a guide dog. Thematic analysis of the results reveals that a dog’s safe behaviour in the face of traffic was the most important positive aspect of a guide dog’s behaviour and pulling or high tension on the lead and /or harness was the most discussed negative aspect. Other aspects of guide dog behaviour were highlighted as particularly pleasing or disappointing by owners including attentiveness to the task, work, environment and owner; confidence in work and decision making (with confident dogs resulting in confident owners) obedience and control; calmness and locating objectives. The results reveal important areas of behaviour that are not currently considered priorities in guide dog assessments; these key areas were consistency of behaviour, the dog’s maturity and the dog’s behaviour in relation to children. The survey revealed a large range in what owners considered problematic or pleasing behaviours and this highlights the heterogeneity in guide dog owners and the potential multifarious roles of the guide dog. This study contributes to the literature on which behaviour is considered appropriate or inappropriate in dogs and on the nature of human-animal interactions. PMID:28423053

Perspectives on procedure-based assessments: a thematic analysis of semistructured interviews with 10 UK surgical trainees.

PubMed

Shalhoub, Joseph; Marshall, Dominic C; Ippolito, Kate

2017-03-24

The introduction of competency-based training has necessitated development and implementation of accompanying mechanisms for assessment. Procedure-based assessments (PBAs) are an example of workplace-based assessments that are used to examine focal competencies in the workplace. The primary objective was to understand surgical trainees' perspective on the value of PBA. Semistructured interviews with 10 surgical trainees individually interviewed to explore their views. Interviews were audio-recorded and transcribed; following this, they were open and axial coded. Thematic analysis was then performed. Semistructured interviews yielded several topical and recurring themes. In trainees' experience, the use of PBAs as a summative tool limits their educational value. Trainees reported a lack of support from seniors and variation in the usefulness of the tool based on stage of training. Concerns related to the validity of PBAs for evaluating trainees' performance with reports of 'gaming' the system and trainees completing their own assessments. Trainees did identify the significant value of PBAs when used correctly. Benefits included the identification of additional learning opportunities, standardisation of assessment and their role in providing a measure of progress. The UK surgical trainees interviewed identified both limitations and benefits to PBAs; however, we would argue based on their responses and our experience that their use as a summative tool limits their formative use as an educational opportunity. PBAs should either be used exclusively to support learning or solely as a summative tool; if so, further work is needed to audit, validate and standardise them for this purpose. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Participants' views of telephone interviews within a grounded theory study.

PubMed

Ward, Kim; Gott, Merryn; Hoare, Karen

2015-12-01

To offer a unique contribution to the evolving debate around the use of the telephone during semistructured interview by drawing on interviewees' reflections on telephone interview during a grounded theory study. The accepted norm for qualitative interviews is to conduct them face-to-face. It is typical to consider collecting qualitative data via telephone only when face-to-face interview is not possible. During a grounded theory study, exploring users' experiences with overnight mask ventilation for sleep apnoea, the authors selected the telephone to conduct interviews. This article reports participants' views on semistructured interview by telephone. An inductive thematic analysis was conducted on data pertaining to the use of the telephone interview in a grounded theory study. The data were collected during 4 months of 2011 and 6 months in 2014. The article presents an inductive thematic analysis of sixteen participants' opinions about telephone interviewing and discusses these in relation to existing literature reporting the use of telephone interviews in grounded theory studies. Overall, participants reported a positive experience of telephone interviewing. From each participants reports we identified four themes from the data: being 'phone savvy; concentrating on voice instead of your face; easy rapport; and not being judged or feeling inhibited. By drawing on these data, we argue that the telephone as a data collection tool in grounded theory research and other qualitative methodologies need not be relegated to second best status. Rather, researchers can consider telephone interview a valuable first choice option. © 2015 John Wiley & Sons Ltd.

Perspectives of policy-makers and stakeholders about health care waste management in community-based care in South Africa: a qualitative study.

PubMed

Hangulu, Lydia; Akintola, Olagoke

2017-04-19

In South Africa, a new primary health care (PHC) re-engineering initiative aims to scale up the provision of community-based care (CBC). A central element in this initiative is the use of outreach teams comprising nurses and community health workers to provide care to the largely poor and marginalised communities across the country. The provision of care will inevitably lead to an increase in the amount of health care waste (HCW) generated in homes and suggests the need to pay more attention to the HCW that emanates from homes where there is care of a patient. CBC in South Africa is guided by the home-based care policy. However, this policy does not deal with issues about how HCW should be managed in CBC. This study sought to explore health care waste management (HCWM) in CBC in South Africa from the policy-makers' and stakeholders' perspective. Semi-structured interviews were conducted with 9 policy-makers and 21 stakeholders working in 29 communities in Durban, South Africa. Interviews were conducted in English; were guided by an interview guide with open-ended questions. Data was analysed thematically. The Durban Solid waste (DSW) unit of the eThekwini municipality is responsible for overseeing all waste management programmes in communities. Lack of segregation of waste and illegal dumping of waste were the main barriers to proper management practices of HCW at household level while at the municipal level, corrupt tender processes and inadequate funding for waste management programmes were identified as the main barriers. In order to address these issues, all the policy-makers and stakeholders have taken steps to collaborate and develop education awareness programmes. They also liaise with various government offices to provide resources aimed at waste management programmes. HCW is generated in CBC and it is poorly managed and treated as domestic waste. With the rollout of the new primary health care model, there is a greater need to consider HCWM in CBC. There is need for the Department of Health to work together with the municipality to ensure that they devise measures that will help to deal with improper HCWM in the communities.

Students' Communicative Resources in Relation to Their Conceptual Understanding--The Role of Non-Conventionalized Expressions in Making Sense of Visualizations of Protein Function

ERIC Educational Resources Information Center

Rundgren, Carl-Johan; Hirsch, Richard; Chang Rundgren, Shu-Nu; Tibell, Lena A. E.

2012-01-01

This study examines how students explain their conceptual understanding of protein function using visualizations. Thirteen upper secondary students, four tertiary students (studying chemical biology), and two experts were interviewed in semi-structured interviews. The interviews were structured around 2D illustrations of proteins and an animated…

Compatibility of the Relationship of Early Recollections and Life Style with Parent Schemas Obtained through Adlerian Interviews

ERIC Educational Resources Information Center

Canel, Azize Nilgün

2016-01-01

In this study, the Adlerian Interview Form has been used as a semi-structured, in-depth interview method to identify the experiences of six participants regarding Adler's concepts of early recollections and life style. Subsequent to transcribing the obtained information, recollections to be included in the analysis were subjected to the criterion…

Interviews in qualitative research.

PubMed

Peters, Kath; Halcomb, Elizabeth

2015-03-01

Interviews are a common method of data collection in nursing research. They are frequently used alone in a qualitative study or combined with other data collection methods in mixed or multi-method research. Semi-structured interviews, where the researcher has some predefined questions or topics but then probes further as the participant responds, can produce powerful data that provide insights into the participants' experiences, perceptions or opinions.

Non-Use of Cochlear Implants in Children: Child and Parent Perspectives

ERIC Educational Resources Information Center

Watson, Linda M.; Gregory, Susan

2005-01-01

Five cases of non-use of cochlear implants by children were investigated through semi-structured interviews with the children and their carers. The children were interviewed at school by a researcher who is deaf, and the carers, all of whom were hearing, were interviewed at home by a hearing researcher when the children were not present. The…

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

DTIC Science & Technology

2016-03-01

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

Clinical Interview Assessment of Financial Capacity in Older Adults with Mild Cognitive Impairment and Alzheimer’s Disease

PubMed Central

Marson, Daniel C.; Martin, Roy C.; Wadley, Virginia; Griffith, H. Randall; Snyder, Scott; Goode, Patricia S.; Kinney, F. Cleveland; Nicholas, Anthony P.; Steele, Terri; Anderson, Britt; Zamrini, Edward; Raman, Rema; Bartolucci, Alfred; Harrell, Lindy E.

2009-01-01

Objectives To investigate financial capacity in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) using a clinician interview approach. Design Cross-sectional. Setting Tertiary care medical center. Participants Healthy older adults (N=75), patients with amnestic MCI (N=58), mild AD (N=97), and moderate AD (N=31). Measurements The investigators and five study physicians developed a conceptually based, semi-structured clinical interview for evaluating seven core financial domains and overall financial capacity (Semi-Structured Clinical Interview for Financial Capacity; SCIFC). For each participant, a physician made capacity judgments (capable, marginally capable, or incapable) for each financial domain and for overall capacity. Results Study physicians made a total of over 11,000 capacity judgments across the study sample (N=261). Very good inter-rater agreement was obtained for the SCIFC judgments. Increasing proportions of marginal and incapable judgment ratings were associated with increasing disease severity across the four study groups. For overall financial capacity, 95 percent of physician judgments for older controls were rated as capable, as compared to only 82% for patients with MCI, 26% for patients with mild AD, and 4% for patients with moderate AD. Conclusion Financial capacity in cognitively impaired older adults can be reliably evaluated by physicians using a relatively brief, semi-structured clinical interview. Financial capacity shows mild impairment in MCI, emerging global impairment in mild AD, and advanced global impairment in moderate AD. MCI patients and their families should proactively engage in financial and legal planning given these patients’ risk of developing AD and accelerated loss of financial abilities. PMID:19453308

Ethical Issues in Public Health Practice in Michigan

PubMed Central

Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

2009-01-01

Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

Promoting Holistic Well-Being in Chronic Stroke Patients Through Leisure Art-Based Creative Engagement.

PubMed

Sit, Janet W H; Chan, Amy W H; So, Winnie K W; Chan, Carmen W H; Chan, Aileen W K; Chan, Helen Y L; Fung, Olivia W M; Wong, Eliza M L

To examine the potential value of a creative art-based activity as a caring modality for promoting holistic well-being among chronic stroke patients, and to explore the feelings and meanings that stroke patients derived from their experience in leisure art-based creative engagement (LACE). Qualitative design. Participants were recruited through purposive and snowball sampling. Individual semi-structured interviews were conducted. Qualitative content analysis was performed. The design and implementation of LACE was guided by Watson's theory of caring. Twenty-four participants completed the study. Four themes emerged from participants' account of experiences with the LACE: (1) appreciation of opportunities, (2) appreciation of self, (3) appreciation of others, and (4) appreciation of life. From the perspective of the participants, engaging in LACE enhances their sense of enjoyment and self-expression. Furthermore, they perceived LACE as an affirmation of life and an empowering process strengthening their connection and appreciation with the self and others. This study adds evidence to existing literature on Watson's theory-guided design and implementation of caring initiatives for community rehabilitation and has laid the groundwork for developing further evidencebased research in leisure art-based caring occasions for promoting holistic well-being in stroke rehabilitation.

A qualitative study on tobacco smoking and betel quid use among Burmese refugees in Australia.

PubMed

Furber, Susan; Jackson, Janet; Johnson, Keryn; Sukara, Radmila; Franco, Lisa

2013-12-01

Anecdotal evidence suggests that there are high rates of smoking among Burmese men in Wollongong, Australia. A qualitative study was undertaken to explore the beliefs and experiences of Burmese refugees in Wollongong on smoking to guide the development of smoking cessation interventions. Three focus groups were conducted with Burmese refugees. Ten semi-structured interviews were conducted with service providers involved with Burmese refugees. Qualitative content analysis was used to categorise responses to the questions. Participants were aware of the health effects of tobacco smoking but had little knowledge of support for quitting. Many participants chewed betel quid and were unaware of the health consequences. Service providers noted the lack of resources on smoking and betel quid use for Burmese people. Smoking cessation interventions for Burmese people should consider the co-related use of betel quid due to the possibility of inadvertently encouraging use of betel nut as an alternative to tobacco.

Breaking Boundaries: Complementary and Alternative Medicine Provider Framing of Preventive Care.

PubMed

Agarwal, Vinita

2017-11-01

This textual examination extends understandings of how complementary and alternative medicine (CAM) providers constitute preventive care in their discourse by identifying the frame of breaking boundaries referencing relational, structural, and philosophical orientations in their practice with their clients. Analysis of semistructured, in-depth interviews with CAM providers ( n = 17) reveals that the frame of breaking boundaries was comprised of three themes: finding one's own strength; I don't prescribe, so I'm exploring; and ground yourself, and have an escape route. The themes describe preventive care by identifying how CAM providers negotiate their relational positionality in connecting with clients, structural positionality within the field of health care, and philosophical positionality within the ontological understandings that guide how health is defined and conceptualized. The study contributes toward enhancing diverse understandings of constituting preventive care in practice and suggests pragmatic implications for addressing biomedical provider communication with their patients seeking CAM care alongside conventional treatments.

"You gotta try it all": Parents' Experiences with Robotic Gait Training for their Children with Cerebral Palsy.

PubMed

Beveridge, Briony; Feltracco, Deanna; Struyf, Jillian; Strauss, Emily; Dang, Saniya; Phelan, Shanon; Wright, F Virginia; Gibson, Barbara E

2015-01-01

Innovative robotic technologies hold strong promise for improving walking abilities of children with cerebral palsy (CP), but may create expectations for parents pursuing the "newest thing" in treatment. The aim of this qualitative study was to explore parents' values about walking in relation to their experiences with robotic gait training for their children. Semi-structured interviews were conducted with parents of five ambulatory children with CP participating in a randomized trial investigating robotic gait training effectiveness. Parents valued walking, especially "correct" walking, as a key component of their children's present and future well-being. They continually sought the "next best thing" in therapy and viewed the robotic gait trainer as a potentially revolutionary technology despite mixed experiences. The results can help inform rehabilitation therapists' knowledge of parents' values and perspectives, and guide effective collaborations toward meeting the therapeutic needs of children with CP.

Depression, Social Isolation, and the Lived Experience of Dancing in Disadvantaged Adults.

PubMed

Murrock, Carolyn J; Graor, Christine Heifner

2016-02-01

This qualitative study described the lived experience of dancing as it related to depression and social isolation in 16 disadvantaged adults who completed a 12-week dance intervention. It is the first qualitative study to explore the experience of dance as an adjunct therapy, depression, and social isolation. A descriptive phenomenological framework consisted of two focus groups using semi-structured interviews. A Giorgian approach guided thematic analysis. Four themes emerged: (1) dance for myself and health, (2) social acceptance, (3) connection with others: a group, and (4) not wanting to stop: unexpected benefits from dancing. As the participants continued to dance, they developed a sense of belonging and group identity, which may have maintained group involvement and contributed to reducing depression and social isolation. Thus, dancing is a complementary therapy that should be considered when working with adults with depression and social isolation. Copyright © 2015 Elsevier Inc. All rights reserved.

"Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder.

PubMed

Perich, Tania; Ussher, Jane; Parton, Chloe

2017-11-16

Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Themes identified included 'Constructions of mood change: menopause or bipolar disorder?',' Life events, bipolar disorder and menopause coming together'; 'Treatment choices for mood change during menopause'. The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices.

Healing patterns revealed in middle school boys' experiences of being bullied using Roger's Science of Unitary Human Beings (SUHB).

PubMed

Willis, Danny G; Griffith, Catherine A

2010-08-01

Although two of the primary risk factors for being bullied include "male" and "middle school" status, a gap in knowledge exists of middle school boys' personal accounts and meanings of being bullied and their healing. Giorgi's descriptive phenomenological approach using open-ended semi-structured individual interviews was used to collect and analyze evidence related to middle school boys' lived experiences of being bullied and healing. Roger's Science of Unitary Human Beings (SUHB) guided interpretation of the healing patterns. Three patterns of healing were identified in boys' experiences: meaning-making, self-transcendence, and nonviolently claiming personal power. Evidence of healing patterns exists in middle school boys' experiences of being bullied, offering a foundation for further research and practice focused on healing. When working with middle school boys who have been bullied, nurses need to ask about their experiences and promote their healing.

Strategies for Aging in Place

PubMed Central

Gould, Odette N.; Gibbons, Caroline; Simard, Majella; Éthier, Sophie; Villalon, Lita

2015-01-01

For healthy and independent older adults, aging in place can be seen as identical to any other adult living at home. Little is known about how frail seniors, particularly those who speak a minority language, manage the challenges of aging in place. The present qualitative descriptive study explores the strategies that Canadian French-speaking seniors have put in place to counter their loss of independence and promote their ability to stay in their home. Semistructured individual interviews were conducted with 39 older adults and transcribed, followed by content analysis to identify common themes related to study objectives. Six themes emerged in response to strategies described for aging in place. Findings reveal the limited extent to which language issues were perceived as a barrier by participants. In conclusion, the results of this study provide us with fruitful insights to guide community nursing practice, future research, and public policy. PMID:28462299

Barriers and strategies to an iterative model of advance care planning communication.

PubMed

Ahluwalia, Sangeeta C; Bekelman, David B; Huynh, Alexis K; Prendergast, Thomas J; Shreve, Scott; Lorenz, Karl A

2015-12-01

Early and repeated patient-provider conversations about advance care planning (ACP) are now widely recommended. We sought to characterize barriers and strategies for realizing an iterative model of ACP patient-provider communication. A total of 2 multidisciplinary focus groups and 3 semistructured interviews with 20 providers at a large Veterans Affairs medical center. Thematic analysis was employed to identify salient themes. Barriers included variation among providers in approaches to ACP, lack of useful information about patient values to guide decision making, and ineffective communication between providers across settings. Strategies included eliciting patient values rather than specific treatment choices and an increased role for primary care in the ACP process. Greater attention to connecting providers across the continuum, maximizing the potential of the electronic health record, and linking patient experiences to their values may help to connect ACP communication across the continuum. © The Author(s) 2014.

Military Wives' Transition and Coping: Deployment and the Return Home

PubMed Central

Marnocha, Suzanne

2012-01-01

The objective of this qualitative study is to explore the experiences of wives of deployed soldiers. Semistructured interviews were used to answer the research questions. Meleis' Transitions Theory was used to guide the understanding of the wives' experiences. Phase One: news of deployment, property of awareness, themes of emotional chaos and making preparations. Phase Two: during deployment, property of engagement, themes of taking the reins and placing focus elsewhere, along with the property of change and difference, with themes of emotional and physical turmoil, staying strong, and reaching out. Phase Three: after deployment, property of time span, themes of absence makes the heart grow fonder and reestablishing roles. The study concluded that the wife often feels forgotten during deployment. Nurses can give better care by understanding how the different phases of deployment and separation affect the wife's coping ability and her physical and emotional health. PMID:22844613

Multidisciplinary team of intensive therapy: humanization and fragmentation of the work process.

PubMed

Evangelista, Viviane Canhizares; Domingos, Thiago da Silva; Siqueira, Fernanda Paula Cerântola; Braga, Eliana Mara

2016-01-01

to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team. descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis. from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization. care activities in intensive therapy are guided by the humanization of care and corroborate the hospital management as a challenge to be overcome to boost advances in the operationalization of this Brazilian policy.

Influencing factors on cervical cancer screening from the Kurdish women's perspective: A qualitative study.

PubMed

Rasul, V H; Cheraghi, M A; Behboodi Moqadam, Z

2015-01-01

Aim: This study was aimed to explore and describe the Kurdish women's perception of cervical cancer screening. Methods: A qualitative design based on a conventional content analysis approach. Purposive sampling was applied to 19 women chosen, who had a Pap smear or refused to have one. The study was performed in the Kurdistan Region, Iraq. Semi-structure din-depth individual interviews were carried out to collect data. Results: Four main themes including conflict, belief, and awareness about cervical cancer screening and socio-cultural factors emerged during data analysis Conclusions: Cervical cancer has a high mortality rate in the developing countries. However, only a few Kurdish women participated in the cervical cancer screening in the Kurdistan Region, Iraq. Understanding the factors associated with the women's perception of cervical cancer could guide future educational planning and clinical interventions improve the cervical cancer screening.

Influencing factors on cervical cancer screening from the Kurdish women’s perspective: A qualitative study

PubMed Central

Rasul, VH; Cheraghi, MA; Behboodi Moqadam, Z

2015-01-01

Aim:This study was aimed to explore and describe the Kurdish women’s perception of cervical cancer screening. Methods: A qualitative design based on a conventional content analysis approach. Purposive sampling was applied to 19 women chosen, who had a Pap smear or refused to have one. The study was performed in the Kurdistan Region, Iraq. Semi-structure din-depth individual interviews were carried out to collect data. Results: Four main themes including conflict, belief, and awareness about cervical cancer screening and socio-cultural factors emerged during data analysis Conclusions: Cervical cancer has a high mortality rate in the developing countries. However, only a few Kurdish women participated in the cervical cancer screening in the Kurdistan Region, Iraq. Understanding the factors associated with the women’s perception of cervical cancer could guide future educational planning and clinical interventions improve the cervical cancer screening. PMID:28255397

Are Generation Y Nurses Satisfied on the Job? Understanding Their Lived Experiences.

PubMed

Anselmo-Witzel, Sonia; Orshan, Susan A; Heitner, Keri L; Bachand, Jeanie

2017-04-01

The purpose of this study was to explore the lived experiences of job satisfaction among Generation Y nurses in the workplace. Job satisfaction in nursing is at an all-time low. With an increasing shortage of nurses, there is a need for more awareness and understanding of job satisfaction and intent to stay among Generation Y nurses who are the future generation of nurses. Descriptive phenomenology-guided, in-depth semistructured interviews were conducted to explore the lived experiences of job satisfaction among 10 Generation Y nurses. Four main themes and 6 subthemes that emerged brought meaning to the nurses' experiences. The 4 main themes were experiences of feeling good, relationships, job strain, and having choices. Findings indicated Generation Y nurses want to fulfill inner feelings of job satisfaction. If these inner feelings are not met, they will seek other opportunities to fulfill job satisfaction.

A Qualitative Study of Survival Strategies Used by Low-Income Black Women Who Experience Intimate Partner Violence

PubMed Central

St. Vil, Noelle M.; Sabri, Bushra; Nwokolo, Vania; Alexander, Kamila A.; Campbell, Jacquelyn C.

2017-01-01

Women who experience intimate partner violence (IPV) are often portrayed as helpless victims. Yet many women who experience IPV implement strategies to help them survive the abuse. This qualitative study sought to explore the survivor strategies used by low-income black women who experience IPV. Authors used a semistructured interview guide to survey 26 survivors who reported being in an IPV relationship in the past two years. Thematic analysis revealed three types of survivor strategies used by low-income black women: (1) internal (use of religion and becoming self-reliant), (2) interpersonal (leave the abuser or fight back), and (3) external (reliance on informal, formal, or both kinds of sources of support). This article informs social work practitioners of the strategies used by low-income black women in surviving IPV so that practitioners can develop interventions that support these strategies. PMID:28395046

Wild birds as pets in Campina Grande, Paraíba State, Brazil: an ethnozoological approach.

PubMed

Licarião, Morgana R; Bezerra, Dandara M M; Alves, Rômulo R N

2013-03-01

Birds are one of the animals most widely used by humans and are highly valued as pets. The present work reports the use of wild birds as pets in the city of Campina Grande, Paraíba State (PB), Brazil. The owners' choice and perceptions of the species ecology was assessed as well. The methodology employed included unstructured and semi-structured interviews, guided tours and direct observations. A total of 26 bird species distributed among ten families and four orders were identified. The most frequently encountered order was Passeriformes (76.9%), with a predominance of the family Emberizidae (34.6%). The specimens kept as pets were principally obtained in public markets or between the breeders themselves. The popularity of birds as pets, compounded by the inefficiency of official controls over the commerce of wild animals has stimulated the illegal capture and breeding of wild birds in Campina Grande.

Inadequate performance measures affecting practices, organizations and outcomes of Ontario's family health teams.

PubMed

Ashcroft, Rachelle

2014-01-01

Emphasis on quantity as the main performance measure may be posing challenges for Family Health Team (FHT) practices and organizational structures. This study asked: What healthcare practices and organizational structures are encouraged by the FHT model? An exploratory qualitative design guided by discourse analysis was used. This paper presents findings from in-depth semi-structured interviews conducted with seven policy informants and 29 FHT leaders. Participants report that performance measures value quantity and are not inclusive of the broad scope of attributes that comprise primary healthcare. Performance measures do not appear to be accurately capturing the demand for healthcare services, or the actual amount of services being provided by FHTs. RESULTS suggest that unintended consequences of performance measures may be posing challenges to access and health outcomes. It is recommended that performance measures be developed and used to measure, support and encourage FHTs to achieve the goals of PHC. Copyright © 2014 Longwoods Publishing.

Curing and Caring: The Work of Primary Care Physicians With Dementia Patients

PubMed Central

CarolinaApesoa-Varano, Ester; Barker, Judith C.; Hinton, Ladson

2013-01-01

The symbolic framework guiding primary care physicians’ (PCPs) practice is crucial in shaping the quality of care for those with degenerative dementia. Examining the relationship between the cure and care models in primary care offers a unique opportunity for exploring change toward a more holistic approach to health care. The aims of this study were to (a) explore how PCPs approach the care of patients with Alzheimer’s disease (AD), and (b) describe how this care unfolds from the physicians’ perspectives. This was a cross-sectional study of 40 PCPs who completed semistructured interviews as part of a dementia caregiving study. Findings show that PCPs recognize the limits of the cure paradigm and articulate a caring, more holistic model that addresses the psychosocial needs of dementia patients. However, caring is difficult to uphold because of time constraints, emotional burden, and jurisdictional issues. Thus, the care model remains secondary and temporary. PMID:21685311

Structural Violence in Health Care: Lived Experience of Street-Based Female Commercial Sex Workers in Kathmandu.

PubMed

Basnyat, Iccha

2017-01-01

Thirty-five in-depth, semi-structured interviews were conducted with female, street-based, commercial sex workers in Kathmandu, Nepal. The framework of structural violence guided this study in identifying the structural context that impacts the female sex workers' lives and may cause harm to their health. Structural violence in health care was revealed through thematic analysis as (a) discrimination, (b) forced choice, and (c) limitations to health information sources. Lived experiences highlight how the sex workers engaged with structural limitations in health care access, services, and utilization. Structural violence conveys a message about who is entitled to health care and what a society emphasizes and expects regarding acceptable health behavior. Examining the structural violence highlighted how the sex workers negotiated, understood, and engaged with structural limitations in health care access, services, and utilization. © The Author(s) 2015.

Perceptions of mental health among recently immigrated Mexican adolescents.

PubMed

Garcia, Carolyn M; Saewyc, Elizabeth M

2007-01-01

Rates of anxiety, depression, and suicidal ideation are high among Latino adolescents in the U.S., many of whom are immigrants. Immigration during adolescence creates risk factors for mental health problems. The purpose of this study was to explore the health-related perceptions of Mexican-origin immigrant adolescents to inform the design of culturally and developmentally appropriate mental health services. This focused ethnography was guided by Bronfenbrenner's ecological framework and symbolic interactionism. Fourteen adolescents were recruited from two non-health-based community settings. Data from one-to-one semi-structured interviews and a visual narrative project were coded and analyzed inductively. Three thematic patterns were identified: "mentally healthy," "mentally unhealthy," and "health promotion." Increased awareness of cultural influences and immigration on Latino adolescents' mental health is needed. Mental health nurses are in a unique position to educate and to influence accessibility of services.

A Phenomenological Study of Nurse Manager Interventions Related to Workplace Bullying.

PubMed

Skarbek, Anita J; Johnson, Sandra; Dawson, Christina M

2015-10-01

The aim of this study was to acquire nurse managers' perspectives as to the scope of workplace bullying, which interventions were deemed as effective and ineffective, and what environmental characteristics cultivated a healthy, caring work environment. Research has linked workplace bullying among RNs to medical errors, unsafe hospital environments, and negative patient outcomes. Limited research had been conducted with nurse managers to discern their perspectives. Six nurse managers from hospital settings participated in in-depth, semistructured interviews. Ray's theory of bureaucratic caring guided the study. These themes emerged: (a) awareness, (b) scope of the problem, (c) quality of performance, and (d) healthy, caring environment. Findings indicated mandated antibullying programs were not as effective as individual manager interventions. Systems must be in place to hold individuals accountable for their behavior. Communication, collective support, and teamwork are essential to create environments that lead to the delivery of safe, optimum patient care.

Sport Participation for Elite Athletes With Physical Disabilities: Motivations, Barriers, and Facilitators.

PubMed

McLoughlin, Gabriella; Weisman Fecske, Courtney; Castaneda, Yvette; Gwin, Candace; Graber, Kim

2017-10-01

There are many reasons why individuals are motivated to participate in sports. Less attention, however, is given for studying motivation and athlete development in adapted sport. The purpose of this study was to identify the motivations, facilitators, and barriers to sports participation of elite athletes with a physical disability. Participants (N = 23, 17 males, six females, mean age: 24.3 years) were recruited through online listservs, e-mails, and snowball sampling. A semistructured interview guide was employed. Analysis was conducted and grounded in self-determination theory and literature surrounding barriers and facilitators of sports participation. Through coding by multiple researchers, six themes emerged. Themes indicated that athletes attributed participation to constructs of self-determination theory as well as overcoming specific barriers such as cost, time constraints, and lack of opportunity. Among facilitators to their athletic development, there were empowerment and advocacy, increased health, college scholarships, and achieving performance-related goals.

Adolescence and asthma management: the perspective of adolescents receiving primary health care☆

PubMed Central

Araújo, Alisson; Rocha, Regina Lunardi; Alvim, Cristina Gonçalves

2014-01-01

Objective: To study the influence of adolescence characteristics on asthma management. Methods: This was a qualitative study conducted in the city of Divinópolis, Minas Gerais, Southeast Brazil. Data were collected through semistructured interviews guided by a questionnaire with seven asthmatic adolescents followed-up in the primary public health care service of the city. Results: Using content analysis, three thematic categories were observed in the adolescents' responses: 1) family relationships in the treatment of asthma in adolescence; 2) the asthmatic adolescents and their peers; and 3) the role of the school for the asthmatic adolescents. Conclusions: The results demonstrated that peers, family, and school should be more valued by health professionals and by health care services when treating asthmatic adolescents, as these social relationships are closely associated with the adolescent and have an important role in asthma management. Attempts to meet the demands of adolescents contribute to improve asthma management. PMID:25479845

Continent or incontinent? That is the question.

PubMed

Taunton, Roma Lee; Swagerty, Daniel L; Lasseter, Joyce A; Lee, Robert H

2005-09-01

A qualitative, emergent, case study design guided the description of care provided to nursing home residents with urinary incontinence in three Midwestern nursing facilities. Participants included 17 residents and 16 family members or friends of the respective residents. Staff and managers involved in the planning and delivery of care to the participating residents also were included. The three facilities represented variation in size, location, ownership, and Medicare certification. Data were collected via observation, resident record audit, and semi-structured interview. Definitions of incontinence varied among staff. A collectively held expectation that residents would be toileted every 2 hours was not met. Maintaining skin integrity was the primary motivation for keeping residents clean and dry. Medical directors viewed incontinence as a nursing problem. Staff described situations in which incontinence was improved for specific residents, but there was little evidence of formal programs to maintain continence or improve incontinence.

Professional concerns of beginning teachers of deaf and hard of hearing students.

PubMed

Guteng, Simon I

2005-01-01

The professional concerns of beginning teachers of students who are deaf or hard of hearing were examined. Five first-year teachers of deaf and hard of hearing students served as participants. Two of the participants were itinerant teachers; three taught in self-contained classrooms. Participants were selected from programs serving deaf and hard of hearing students in rural and urban areas of the midwestern and southwestern United States. To interview the study participants, the researcher used an in-depth phenomenological method employing semi-structured questions and guided by a constructivist paradigm. Data were analyzed using qualitative analysis strategies (Bogdan & Biklen, 1992; Miles & Huberman, 1994). Results showed that concerns of beginning teachers of deaf and hard of hearing students are specific to service delivery models and geography. Participants provided specific recommendations for addressing the concerns of beginning teachers of deaf and hard of hearing students.

The Challenges of Providing Postpartum Education in Dar es Salaam, Tanzania: Narratives of Nurse-Midwives and Obstetricians.

PubMed

Mselle, Lilian Teddy; Aston, Megan; Kohi, Thecla W; Mbekenga, Columba; Macdonald, Danielle; White, Maureen; Price, Sheri; Tomblin Murphy, Gail; O'Hearn, Shawna; Jefferies, Keisha

2017-10-01

Postpartum education can save lives of mothers and babies in developing countries, and the World Health Organization recommends all mothers receive three postpartum consultations. More information is needed to better understand how postpartum education is delivered and ultimately improves postpartum health outcomes. The purpose of this qualitative study was to examine how postpartum care was delivered in three postnatal hospital clinics in Dar es Salaam, Tanzania. Semistructured interviews with 10 nurse-midwives and three obstetricians were conducted. Feminist poststructuralism guided the research process. Postpartum education was seen to be an urgent matter; there was a lack of supportive resources and infrastructure in the hospital clinics, and nurse-midwives and obstetricians had to negotiate conflicting health and traditional discourses using various strategies. Nurse-midwives and obstetricians are well positioned to deliver life-saving postpartum education; however, improvements are required including increased number of nurse-midwives and obstetricians.

Health promotion in the trucking setting: Understanding Dutch truck drivers' road to healthy lifestyle changes.

PubMed

Boeijinga, Anniek; Hoeken, Hans; Sanders, José

2016-10-17

The working environment, the nature of the work, and the characteristics of truck drivers as a social group typically pose great challenges for the truck drivers' health and health promotion activities aiming to improve it. The purpose was to obtain a better understanding of (a) Dutch truck drivers' perceptions of health and lifestyle themes, and (b) the challenges they experience in their pursuit of a more healthy lifestyle, as a guiding framework for the development of health interventions targeting this occupational group. In this qualitative study, we conducted and analyzed 20 semi-structured interviews and seven cases of participant observations with Dutch truck drivers. Grounded theory was used to analyze the data. Our findings illustrate that Dutch truck drivers wish to improve their lifestyle but have unproductive associations with concepts of healthy living as well as a tendency to downplay their health risks. In addition, they experience barriers within their work and personal environment that prevent them from translating their intentions into actual lifestyle changes. Based on the insights derived from the interviews, we discuss recommendations for the development of more effective health promotion interventions for truck drivers.

South Asian adolescents' experiences of acculturative stress and coping.

PubMed

Tummala-Narra, Pratyusha; Deshpande, Anita; Kaur, Jasleen

2016-03-01

Despite the significant growth in the South Asian population in the United States over the past 2 decades, the experiences of South Asian adolescents have remained largely invisible. Guided by a socioecological perspective (American Psychological Association, 2012; García Coll & Marks, 2012), this study examined South Asian adolescents' experiences of acculturative stress and approaches to coping with this stress across home and school contexts. A semistructured interview was completed by 16 participants (9 girls, 7 boys; ages 14-18 years) from different South Asian backgrounds, attending an urban public high school in the Northeastern part of the United States. Conventional content analysis was used to analyze the interview data, and revealed 4 broad categories or domains related to participants' experiences as young South Asians in the U.S. These domains include the following: (a) Connection to family, community, and heritage; (b) Challenges to acculturation; (c) Stress accompanying the navigation across cultural contexts; and (d) Coping and resilience. Participants' narratives reflect acculturative stress experienced in home and school contexts which can inhibit psychological well-being and bicultural identity development. The findings have important implications for culturally informed research, intervention, and policy. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Bereaved mothers' and fathers' perceptions of a legacy intervention for parents of infants in the NICU.

PubMed

Akard, T F; Duffy, M; Hord, A; Randall, A; Sanders, A; Adelstein, K; Anani, U E; Gilmer, M J

2018-01-01

Legacy-making, actions or behaviors aimed at being remembered, may be one strategy to enhance coping and improve grief outcomes for bereaved parents and siblings. While legacy interventions have been developed and tested in pediatric and adult populations, legacy activities specific to bereaved parents in the neonatal intensive care unit remain unexplored. This study explored bereaved parents' perceptions of a digital storytelling legacy-making intervention for parents after the death of an infant. Six bereaved mothers and fathers participated in a focus group interview three to 12 months after the death of an infant in the NICU. A semi-structured interview guide with open-ended questions was used to obtain parent self-reports. Qualitative content analysis identified emerging themes. Four major themes emerged regarding participants' perceptions of a legacy intervention: (a) parents' willingness to participate in a legacy intervention, (b) parents' suggestions for a feasible intervention, (c) parents' suggestions for an acceptable intervention, and (d) parents' perceived benefits of legacy-making. Participants reported that a legacy-making intervention via digital storytelling would be feasible, acceptable, and beneficial for NICU parents. Study results support the need and desire for legacy-making services to be developed and offered in the NICU.

Protective factors against suicide among young-old Chinese outpatients

PubMed Central

2014-01-01

Background Suicide is common among the elderly worldwide. However, no literature could be found on the beliefs/expectations that protect young-old people from attempting suicide. The purpose of this study was to explore young-old outpatients’ reasons for not killing themselves in Taiwan. Method Data for this qualitative descriptive study were extracted from a large research series. From the 83 elderly outpatients in the original sample, 31 were chosen for this study because they were young-old (65–74 years old) and from two randomly selected medical centers in northern Taiwan. Data on participants’ reasons for not killing themselves in unhappy situations were collected in individual interviews using a semi-structured guide and analyzed by content analysis. Results Analysis of interview data identified six major themes: satisfied with one’s life, suicide cannot resolve problems, fear of humiliating one’s children, religious beliefs, never thought about suicide, and living in harmony with nature. Conclusion These identified protective factors (reasons for living) could be added to suicide-prevention programs for the elderly. Our findings may also serve as a reference for geriatric researchers in western countries with increasing numbers of elderly ethnic minority immigrants. PMID:24739419

A qualitative study of the emotional coping and support needs of children living with a parent with a brain injury.

PubMed

Rohleder, Poul; Lambie, John; Hale, Emily

2017-01-01

To examine emotional coping and support needs in children of persons with acquired brain injury, with a view to understanding what interventions would be helpful for these children. The study was qualitative, using a thematic analysis approach. Six children between 9-18 years of age, six parents (three with ABI) and three support workers were interviewed either at home or at a support centre, using a semi-structured interview guide. Children reported using a variety of adaptive and maladaptive emotional coping strategies, but were consistent in expressing a need for credible validation, i.e. sharing experiences with peers. The results are presented under four overarching themes: difficulties faced; emotions experienced; coping strategies; and reported support needs. The results reveal an interaction between the child's experiences of complex loss that is difficult to acknowledge, emotional distancing between parent and child and the children's need for credible validation. All children expressed a desire for talking to peers in a similar situation to themselves, but had not had this opportunity. Interventions should set up such peer interaction to create credible validation for the specific distress suffered by this population.

[Intraprofessional communication during shift change].

PubMed

Martín Pérez, Sonsoles; Vázquez Calatayud, Mónica; Lizarraga Ursúa, Yolanta; Oroviogoicoechea Ortega, Cristina

2013-05-01

Effective communication between professionals is crucial to ensure patient safety. 1) Explore the intraprofessional communication process during nurse shift change; 2) identify improvement strategies to facilitate optimal communication process. Exploratory study conducted from January to May 2011 in an intermediate unit. There were performed 16 structured observations of the communication process and 4 semistructured interviews and 16 anonymous surveys (designed by the evidence, interviews and observations) to the nurses who agreed to participate in the study. Strengths: complete process and the usefulness of the computer record. lack of common structure, repetition and forgetfulness of information, numerous interruptions during the process and noise. The 68.75% of nurses said that part of the transmitted information was irrelevant and too long. All of them perceived the need for changes in the existing process. Some strategies were identified to improve the development of a guide based on the mnemonic SBAR. It was adapted to the structure of the software as well as a change in location for the transmission of information. We propose to have an effective intraprofessional communication in order to ensure patient safety. In addition the transmission of information during the shift change should be done through a systematic process in a quiet place without interruptions.

The New South Wales Allied Health Workplace Learning Study: barriers and enablers to learning in the workplace.

PubMed

Lloyd, Bradley; Pfeiffer, Daniella; Dominish, Jacqueline; Heading, Gaynor; Schmidt, David; McCluskey, Annie

2014-03-25

Workplace learning refers to continuing professional development that is stimulated by and occurs through participation in workplace activities. Workplace learning is essential for staff development and high quality clinical care. The purpose of this study was to explore the barriers to and enablers of workplace learning for allied health professionals within NSW Health. A qualitative study was conducted with a purposively selected maximum variation sample (n =46) including 19 managers, 19 clinicians and eight educators from 10 allied health professions. Seven semi-structured interviews and nine focus groups were audio-recorded and transcribed. The 'framework approach' was used to guide the interviews and analysis. Textual data were coded and charted using an evolving thematic framework. Key enablers of workplace learning included having access to peers, expertise and 'learning networks', protected learning time, supportive management and positive staff attitudes. The absence of these key enablers including heavy workload and insufficient staffing were important barriers to workplace learning. Attention to these barriers and enablers may help organisations to more effectively optimise allied health workplace learning. Ultimately better workplace learning may lead to improved patient, staff and organisational outcomes.

Losses related to everyday occupations for adults affected by mental illness.

PubMed

Baker, Amy Elizabeth Zanker; Procter, Nicholas Gerard

2014-07-01

This paper presents findings from a larger study that explored losses from mental illness. Losses associated with occupations--a key theme from this participatory action research study--are the focus of this paper. Semi-structured in-depth interviews were carried out with 16 people who had been diagnosed with a mental illness and attended a community mental health centre. Interviews were transcribed verbatim and thematically analysed, guided by processes proposed by Dey. Numerous losses influenced participants' ability to initiate or engage in daily occupations. Some losses perpetuated further loss, at times with profound consequences, such as the loss of a house following a loss of work. Engaging in chosen occupations was often described as a longer-term goal or something participants did infrequently, due to losses such as motivation, energy, or normal sleeping patterns. The desire to work and participate in everyday occupations was emphasized and its benefits highlighted, despite previous difficulties. Implications for occupational therapists include the importance of exploring, validating, and responding to losses when these are shared, and being aware of and striving to support people experiencing losses in the areas of work, motivation, sleep patterns, and energy, which were perceived as especially challenging for participants in this study.

Nursing leadership in an academic hospital in Gauteng.

PubMed

Maboko, D R

2012-10-01

This study was aimed at describing nursing leadership in an academic hospital in Gauteng, South Africa. Nurse managers' leadership styles affect nurses' attitudes, behaviour and work performance. However, little is known about how nurses experience nurse leadership and what leadership styles are found in academic hospitals in Gauteng. The study was based on Maxwell's framework of leadership (relationships, equipping, leadership and attitude). A qualitative design was used in order to describe the experiences of registered nurses and nurse managers. The population of the study was all registered nurses and nurse managers of the hospital in which the study was conducted. In phase one of the study, a discussion group with 35 registered nurses using the nominal group technique was held to respond to the following statement: 'Please explain how you have experienced leadership by nurse managers in this hospital'. In phase two of the study, five nurse managers were interviewed individually, using a semi-structured interview guide. Some nurse managers were practising autocratic leadership in this hospital. he nurse managers need to be taught about contemporary leadership styles such as transformational leadership and visionary leadership and also about supervision, role modelling and caring. © 2011 Blackwell Publishing Ltd.

Human papillomavirus vaccine motivators and barriers among community college students: Considerations for development of a successful vaccination program.

PubMed

Hirth, Jacqueline M; Batuuka, Denise N; Gross, Tyra T; Cofie, Leslie; Berenson, Abbey B

2018-02-14

Previous interventions in colleges to improve human papillomavirus (HPV) vaccination have not been highly successful. Although barriers have been assessed in traditional colleges, less is known about vaccination barriers in community colleges. We approached students aged 18-26 years old enrolled at a community college for an in-person semi-structured qualitative interview on HPV vaccination and health, with questions guided by the Theory of Planned Behavior. Data collection took place between April 2015 and December 2015. Thematic analysis techniques were used to analyze the data. During interviews with 19 students, 4 themes emerged, including: general vaccine attitudes, barriers to HPV vaccination, motivators to HPV vaccination, and social influences. Participants felt that vaccines were beneficial, but were concerned about side effects. They felt that getting the HPV vaccine would be inconvenient, and they did not know enough about it to decide. Most would not trust their friends' opinions, but would want to know about side effects that their vaccinated friends experienced. Successful interventions at community colleges should include several components to increase convenience as well as utilize interactive methods to promote HPV vaccine awareness. Copyright © 2018. Published by Elsevier Ltd.

Motivators and Barriers to Reducing Sedentary Behavior Among Overweight and Obese Older Adults.

PubMed

Greenwood-Hickman, Mikael Anne; Renz, Anne; Rosenberg, Dori E

2016-08-01

To explore individual, social, environmental, and program-related motivators, barriers, and impacts of sedentary behavior (SB) reduction among a group of overweight and obese older adults aged 60 and older. Semistructured interviews were conducted with 24 participants following a SB reduction intervention. Transcripts from these interviews were iteratively coded by a team, and key themes were defined and refined guided by the social-ecological framework. Motivators included the desire to improve health, newly acquired awareness of SB, the ease of incorporating SB reduction into current lifestyle, an adaptable environment, and the use of reminders. Barriers included existing health conditions, enjoyment of sedentary activities, unadaptable environments, fatigue, and difficulty understanding SB reduction as distinct from physical activity (PA). Participants reported impacts on physical and mental health and changes in awareness, exercise, and daily activity. Although in many ways motivators and barriers to reducing SB are similar to those of PA, SB interventions have special considerations and may ultimately be easier for some individuals to incorporate into their lifestyle. © The Author 2015. 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.

Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in Australia: phase 2 results.

PubMed

Drury, Vicki; Craigie, Mark; Francis, Karen; Aoun, Samar; Hegney, Desley G

2014-05-01

This is the first two-phase Australian study to explore the factors impacting upon compassion satisfaction, compassion fatigue, anxiety, depression and stress and to describe the strategies nurses use to build compassion satisfaction into their working lives. Compassion fatigue has been found to impact on job satisfaction, the quality of patient care and retention within nursing. This study provides new knowledge on the influences of anxiety, stress and depression and how they relate to compassion satisfaction and compassion fatigue. In Phase 2 of the study, 10 nurses from Phase 1 of the study participated in individual interviews and a focus group. A semi-structured interview schedule guided the conversations with the participants. Data analysis resulted in seven main themes: social networks and support;infrastructure and support; environment and lifestyle; learning; leadership; stress; and suggestions to build psychological wellness in nurses. Findings suggest that a nurse’s capacity to cope is enhanced through strong social and collegial support, infrastructure that supports the provision of quality nursing care and positive affirmation. These concepts are strongly linked to personal resilience. for nursing management These findings support the need for management to develop appropriate interventions to build resilience in nurses.

Spiritual Concerns in Hindu Cancer Patients Undergoing Palliative Care: A Qualitative Study

PubMed Central

Simha, Srinagesh; Noble, Simon; Chaturvedi, Santosh K

2013-01-01

Aims: Spiritual concerns are being identified as important components of palliative care. The aim of this study was to explore the nature of spiritual concerns in cancer patients undergoing palliative care in a hospice in India. Materials and Methods: The methodology used was a qualitative method: Interpretive phenomenological analysis. A semi-structured interview guide was used to collect data, based on Indian and western literature reports. Certain aspects like karma and pooja, relevant to Hindus, were included. Theme saturation was achieved on interviewing 10 participants. Results: The seven most common spiritual concerns reported were benefit of pooja, faith in God, concern about the future, concept of rebirth, acceptance of one's situation, belief in karma, and the question Why me? No participant expressed four of the concerns studied: Loneliness, need of seeking forgiveness from others, not being remembered later, and religious struggle. Conclusions: This study confirms that there are spiritual concerns reported by patients receiving palliative care. The qualitative descriptions give a good idea about these experiences, and how patients deal with them. The study indicates the need for adequate attention to spiritual aspects during palliative care. PMID:24049350

Bipolar patients' quality of life in mixed states: a preliminary qualitative study.

PubMed

Lee Mortensen, Gitte; Vinberg, Maj; Lee Mortensen, Steen; Balslev Jørgensen, Martin; Eberhard, Jonas

2015-01-01

Approximately 20% of patients with bipolar disorder experience mixed states. Mixed states are associated with more comorbidity, poorer treatment response and prognosis, increased relapse rate, and decreased functioning. This study aimed to produce in-depth knowledge about bipolar patients' quality of life (QoL) and functioning related to mixed states. This study used qualitative research methods. A semi-structured interview guide based on a literature study was applied in interviews with 6 remitted bipolar I patients having experienced mixed states. A medical anthropological approach was applied to analyse the data. Participants described mixed states as worse than other bipolar disorder states and their residual symptoms were prolonged. Mixed states affected the functioning of patients in key life domains such as self-esteem, family, love and social life, physical well-being, and working capability. Mixed states may severely affect the QoL and functioning of bipolar patients. Our results indicate that improving these should be a main goal of patient treatment. With an aim of adequately identifying and treating mixed states, our findings highlight the need for knowledge about this particularly severe expression of bipolar disorder. These results should be confirmed in a larger sample of patients with varying socioeconomic status.

Library services and user satisfaction in developing countries: a case study.

PubMed

Mairaj, Muhammad Ijaz; Naseer, Mirza Muhammad

2013-12-01

Punjab Institute of Cardiology (PIC) is a recognised teaching hospital for cardiac care in the Punjab province of Pakistan. PIC has established a library to fulfil the research and information needs of health care professionals. This study aims to evaluate the satisfaction of users with the services of PIC library. A purposive sample of 15 health care professionals was selected. A semistructured interview technique based on an interview guide was used for collection of data. The data were qualitatively analysed using a thematic approach. Users of PIC library were satisfied with the library collection, organisation, reference and circulation services, staff attitudes, cooling and heating. They were concerned about library space, hours, furniture and environment, and suggested more availability of electronic library services, newer collections, better Internet access and comfortable furniture. The study proved useful to investigate users' satisfaction with the services of PIC library. It concludes that the PIC library should maintain and strengthen the services with which users are satisfied, and improve those about which they are concerned. The study will be useful to libraries in other developing countries for improvement in their services. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

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

PubMed

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

2018-04-01

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

Appropriateness for Total Joint Replacement: Perspectives of Decision-Makers

PubMed Central

Clavel, Nathalie; De coster, Carolyn; Pomey, Marie-Pascale; Sanmartin, Claudia; Bohm, Éric; Dunbar, Michael J.; Frank, CY; Hawker, Gillian; Noseworthy, Tom

2016-01-01

Background: Improving access to total joint replacement (TJR) has been a priority. Without robust mechanisms to ensure appropriateness, these procedures may be overused, incurring substantial costs. In that context, decision-makers are particularly concerned with the appropriateness of TJR. Objective: While our previous research focused on the appropriateness of TJR from clinical and patient perspectives, this study is aimed at understanding decision-makers' perspectives. Methods: Using a semi-structured guide, we interviewed a convenience sample of decision-makers in four Canadian provinces (Alberta, Manitoba, Nova Scotia and Quebec) between February and March 2013. For the purposes of this study, a decision-maker was defined as a manager, institutional leader or policy maker. Results: Fifteen interviews were conducted with decision-makers at ministry (n = 3), regional (n = 6) and institutional levels (n = 8). Decision-makers see themselves as having a key role in the appropriateness discourse, that of optimizing resource allocation and efficient delivery of services for TJR, to improve population outcomes. Conclusion: The decision-makers' view of appropriateness recognizes the importance of the clinical view, but it offers a very different input into the appropriateness discourse, more closely aligned with appropriateness of setting, which refers to cost-effectiveness considerations. PMID:27027795

Employers' perspectives of students in a master of public health (nutrition) program.

PubMed

Fox, Ann; Emrich, Teri

2012-01-01

Efforts to support workforce development led to the launch of a new master of public health program aimed at improving access to graduate studies for practising nutrition professionals. The first cohort of students identified employer support as a key determinant of their success. In order to identify ways of addressing both student and employer needs, we explored the perspectives of students' employers. Seventeen in-depth, semi-structured, open-ended interviews were conducted with employers. Interviews were audiotaped and transcribed. Transcripts were organized using NVivo software and coded thematically. All employers indicated support for employee education and development in principle, but most faced practical challenges related to limited staffing during education leaves. Organizational policies varied considerably across employer groups. Collective agreements that guided education policy were seen to ensure consistent support for employees, but also to limit creative approaches to education support in some situations. Employers highly valued graduate student projects that were directly related to the workplace; these projects presented opportunities for collaboration among the university, students, and employers. Universities need to work with employers and other stakeholders to identify ways of overcoming barriers to public health nutrition graduate education and workforce development.

The nature of ethical conflicts and the meaning of moral community in oncology practice.

PubMed

Pavlish, Carol; Brown-Saltzman, Katherine; Jakel, Patricia; Fine, Alyssa

2014-03-01

To explore ethical conflicts in oncology practice and the nature of healthcare contexts in which ethical conflicts can be averted or mitigated. Ethnography. Medical centers and community hospitals with inpatient and outpatient oncology units in southern California and Minnesota. 30 oncology nurses, 6 ethicists, 4 nurse administrators, and 2 oncologists. 30 nurses participated in six focus groups that were conducted using a semistructured interview guide. Twelve key informants were individually interviewed. Coding, sorting, and constant comparison were used to reveal themes. Most ethical conflicts pertained to complex end-of-life situations. Three factors were associated with ethical conflicts: delaying or avoiding difficult conversations, feeling torn between competing obligations, and the silencing of different moral perspectives. Moral communities were characterized by respectful team relationships, timely communication, ethics-minded leadership, readily available ethics resources, and provider awareness and willingness to use ethics resources. Moral disagreements are expected to occur in complex clinical practice. However, when they progress to ethical conflicts, care becomes more complicated and often places seriously ill patients at the epicenter. Practice environments as moral communities could foster comfortable dialogue about moral differences and prevent or mitigate ethical conflicts and the moral distress that frequently follows.

Between life and death: women's experiences of coming close to death, and surviving a severe postpartum haemorrhage and emergency hysterectomy.

PubMed

Elmir, Rakime; Schmied, Virginia; Jackson, Debra; Wilkes, Lesley

2012-04-01

to describe women's experiences of having an emergency hysterectomy following a severe postpartum haemorrhage. a qualitative research approach was used to guide this study. Data were collected through semi-structured, tape recorded face to face, email internet and telephone interviews. three States in Australia: New South Wales, Victoria and Western Australia. twenty-one Australian women who experienced a severe post partum followed by an emergency hysterectomy participated in the study. The median age of participants at time of interview was 42 years and the median time since having the hysterectomy was four years. a process of inductive analysis revealed the major theme, 'between life and death' and three sub-themes, 'being close to death: bleeding and fear', 'having a hysterectomy: devastation and realisation' and 'reliving the trauma: flashbacks and memories'. formulating a plan of care for women identifiably at risk of PPH and ensuring appropriate follow-up counselling is made, is key to help reduce the emotional and psychological symptoms experienced by these women in the aftermath of severe postpartum haemorrhage and hysterectomy. Copyright © 2011 Elsevier Ltd. All rights reserved.

The New South Wales Allied Health Workplace Learning Study: barriers and enablers to learning in the workplace

PubMed Central

2014-01-01

Background Workplace learning refers to continuing professional development that is stimulated by and occurs through participation in workplace activities. Workplace learning is essential for staff development and high quality clinical care. The purpose of this study was to explore the barriers to and enablers of workplace learning for allied health professionals within NSW Health. Methods A qualitative study was conducted with a purposively selected maximum variation sample (n = 46) including 19 managers, 19 clinicians and eight educators from 10 allied health professions. Seven semi-structured interviews and nine focus groups were audio-recorded and transcribed. The ‘framework approach’ was used to guide the interviews and analysis. Textual data were coded and charted using an evolving thematic framework. Results Key enablers of workplace learning included having access to peers, expertise and ‘learning networks’, protected learning time, supportive management and positive staff attitudes. The absence of these key enablers including heavy workload and insufficient staffing were important barriers to workplace learning. Conclusion Attention to these barriers and enablers may help organisations to more effectively optimise allied health workplace learning. Ultimately better workplace learning may lead to improved patient, staff and organisational outcomes. PMID:24661614

Barriers and facilitators to electronic documentation in a rural hospital.

PubMed

Whittaker, Alice A; Aufdenkamp, Marilee; Tinley, Susan

2009-01-01

The purpose of the study was to explore nurses' perceptions of barriers and facilitators to adoption of an electronic health record (EHR) in a rural Midwestern hospital. This study was a qualitative, descriptive design. The Staggers and Parks Nurse-Computer Interaction Framework was used to guide directed content analysis. Eleven registered nurses from oncology and medical-surgical units were interviewed using three semistructured interview questions. Predetermined codes and operational definitions were developed from the Staggers and Parks framework. Narrative data were analyzed by each member of the research team and group consensus on coding was reached through group discussions. Participants were able to identify computer-related, nurse-related, and contextual barriers and facilitators to implementation of EHR. In addition, two distinct patterns of perceptions and acceptance were identified. The Staggers and Parks Nurse-Computer Interaction framework was found to be useful in identifying computer, nurse, and contextual characteristics that act as facilitators or barriers to adoption of an EHR system. Acceptance and use of an EHR are enhanced when barriers are managed and facilitators are supported. Understanding and management of facilitators and barriers to EHR adoption may impact nurses' ability to provide and document nursing care.

The elder abuse and neglect phenomenon in the ultra-Orthodox Jewish society: social workers' perspectives.

PubMed

Band-Winterstein, Tova

2018-02-13

In the last 30 years, elder abuse and neglect has been recognized as a social and health-related problem. The aim of this paper is to describe the phenomenon of elder abuse and neglect in a separatist faith-based society (ultra-Orthodox Jewish society-UOJS). A qualitative-phenomenological study with 28 social workers who underwent in-depth semi-structured interviews based on an interview guide consisting of the following items: visibility of the elder abuse and neglect phenomenon in the ultra-Orthodox society, and dilemmas and sensitive issues that arise when working with this population. Three main themes emerged: (1) Between the commandment to honor one's parents and concealment patterns: Cultural barriers to exposing the abuse and neglect phenomenon; (2) "Life is demanding:" The unique expression of abusive and neglectful behavior in the UOJS; (3) Culturally related dilemmas when intervening with cases of elder abuse and neglect. Ultra-Orthodox Jewish cultural belief is a differentiating component in the context of elder abuse and neglect. Social workers need to develop a deep understanding of the unique characteristics of the phenomenon and cultural sensitivity to cope with it to address the well-being of older ultra-Orthodox Jews.

Exploring the Medical and Psychosocial Concerns of Adolescents and Young Adults With Craniofacial Microsomia: A Qualitative Study.

PubMed

Hamilton, Kayla V; Ormond, Kelly E; Moscarello, Tia; Bruce, Janine S; Bereknyei Merrell, Sylvia; Chang, Kay W; Bernstein, Jonathan A

2018-01-01

This study explores the experiences of adolescents and young adults with craniofacial microsomia, including the impact of growing up with this craniofacial condition on daily life and sense of self. The results may guide future research on optimally supporting individuals with craniofacial microsomia during this critical life phase. Participants were recruited through a craniofacial center, online patient support groups, and social media sites. Eleven individual semistructured interviews with participants between 12 and 22 years old were conducted by a single interviewer, transcribed, iteratively coded, and thematically analyzed. Five themes were evident in the data: (1) impact on personal growth and character development, (2) negative psychosocial impact, (3) deciding to hide or reveal the condition, (4) desire to make personal surgical decisions, and (5) struggles with hearing loss. We identified both medical and psychosocial concerns prevalent among adolescents with craniofacial microsomia. Although adolescents with craniofacial microsomia exhibit considerable resilience, the challenges they face impact their sense of self and should be addressed through psychosocial support and counseling. Further research should investigate the potential benefit of the wider use of hearing aids, as well as the involvement of patients in decision-making about reconstructive ear surgery.

The order of importance of component parts of the Biblical worldview in Christian high school students

NASA Astrophysics Data System (ADS)

van Meter, Kenneth G.

This micro-ethnographic study is an exploration of the relative degree of importance of the several components of a worldview as articulated by a purposive sample of fourteen upper division students currently enrolled in advance placement classes in ACSI and WASC accredited Christian high schools in Northern California. The research design uses an original questionnaire followed up with a semi-structured interview of the student using the responses on the questionnaire as a guide for the interview. The questionnaire uses a Likert scale in asking the students to rate the importance of seven components of a worldview and then to rank those same components in order of importance. Results suggest that the subjects of God, morality and truth are of highest importance, and the human predicament and origins are of least importance. The subjects of the purpose of human existence and the resolution to the human predicament were intermediate in importance. Additional themes of temporal immediacy and the ability to connect worldview components into a comprehensive whole were also identified. The influence of the family unit as of primary importance in worldview development was affirmed. Suggestions for strengthening instructional practices and curriculum for Christian school educators are provided.

A Study to Determine the Role of Competition in Contracting for the Movement of Air Freight within the Domestic Market.

DTIC Science & Technology

1980-06-01

ES2ABLISHMENT OF MOBILIZATION VALUES FOR SELECTED AIRCRAFT ... ............ 83 B. INTERVIEW GUIDE , SUBPROBLEM 1 .. ......... 87 C. INTERVIEW GUIDE , SUBPROBLEM...2 (PEACETIME). ... 91 D. INTERVIEW GUIDE , SUBPROBLEM 2 (EMERGENCY) . 96 E. FORMAL QUESTIONNAIRE, SUBPROBLEM 3 ........ .100 vi Page F. INTERVIEW GUIDE ... ratemaking func- tion under part 288 [of the FAA Act of 19581. On the basis of this review, we propose for three principal reasons to amend Part 288 to

Learning Strategies Used by High School Students Learning English as a Second Language

DTIC Science & Technology

1985-02-01

Discussion 34 REFERENCES 39 APPENDICES Z1 A Teachers Interview Guide 43 B Student Interview Guide 55 C Classroom Observation Guide 67 ix LIST OF TABLES...and teacher interviews were performed individually. There were only 3.7 strategies per classroom observation . Because roughly equal amounts of time...FOR SPEAKING AND UNDERSTANDING ENGLISH Classroom Observation Guide The purpose of this observation guide is to describe an approach for cot- lecting

All the World's a School

ERIC Educational Resources Information Center

Young, Jonathan

2017-01-01

This article reports on a research project which focused on the aspirations and identities of students in an international school. Ten boys and ten girls were interviewed using semi-structured and photo-elicitation interviews. This research indicates convincingly that socio-economic background and international capital are crucial factors framing…

Study of Teacher Practices in Health Sciences in Brazil

ERIC Educational Resources Information Center

Novais, Maykon A. P.; Ramos, Monica Parente; Nappo, Solange A.; Sigulem, Daniel

2010-01-01

This study involved fourteen semistructured interviews with teaching staff at a Brazilian university. These interviews were aimed at unveiling possible transformations caused by distance education in classroom teaching and in medical assistance practices. The discourses collected were analyzed using qualitative methods and divided into groups with…

Prospective Teachers' Perceptions on Different Aspects of Portfolio

ERIC Educational Resources Information Center

Ok, Ahmet; Erdogan, Mehmet

2010-01-01

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

78 FR 3431 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

... protocols to collect further qualitative information through interviews and/or focus groups with program... Readiness Goals and Head Start Program Functioning'' research project. The purpose of this study is to... functioning. ACF is proposing to use a semi-structured telephone interview protocol to collect information...

The Mentoring Experience: Leadership Development Program Perspectives

ERIC Educational Resources Information Center

Lamm, Kevan W.; Sapp, Rochelle; Lamm, Alexa J.

2017-01-01

Using a semi-structured interview approach, ten mentors from a leadership development program focused on building leaders in Colleges of Agriculture and Life Sciences across the nation provided insights regarding their mentoring method, process, and experiences. Mentors interviewed agreed the mentoring process was beneficial for themselves as well…

Latina/o Students' Needs

ERIC Educational Resources Information Center

Mahaffy, Kimberly A.; Pantoja, Christina

2013-01-01

To better understand Latina/o students' needs in a predominantly White institution of higher education with low Latina/o retention rates, semistructured interviews were completed with 30 Latina/o students. The themes that emerged through qualitative analysis of the interviews were: linguistic and financial barriers; a need for unity; availability…

10 CFR 712.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... derogatory under the criteria listed in 10 CFR part 710, subpart A. Semi-structured interview means an interview by a Designated Psychologist, or a psychologist under his or her supervision, who has the latitude to vary the focus and content of the questions depending on the interviewee's responses. Site...

10 CFR 712.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... derogatory under the criteria listed in 10 CFR part 710, subpart A. Semi-structured interview means an interview by a Designated Psychologist, or a psychologist under his or her supervision, who has the latitude to vary the focus and content of the questions depending on the interviewee's responses. Site...

Professional liability insurance and medical error disclosure.

PubMed

McLennan, Stuart; Shaw, David; Leu, Agnes; Elger, Bernice

2015-01-01

To examine medicolegal stakeholders' views about the impact of professional liability insurance in Switzerland on medical error disclosure. Purposive sample of 23 key medicolegal stakeholders in Switzerland from a range of fields between October 2012 and February 2013. Data were collected via individual, face-to-face interviews using a researcher-developed semi-structured interview guide. Interviews were transcribed and analysed using conventional content analysis. Participants, particularly those with a legal or quality background, reported that concerns relating to professional liability insurance often inhibited communication with patients after a medical error. Healthcare providers were reported to be particularly concerned about losing their liability insurance cover for apologising to harmed patients. It was reported that the attempt to limit the exchange of information and communication could lead to a conflict with patient rights law. Participants reported that hospitals could, and in some case are, moving towards self-insurance approaches, which could increase flexibility regarding error communication The reported current practice of at least some liability insurance companies in Switzerland of inhibiting communication with harmed patients after an error is concerning and requires further investigation. With a new ethic of transparency regarding medical errors now prevailing internationally, this approach is increasingly being perceived to be misguided. A move away from hospitals relying solely on liability insurance may allow greater transparency after errors. Legalisation preventing the loss of liability insurance coverage for apologising to harmed patients should also be considered.

Evaluating perceived benefits of ecoregional assessments.

PubMed

Bottrill, Madeleine C; Mills, Morena; Pressey, Robert L; Game, Edward T; Groves, Craig

2012-10-01

The outcomes of systematic conservation planning (process of assessing, implementing, and managing conservation areas) are rarely reported or measured formally. A lack of consistent or rigorous evaluation in conservation planning has fueled debate about the extent to which conservation assessment (identification, design, and prioritization of potential conservation areas) ultimately influences actions on the ground. We interviewed staff members of a nongovernmental organization, who were involved in 5 ecoregional assessments across North and South America and the Asia-Pacific region. We conducted 17 semistructured interviews with open and closed questions about the perceived purpose, outputs, and outcomes of the ecoregional assessments in which respondents were involved. Using qualitative data collected from those interviews, we investigated the types and frequency of benefits perceived to have emerged from the ecoregional assessments and explored factors that might facilitate or constrain the flow of benefits. Some benefits reflected the intended purpose of ecoregional assessments. Other benefits included improvements in social interactions, attitudes, and institutional knowledge. Our results suggest the latter types of benefits enable ultimate benefits of assessments, such as guiding investments by institutional partners. Our results also showed a clear divergence between the respondents' expectations and perceived outcomes of implementation of conservation actions arising from ecoregional assessments. Our findings suggest the need for both a broader perspective on the contribution of assessments to planning goals and further evaluation of conservation assessments. ©2012 Society for Conservation Biology.

Patients' Perceptions of a Pressure Ulcer Prevention Care Bundle in Hospital: A Qualitative Descriptive Study to Guide Evidence-Based Practice.

PubMed

Roberts, Shelley; Wallis, Marianne; McInnes, Elizabeth; Bucknall, Tracey; Banks, Merrilyn; Ball, Lauren; Chaboyer, Wendy

2017-10-01

Pressure ulcers place a significant burden on patients and hospitals. Our team developed and tested a pressure ulcer prevention care bundle (PUPCB) in a cluster randomized trial. As part of the process evaluation conducted alongside the trial, we explored patients' perceptions of the intervention. To identify patients' perceptions and experiences of a PUPCB in hospital. This qualitative descriptive study explored the perceptions of a subset of patients who participated in a trial testing the PUPCB across four intervention hospitals. A trained interviewer conducted semistructured interviews, which were digitally recorded, transcribed, and analyzed using thematic analysis. Nineteen patients were interviewed across the four hospitals. Three main themes emerged: (a) importance of personal contact in PUPCB delivery; (b) understanding pressure ulcer prevention (PUP) enhances participation; and (c) individual factors impact patients' engagement in PUP. The extent to which patients adopted the intervention appeared to be influenced by the complexity of education materials, compatibility with patients' existing knowledge and beliefs, and perceived advantage of the intervention; ability for human interaction; and patient-related facilitators and barriers to participating in PUP care. This study found patients accepted a PUPCB that encouraged participation in care, particularly as it involved personal and positive interactions with nurses and provision of information that was easy to understand and resonated with patients. © 2017 Sigma Theta Tau International.

Barriers and facilitators of adherence to antidepressants among outpatients with major depressive disorder: A qualitative study

PubMed Central

Jacob, Sabrina Anne; Tangiisuran, Balamurugan

2017-01-01

Background One of the major challenges in treating major depressive disorder (MDD) is patients’ non-adherence to medication. This study aimed to explore the barriers and facilitators of patients’ adherence to antidepressants among outpatients with MDD. Methods Semi-structured and individual in-depth interviews were conducted among patients with MDD who were taking antidepressants, in the psychiatric clinic of a government-run hospital in Malaysia. Participants were purposively sampled from different genders and ethnicities. Interviews were conducted using a validated topic guide, and responses were audio-recorded, transcribed verbatim, checked, and analyzed using the grounded theory approach. Results A total of 30 patients were interviewed. Forty different themes and sub-themes were identified which were conceptually divided into two distinct categories related to barriers and facilitators to adherence. The barriers were: patient-specific, medication-specific, healthcare provision and system, social-cultural, and logistics. The facilitators were: having insight, perceived health benefits, regular activities, patient-provider relationship, reminders, and social support networks. Conclusions Patient-specific barriers and medication side effects were the major challenges for adhering to treatment. Perceived health benefits and having insight on the need for treatment were the most frequently cited facilitators. Targeted interventions should be developed to address the key barriers, and promote measures to facilitate adherence in this group of patients. PMID:28614368

Childbirth experience according to a group of Brazilian primiparas.

PubMed

Nakano, Ana Márcia Spanó; Homsi Jorge Ferreira, Cristine; de Almeida, Ana Maria; Gomes, Flávia Azevedo

2012-12-01

to understand the meaning of the childbirth experience for Brazilian primiparas in the postpartum period. a qualitative approach using semi-structured interviews. Content analysis was used to derive the two themes that emerged from the discourses. participants were recruited at four primary-level health-care units in Ribeirão Preto, Brazil. After providing written informed consent, an appointment was made for an interview at the participants' homes. 20 primiparas in the postpartum period, aged 15-26 years old, who attended the health-care units to vaccinate their infants and test for phenylketonuria. two thematic categories emerged from the interviews: the meaning attributed to childbirth (with four subcategories) and perceptions of care. Among the participants, the childbirth experience was marked by the 'fear of death' and 'losing the child'. The pain of giving birth was expected, and the moment of childbirth was associated with pain of high intensity. childbirth is considered synonymous with physical and emotional suffering, pain, fear and risk of death. this research indicates the need to break the current mechanistic model of care on which health professionals' actions are based. Care during childbirth must be guided by the foundation that women are the subjects of childbirth actions, in an attempt to emphasise actions that grant them with the autonomy and empowerment needed to experience the situation. Copyright © 2011 Elsevier Ltd. All rights reserved.

"Why throw away something useful?": Attitudes and opinions of people treated for bipolar disorder and their relatives on organ and tissue donation.

PubMed

Padoan, Carolina S; Garcia, Lucas F; Rodrigues, Aline A; Patusco, Lucas M; Atz, Mariana V; Kapczinski, Flavio; Goldim, José R; Magalhães, Pedro V S

2017-03-01

In regard to mental illness, brain donation is essential for the biological investigation of central pathology. Nevertheless, little is known about the thoughts of people with mental disorders on tissue donation for research. Here, our objective was to understand the attitudes and opinions of people treated for bipolar disorder and their relatives regarding donation in general, and particularly donation for research. This is a qualitative study that used in-depth interviews to determine the thoughts of participants regarding tissue donation for research. Theoretical sampling was used as a recruitment method. Grounded theory was used as a framework for content analyses of the interviews. A semi-structured interview guide was applied with the topics: donation in general; donation for research; mental health and body organs; opinion regarding donation; feelings aroused by the topic. Although all participants were aware of organ donation for transplant, they were surprised that tissue could be donated for research. Nevertheless, once they understood the concept they were usually in favor of the idea. Although participants demonstrated a general lack of knowledge on donation for research, they were willing to learn more and viewed it as a good thing, with altruistic reasons often cited as a motive for donation. We speculate that bridging this knowledge gap may be a fundamental step towards a more ethical postmortem tissue donation process.

Young children's experiences of participating in group treatment for children exposed to intimate partner violence: A qualitative study.

PubMed

Pernebo, Karin; Almqvist, Kjerstin

2016-01-01

The risk of exposure to intimate partner violence (IPV) between caregivers is increased during early childhood. The adverse effects on the health and development of the youngest children may be severe. Effective and promising interventions for children who have experienced IPV have been developed and evaluated. However, there is a lack in knowledge about how the children themselves experience the interventions. The aim of this study was to contribute to the evaluation of group treatment designed to improve the psychological health of young children in the aftermath of family violence by elucidating the children's experiences of participating. Nine children, aged 4 to 6 years, were interviewed after participating in group programmes specifically designed for children who have been exposed to intimate partner violence. A semi-structured interview guide with open-ended questions was used. The interviews were transcribed and analysed using interpretative phenomenological analysis, to ensure a focus on the children's own views and experiences. Five master themes embracing the children's experiences were identified: joy - positive emotional experience of participation; security - feeling safe; relatedness - relationships within the group; to talk - externalised focus on the violence; and competence - new knowledge and skills. Theoretical and clinical implications and the benefit of including very young children's views and experiences in research are discussed. © The Author(s) 2014.

Establishing the cultural equivalence of the Young Children’s Participation and Environment Measure (YC-PEM) for use in Singapore

PubMed Central

Lim, Chun Yi; Law, Mary; Khetani, Mary; Pollock, Nancy; Rosenbaum, Peter

2016-01-01

Aims Establishing the cultural equivalence of clinical assessments is critical to ensuring culturally competent care. Developed in North America, the Young Children’s Participation and Environment Measure (YC-PEM) is a caregiver questionnaire of participation in home, preschool, and community activities and perceptions of environmental impact on participation. The purpose of this study is to establish the cultural equivalence of YC-PEM content for use in Singapore. Methods We conducted semi-structured interviews with 10 early childhood and healthcare providers and cognitive interviews with 10 parents in Singapore to examine the relevance of original YC-PEM content (activities, environmental factors, item wording). Interviews were transcribed, summarized and categorized according to item, semantic, conceptual, and operational dimensions of the Applied Cultural Framework that served as a decision-making guide to keep, modify or delete the items. Results Providers and parents agreed on conceptual, item and semantic changes but less on operational changes. Significant changes were made to improve comprehension of the YC-PEM. Conclusions Despite using the same language, the majority of the YC-PEM items needed modification to be relevant to the Singapore culture. Cultural adaptation of the YC-PEM is important because there are cultural differences in children’s participation, their environments as well as the way people understand words. PMID:26642891

Work-family fit: the impact of emergency medical services work on the family system.

PubMed

Roth, Sheila Gillespie; Moore, Crystal Dea

2009-01-01

The stress associated with a career in emergency medical services (EMS) can impact the work-family fit and function of the family system for EMS personnel. Little research has been conducted on how the demands associated with a career in EMS influences family life. Objective. To describe salient EMS work factors that can impact the family system. Twelve family members (11 spouses and one parent) of EMS workers were interviewed using a semistructured qualitative interview guide that explored issues related to their family members' work that could impact the quality of family life. Using a phenomenological approach, transcribed interview data were examined for themes that illuminated factors that influence work-family fit. Data analysis revealed that shift work impacts numerous aspects of family life, including marital and parental roles, leisure and social opportunities, and home schedules and rhythms. Furthermore, families coped with challenges associated with their loved one's EMS work through negotiating role responsibilities, developing their own interests, giving their family member "space," and providing support by listening and helping the EMS worker process his or her reactions to difficult work. In addition, family members reported concern over their EMS worker's physical safety. Implications from the data are discussed vis-a-vis the work-family fit and family systems models. Education, communication, support systems, and individual interests are key ways to promote a healthy work-family fit.

EXPLANATORY MODELS OF HYPERTENSION AMONG NIGERIAN PATIENTS AT A UNIVERSITY TEACHING HOSPITAL

PubMed Central

Taylor, Kelly D.; Adedokun, Ayoade; Awobusuyi, Olugbenga; Adeniran, Peju; Onyia, Elochukwu; Ogedegbe, Gbenga

2013-01-01

Objective To elicit the explanatory models (EM) of hypertension among patients in a hospital-based primary care practice in Nigeria. Design Semi-structured in-depth individual interviews and focus groups were conducted with 62 hypertensive patients. Interviews and focus groups were audio-taped and transcribed verbatim. Data analysis was guided by phenomenology and content analysis using qualitative research software ATLAS.ti 5.0. Results Patients expressed four categories of EM of hypertension: 1) perceptions of hypertension, 2) consequences, 3) effect on daily life, and 4) perception of treatment. Focus group discussions and key informant interviews yielded a wide range of insights into the social and cultural factors influencing patients’ beliefs and health behavior. Participants were aware of the risks of hypertension. There was disagreement between participants’ own understanding of the serious nature of hypertension, the need for long-term treatment, and the desire to take medication long-term. Participants acknowledged the use of traditional medicine (e.g. teas and herbs) and healers. Different themes emerged for men versus women such that women often focused on family issues while men tended to discuss external stressors stemming from work as a cause of hypertension. Men were concerned with frequent urination, decreased libido and erectile dysfunction. Conclusion Knowledge gained will inform development of patient-centered treatment plans and targeted behavioral and educational interventions. PMID:23534506

Understanding how Overweight and Obese Emerging Adults Make Lifestyle Choices

PubMed Central

Cha, EunSeok; Crowe, James M.; Braxter, Betty J.; Jennings, Bonnie Mowinski

2016-01-01

Purpose To better understand health-related decision making among overweight and obese emerging adults. Design and Methods A cross-sectional design was used in the parent study involving overweight and obese emerging adults, ages 18–29 years. The goal of the parent study was to screen participants’ diabetes risk and identify characteristics of emerging adults with prediabetes (N = 107). A sub-sample of respondents (n = 34) from the parent study were invited to participate in focus group interviews depending on whether they had prediabetes (three groups) or they did not have prediabetes (four groups). Each focus group interview lasted 90–120 minutes following a semi-structured interview guide. Conventional content analysis was used in the data analysis. Because of the similarities between participants with and without prediabetes, the findings were synthesized and reported in the aggregate. Moreover, during the analysis, the authors decided that Rational Choice Theory provided a useful organizing structure for presenting the data. Results Emerging adults’ behavioral decisions were rational reactions to their personal competence, perception of health, environment, and availability of resources to handle problems. Trade-offs calculation and estimations of resource availability were often used when making decisions. Conclusions Emerging adults choose unhealthy behaviors due to inaccurate information and insufficient competence to practice healthy lifestyles rather than because of laziness or being irrational. PMID:27496826

Perceived workplace mistreatment: Case of Latina hotel housekeepers.

PubMed

Hsieh, Yu-Chin Jerrie; Sönmez, Sevil; Apostolopoulos, Yorghos; Lemke, Michael Kenneth

2017-01-01

Latina hotel housekeepers' social class, gender, race/ethnicity, nationality, and United States immigration status render them particularly vulnerable to workplace mistreatment. We sought to reveal the array of policy- and interpersonal-related mistreatment experienced by Latina hotel housekeepers in the southeastern United States employed at 75 local hotels which included 4-star, 3-star, 2-star, and 1-star properties. This ethnographic study involved 27 in-depth interviews with Latina hotel housekeepers. Using semi-structured in-depth interview guides, participants were interviewed until collected data reached saturation. Data were coded to explore themes and relationships for the housekeepers' work environments, and thick descriptions of these environments were developed. Participants ranged in work experience from 1 to 15 years, with all but one unable to reach full-time status, and were paid between $7.25 and $8.00 per hour. Policy-related phenomena, such as low pay, lack of paid sick leave or overtime, and absence of appropriate cleaning tools or protective equipment were all perceived as forms of mistreatment by Latina hotel housekeepers. Interpersonal mistreatment in the form of supervisor favoritism, unfair work assignments, biased allocation of cleaning supplies, disrespect, and verbal abuse due to ethnicity was also perceived. Latina hotel housekeepers endure mistreatment that impacts their psychosocial and physical occupational health. We provide recommendations to minimize workplace mistreatment and improve well-being of Latina hotel housekeepers.

Clinical prioritisations of healthcare for the aged--professional roles.

PubMed

Nortvedt, P; Pedersen, R; Grøthe, K H; Nordhaug, M; Kirkevold, M; Slettebø, A; Brinchmann, B S; Andersen, B

2008-05-01

Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians' considerations in clinical prioritisation within this field is scarce. To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. 20 physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway. The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians' role. Distributing healthcare services in a fair way is generally not described as integral to the clinicians' role in clinical prioritisations. If considerations of justice are not included in clinicians' role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions.

Nurse Perceptions of Pain in Pediatric Traumatic Brain Injury: A Pilot Study.

PubMed

McCaa, Robin

2017-01-01

Pain assessment in the pediatric population is challenging because of age, developmental stage, and patient cooperation. Cognitive impairment, impaired communication, and physical disability that may accompany traumatic brain injury (TBI) further complicate pain assessments. A pilot descriptive qualitative research study was conducted to investigate nurse perceptions of pain in pediatric patients diagnosed with TBI. Specifically, this study sought to answer the following questions: a) Is pain accurately assessed in this population? b) Is pain adequately treated in this population? and c) What obstacles exist, if any, to the assessment and treatment of pain? A convenience sample of three registered nurses employed in a pediatric neurosurgery setting participated in this study. Each nurse participated in one individual, semi-structured, face-to-face interview lasting approximately 30 minutes. Interviews were transcribed verbatim and analyzed for common themes. Common themes identified across all interviews were a) challenging assessments; b) limited, although effective, treatments; and c) communication as an area of opportunity for improvement. Implications for practice and policy include a need for more sensitive pain assessment tools to improve the objectivity and accuracy of pain assessment, clarification of care priorities and organization of care from clinical and management perspectives, and additional research in alternative pain treatments for this population. Findings from this study will guide the development of a larger, more comprehensive study, with the aim of improving practice and policy in pain management for this population.

Humanistic burden of disease for patients with advanced melanoma in Canada.

PubMed

Cheung, Winson Y; Bayliss, Martha S; White, Michelle K; Stroupe, Angela; Lovley, Andrew; King-Kallimanis, Bellinda L; Lasch, Kathryn

2018-06-01

Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach. Many patients' journeys began with the startling diagnosis of an invasive disease and a vastly shortened life expectancy. By the time they reached an advanced stage of melanoma, these patients' overall functioning and quality of life had been greatly diminished by this quickly progressing cancer. The impact was described in terms of physical pain and disability, emotional distress, diminished interactions with friends and family, and burden on caregivers. Our findings provide evidence of signs, symptoms, and functional impacts of advanced melanoma. Signs and symptoms reported (physical, mental, and social) confirm and expand on those reported in the existing clinical literature. Primary care physicians should be better trained to identify melanomas early. Oncology care teams can improve on their current approaches for helping patients navigate treatment options, with information about ancillary services to mitigate disease impacts on HRQL, such as mental health and social supports, as well as employment or financial support services.

From the point-of-purchase perspective: a qualitative study of the feasibility of interventions aimed at portion-size.

PubMed

Vermeer, Willemijn M; Steenhuis, Ingrid H M; Seidell, Jacob C

2009-04-01

Food portion-sizes might be a promising starting point for interventions targeting obesity. The purpose of this qualitative study was to assess how representatives of point-of-purchase settings perceived the feasibility of interventions aimed at portion-size. Semi-structured interviews were conducted with 22 representatives of various point-of-purchase settings. Constructs derived from the diffusion of innovations theory were incorporated into the interview guide. Each interview was recorded and transcribed verbatim. Data were coded and analysed with Atlas.ti 5.2 using the framework approach. According to the participants, offering a larger variety of portion-sizes had the most relative advantages, and reducing portions was the most disadvantageous. The participants also considered portion-size reduction and linear pricing of portion-sizes to be risky. Lastly, a larger variety of portion-sizes, pricing strategies and portion-size labelling were seen as the most complex interventions. In general, participants considered offering a larger variety of portion-sizes, portion-size labelling and, to a lesser extent, pricing strategies with respect to portion-sizes as most feasible to implement. Interventions aimed at portion-size were seen as innovative by most participants. Developing adequate communication strategies about portion-size interventions with both decision-makers in point-of-purchase settings and the general public is crucial for successful implementation.

Hollywood on tobacco: how the entertainment industry understands tobacco portrayal

PubMed Central

Shields, D.; Carol, J.; Balbach, E.; McGee, S.

1999-01-01

OBJECTIVE—To determine how people in the California-based entertainment industry think about the portrayal of tobacco use in movies and on television. Specifically, to explore who decides when to include tobacco in a project; how that decision is made; what issues are considered; what messages are intended; whether and how the issue of secondhand smoke is considered; and what advocacy methods might be useful in influencing future decisions about tobacco portrayal.
DESIGN—Qualitative in-depth interviews of entertainment industry personnel,with a semi-structured interview protocol to guide the interview.
SUBJECTS—54 subjects drawn from a convenience sample of writers, actors, directors, producers, studio executives, and others involved in the film industry.
RESULTS—Hollywood is heterogeneous with varying perspectives on rates of tobacco use portrayal; intentionality of the decision to use and the necessity to portray tobacco use; and its degree of acceptance of responsibility for influencing societal smoking. Tobacco depiction may originate with the writer, actor, or director and is included most frequently to elucidate character or portray reality. On-camera smoking is influenced by actors' off-camera tobacco use.
CONCLUSIONS—The research presented can help advocates better understand the norms and values of those working within the entertainment industry and thereby assist them in creating more effective change strategies.


Keywords: films; movies; television; tobacco use PMID:10629243

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

PubMed

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

2015-07-01

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

Evaluation of the Criterion and Convergent Validity of the Diagnostic Interview for Social and Communication Disorders in Young and Low-Functioning Children

ERIC Educational Resources Information Center

Maljaars, Jarymke; Noens, Ilse; Scholte, Evert; van Berckelaer-Onnes, Ina

2012-01-01

The Diagnostic Interview for Social and Communication Disorders (DISCO; Wing, 2006) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning…

Parental perspectives of screening for adverse childhood experiences in pediatric primary care.

PubMed

Conn, Anne-Marie; Szilagyi, Moira A; Jee, Sandra H; Manly, Jody T; Briggs, Rahil; Szilagyi, Peter G

2018-03-01

Pediatricians recognize a need to mitigate the negative impact that adverse childhood experiences (ACEs) can have on health and development. However, ACEs screening and interventions in primary care pediatrics may be inhibited by concerns about parental perceptions. We assessed parent perspectives of screening for ACEs in the pediatric primary care setting, to understand their views on the potential impact of their ACEs on their parenting and to identify opportunities for pediatric anticipatory guidance. We used purposive sampling to recruit parents of children <6 years receiving care at an urban, pediatric clinic. Semistructured questions guided 1:1 interviews that were later coded by multiple researchers to verify reliability. A thematic framework approach guided analysis and identified main themes and subthemes. We reached thematic saturation after 15 parent interviews, which consistently revealed 3 interrelated themes. First, parents strongly supported ACEs screening as a bridge to needed services, and they recommended using a trauma-sensitive, person-centered approach in pediatric practices. Second, parents understood the intergenerational impact of ACEs and expressed a desire to break the cycle of adversity. Finally, parents saw their child's pediatrician as a potential change-agent who could provide support to meet their parenting goals. Parents want to discuss their ACEs and receive help and guidance from pediatricians. Furthermore, they perceive their child's pediatrician as having an important role to play in meeting their parenting goals. It is important to ensure that pediatricians have the training, skills and familiarity with available resources to meet parental expectations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Multiple case studies of STEM teachers' orientations to science teaching through engineering design

NASA Astrophysics Data System (ADS)

Rupp, Madeline

The following master's thesis is composed of two manuscripts describing STEM teachers' orientations to science teaching through engineering within the context of the Science Learning through Engineering Design (SLED) partnership. The framework guiding both studies was science teaching orientations, a component of pedagogical content knowledge. Data were collected via semi-structured interviews, multi-day classroom observations, pre- and post-observation interviews, implementation plans, and written reflections. Data sources were analyzed to generate two orientations to science teaching through engineering design for each participant. The first manuscript illustrates a single case study conducted with a sixth grade STEM teacher. Results of this study revealed a detailed picture of the teacher's goals, practices, assessments, and general views when teaching science through engineering design. Common themes across the teacher's instruction were used to characterize her orientations to science teaching through engineering design. Overall, the teacher's orientations showed a shift in her practice from didactic to student-centered methods of teaching as a result of integrating engineering design-based curriculum. The second manuscript describes a comparative case study of two sixth grade SLED participants. Results of this study revealed more complex and diverse relationships between the teachers' orientations to teaching science through engineering design and their instruction. Participants' orientations served as filters for instruction, guided by their divergent purposes for science teaching. Furthermore, their orientations and resulting implementation were developed from knowledge gained in teacher education, implying that teacher educators and researchers can use this framework to learn more about how teachers' knowledge is used to integrate engineering and science practices in the K-12 classroom.

Barriers and facilitators to implementing a patient-centered model of contraceptive provision in community health centers.

PubMed

Politi, Mary C; Estlund, Amy; Milne, Anne; Buckel, Christina M; Peipert, Jeffrey F; Madden, Tessa

2016-01-01

The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation. Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception. We also asked about current contraceptive provision and explored organizational practices relevant to implementing the CHOICE model. We used a grounded theory approach to identify major themes. Many participants felt that current contraceptive provision could be improved by the CHOICE model. Potential facilitators included agreement about the necessity for improved contraceptive knowledge among patients and staff; importance of patient-centered contraceptive counseling; and benefits to same-day insertion of long-acting reversible contraception (LARC). Potential barriers included misconceptions about contraception held by staff and providers; resistance to new practices; costs associated with LARC; and scheduling challenges required for same-day insertion of LARC. In addition to staff and provider training, implementing a patient-centered model of contraceptive provision needs to be supplemented by strategies to manage patient and system-level barriers. Community health center staff, providers, and patients support patient-centered contraceptive counseling to improve contraception provision if organizations can address these barriers.

Qualitative Development of a Discrete Choice Experiment for Physical Activity Interventions to Improve Knee Osteoarthritis.

PubMed

Pinto, Daniel; Danilovich, Margaret K; Hansen, Paul; Finn, Daniel J; Chang, Rowland W; Holl, Jane L; Heinemann, Allen W; Bockenholt, Ulf

2017-06-01

To describe the qualitative process used to develop attributes and attribute levels for inclusion in a discrete choice experiments (DCE) for older adult physical activity interventions. Five focus groups (n=41) were conducted, grounded in the Health Action Process Approach framework. Discussion emphasized identification and prioritization attributes for a DCE on physical activity. Semi-structured interviews (n=6) investigated attribute levels and lay-language for the DCE. A focus group with physical activity researchers and health care providers was the final stakeholder group used to establish a comprehensive approach for the generation of attributes and levels. A DCE pilot test (n=8) was then conducted with individuals of the target patient population. All transcripts were analyzed using a constant comparative approach. General community and university-based research setting. Volunteers (N=55) aged >45 years with knee pain, aches, or stiffness for at least 1 month over the previous 12 months. Not applicable. Interview guides, attributes, attribute levels, and discrete choice experiment. The most influential identified attributes for physical activity were time, effort, cost, convenience, enjoyment, and health benefits. Each attribute had 3 levels that were understandable in the pilot test of the DCE. The identification of 6 physical activity attributes that are most salient to adults with knee osteoarthritis resulted from a systematic qualitative process, including attribute-ranking exercises. A DCE will provide insight into the relative importance of these attributes for participating in physical activity, which can guide intervention development. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Ethnomedicinal plants of the Bauri tribal community of Moulvibazar District, Bangladesh

PubMed Central

Das, Protiva Rani; Islam, Md. Tabibul; Mostafa, Mohd. Nabil; Rahmatullah, Mohammed

2013-01-01

Context: Bangladesh reportedly has more than 100 tribal communities; however, documentation of their medicinal practices is markedly absent. Aim: The aim of the present study was to conduct an ethnomedicinal survey among the little known Bauri tribe of Bangladesh, whose tribal medicinal practices are yet to be documented. Settings and Design: The survey was carried out among the Bauri tribal community of Purbo Tila village in Moulvibazar District. The community is believed to be the only Bauri community in the country and had four tribal healers who continue their traditional medicinal practices. Materials and Methods: Interviews of the healers were carried out with the help of a semi-structured questionnaire and the guided field-walk method where the healers took the interviewers on guided field-walks through areas from where they collected their medicinal plants. Here they identified the plants and described their uses. Results: The Bauri healers were observed to use 40 different plant species and one bird species for treatment of ailments such as fever, respiratory tract disorders, pain, gastrointestinal disorders, eye problems like cataract and conjunctivitis, jaundice, abscess, cardiovascular disorders, urinary problems, paralysis, dog bite, snake bite, helminthiasis, lesions on the tongue or lips and piles. Leaves were the major plant part used and constituted 38.3% of total uses followed by fruits at 14.9%. Conclusions: A review of the relevant scientific literature showed that a number of medicinal plants used by the Bauri healers possess pharmacological activities, which were in line with the traditional uses, thus validating their use by the Bauri tribe. PMID:24501442

Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care.

PubMed

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2015-10-01

Patients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS . The aim was to examine the question: how can decision making that is both effective and patient-centred be enacted in ALS multidisciplinary care? Fifty-four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi-structured interviews. Interviews were transcribed, coded and analysed thematically. Comparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision-making process; patient-centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non-specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: 'Participant Engagement'; 'Option Information'; 'Option Deliberation'; and 'Decision Implementation'. Effective and patient-centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient-centred decision making, by incorporating patients' cyclic decision-making patterns and facilitating carer inclusion in decision processes. The model captures the complexities of patient-centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment. © 2013 John Wiley & Sons Ltd.

The Study on the Preferences of Customer Personal Values with Chinese Culture Background in Services

NASA Astrophysics Data System (ADS)

Li, Yi; Zhao, Hong; Yang, Yue

Customer personal values are the important factors which affect customer behaviors, and they guide and decide the customer's attitudes and behaviors on the products or the services. The paper thinks there are only several important customer personal values to guide customer's decisions, and these values will have -strong cultural differences. This study focuses on discussing the preferences of customer personal values with Chinese culture background when customers consume service and analyzes on the customer preferences of customer personal values with the deep interview method. After interviewing 16 responders with the semi-structured questionnaires, the study finds out some interesting results: (1) Some customers have recognized the existent of customer personal values, even though customer perceived values still have the strong influences on customer behaviors. (2) As they pursue to high quality lives, customers enjoy the lives in easy and pleasure way and care about the safe of the family. Quick response, simple and professional services contribute to enhance the experiences of easy and pleasure lives. (3) Non-rational consumers need the respect from the staff and the companies seriously. In comparison, the rational customers care less about the respect. (4) The sociable requirements have become a common consuming psychology of the customers. More and more customers try to gain the friends by consuming some services. (5) The preferences of customer personal values have a close relationship with the Chinese culture, such as collective values, family conception and "face" culture. The results benefit for service companies improving service brands and service quality.

Love as a Battlefield: Attachment and Relationship Dynamics in Couples Identified for Male Partner Violence

ERIC Educational Resources Information Center

Allison, Colleen J.; Bartholomew, Kim; Mayseless, Ofra; Dutton, Donald G.

2008-01-01

The authors explored the attachment dynamics of heterosexual couples identified for male partner violence. Based on semistructured interviews, participants were assessed for attachment orientations. Based on a thematic analysis of the interviews, two strategies for regulating distance within these relationships were identified: pursuit and…

Student Teachers' General and Content-Specific Pedagogical Development within a Mathematics Milieu

ERIC Educational Resources Information Center

Piccolo, Diana L.; Capraro, Mary Margaret; Capraro, Robert M.

2010-01-01

Fourteen elementary and 6 middle level student teachers were observed and interviewed throughout their initial field placement teaching experience. The Classroom Observation and Performance Assessment for Teachers-Revised (COPAT-R) observation instrument and semistructured interviews were used to compare general and content-specific pedagogical…

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

ERIC Educational Resources Information Center

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

2005-01-01

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

Fitness Instructors: How Does Their Knowledge on Weight Loss Measure Up?

ERIC Educational Resources Information Center

Forsyth, Glenys; Handcock, Phil; Rose, Elaine; Jenkins, Carolyn

2005-01-01

Objective: To examine the knowledge, approaches and attitudes of fitness instructors dealing with clients seeking weight loss advice. Design: A qualitative project whereby semi-structured interviews were conducted with ten fitness instructors representing a range of qualifications, work settings and years of experience. Setting: Interviews were…

"Inside-out Pedagogy": Theorising Pedagogical Transformation through Teaching Philosophy

ERIC Educational Resources Information Center

Scholl, Rosie

2014-01-01

This retrospective interview study focused on the impact that training and implementation of Philosophy, in Lipman's tradition of Philosophy for Children, had on the pedagogy of 14 primary teachers at one school. Semi-structured interviews were conducted to document the impact of teaching Philosophy on pedagogy, the resources required to…

Visualizing Peer Connections: The Gendered Realities of African American College Men's Interpersonal Relationships

ERIC Educational Resources Information Center

McGowan, Brian L.

2017-01-01

I explored how African American college men conceptualized gender within their interpersonal relationships at a traditionally White institution. In interviews using both semistructured and photo elicitation interview formats, 17 participants shared stories about their interpersonal relationships with other men and ascribed multiple meanings to…

Perceptions of Physical Activity by Older Adults: A Qualitative Study

ERIC Educational Resources Information Center

Jancey, Jonine M.; Clarke, Ann; Howat, Peter; Maycock, Bruce; Lee, Andy H.

2009-01-01

Objective: To identify issues and perceptions concerning physical activity in older adults. Design: Qualitative study. Setting: Perth, Western Australia. Methods: Sixteen adults aged 65 to 74 years were interviewed in their own homes using a semi-structured interview schedule. Data were analysed using a descriptive qualitative methodology.…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

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

Information Literacy in the Sciences: Faculty Perception of Undergraduate Student Skill

ERIC Educational Resources Information Center

Perry, Heather Brodie

2017-01-01

Academic librarians need reliable information on the needs of faculty teaching undergraduates about seeking and using information. This study describes information gathered from semistructured interviews of teaching faculty in the sciences from several Boston-area colleges. The interview results provided insight into science faculty attitudes…

Emerging Conceptions of ICT-Enhanced Teaching: Australian TAFE Context

ERIC Educational Resources Information Center

Khan, Shahadat Hossain

2015-01-01

This article presents the results of a study, undertaken from a phenomenographic perspective, which examines technical and further education (TAFE) teachers' conceptions of ICT-enhanced teaching. A cohort of 23 teachers from three TAFE institutions in Australia, participated in semi-structured, in-depth interviews. These interviews were used to…

A Constructivist Case Study Examining the Leadership Development of Undergraduate Students in Campus Recreational Sports

ERIC Educational Resources Information Center

Hall, Stacey L.; Forrester, Scott; Borsz, Melissa

2008-01-01

This constructivist case study examined undergraduate student leadership development. Twenty-one student leaders, 13 females and 8 males, in a campus recreational sports department were interviewed using a semi-structured interview protocol. Seven broad themes: organizing, planning, and delegating; balancing academic, personal and professional…

Perceptions Matter: Administrators' Vision of Instruction for Students with Severe Disabilities

ERIC Educational Resources Information Center

Roberts, Carly A.; Ruppar, Andrea L.; Olson, Amy J.

2018-01-01

School administrators play an important role in shaping teaching and learning. However, very little is known regarding how school administrators perceive instruction for students with severe disabilities and how those perceptions shape expectations and visions for instruction. Semistructured interviews were used to interview 12 administrators…

Perceptions of Resiliency and Coping: Homeless Young Adults Speak Out

ERIC Educational Resources Information Center

Thompson, Sanna J.; Ryan, Tiffany N.; Montgomery, Katherine L.; Lippman, Angie Del Prado; Bender, Kimberly; Ferguson, Kristin

2016-01-01

This study explored the perceptions of resilience and coping among homeless young adults, a focus that differs from previous research by considering the unconventional resilience and coping of this high-risk population. Semistructured qualitative interviews were conducted with 45 homeless young adults. Individual interviews were audio recorded,…

Beliefs and Attitudes of Primary School Teachers in Mumbai, India towards Children Who Stutter

ERIC Educational Resources Information Center

Pachigar, Vinati; Stansfield, Jois; Goldbart, Juliet

2011-01-01

Beliefs and attitudes of teachers in Mumbai, India, towards children who stutter were investigated using questionnaires and semi-structured interviews. Questionnaires were completed by 58 teachers, four of whom were subsequently interviewed. Results from the questionnaires showed that teachers believed that a child's environment influenced…

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

ERIC Educational Resources Information Center

Sweeney, Jennifer; Creaner, Mary

2014-01-01

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

Understanding Seniors' Perceptions and Stereotypes of Aging

ERIC Educational Resources Information Center

Horton, Sean; Baker, J.; Cote, J.; Deakin, J. M.

2008-01-01

Research suggests there is a connection between stereotypes, beliefs, and behavior in older individuals. To explore this link of stereotypes affecting beliefs and beliefs affecting behavior, we interviewed young (age 60 to 75) seniors in an effort to further examine these relationships. Semistructured qualitative interviews were conducted with 20…

Driven and No Regrets: A Qualitative Analysis of Students Earning Baccalaureate Degrees in Three Years

ERIC Educational Resources Information Center

Firmin, Michael W.; Gilson, Krista Merrick

2007-01-01

Using rigorous qualitative research methodology, twenty-four college students receiving their undergraduate degrees in three years were interviewed. Following analysis of the semi-structured interview transcripts and coding, themes emerged, indicating that these students possessed self-discipline, self-motivation, and drive. Overall, the results…

Building the Professional Identity of Research Assistants: A Phenomenological Research

ERIC Educational Resources Information Center

Büyükgöze, Hilal; Gün, Feyza

2017-01-01

This research aims to investigate the determining factors in how research assistants build their professional identity. In the study, which is a qualitative research method patterned on phenomenology, data was collected using a semi-structured interview form. Structured interviews were conducted with seven research assistants selected from a…

The Mutual Shaping of Online and Offline Social Relationships

ERIC Educational Resources Information Center

Xie, Bo

2008-01-01

Introduction: This study examines the interplay between online and offline social relationships by focusing on an understudied social group: older Chinese Internet users. Method: Thirty-three semi-structured open-ended interviews were conducted with members of a senior-oriented Chinese Internet community in 2004. Analysis: Interview data were…

Academics' Teacher Identities, Authenticity and Pedagogy

ERIC Educational Resources Information Center

Kreber, Carolin

2010-01-01

Nine academics participated in semi-structured interviews to explore possible linkages between their teacher identities and the pedagogies they employ. A content analysis of the interviews was performed to gain insight into the factors playing a role in how academics define themselves as teachers, the larger educational goals they espouse and the…

What Do Instructional Designers in Higher Education Really Do?

ERIC Educational Resources Information Center

Kumar, Swapna; Ritzhaupt, Albert

2017-01-01

What do instructional designers in higher education really do? With the rise in online courses and programs in higher education, this question is especially important. We interviewed eight instructional designers from across the United States using a semi-structured interview protocol. The results were analyzed using the constant comparative…

Coping Constructs Related to College Students with Chronic Pain

ERIC Educational Resources Information Center

Firmin, Michael W.; Burger, Amanda J.; Sherman, Amanda L.; Grigsby, Megan E.; Croft, Jennifer N.

2011-01-01

This phenomenological, qualitative research study involved in-depth interviews with 22 participants enrolled in a private Midwestern university. Each participant reported living with a respective chronic pain syndrome while also being a full-time student. Our semi-structured, interviews centered around the constructs of physical, social,…

Life Trajectories of Youth Committing to Climate Activism

ERIC Educational Resources Information Center

Fisher, Scott R.

2016-01-01

This article draws from a study investigating the life trajectories of 17 youth climate activists from 14 countries through semi-structured, life memory interviews using Internet-based methods. The interpretations of the interviews focus on the ways in which participants constructed the meanings and functions of experiences and how they…

Fifth Grade Elementary Students' Conceptions of Earthquakes

ERIC Educational Resources Information Center

Savasci, Funda; Uluduz, Hatice

2013-01-01

This study intends to investigate the fifth grade students' conceptions of earthquakes. Twenty two grade 5 students (11-12 years old) from five different elementary schools in Istanbul voluntarily participated in the study. Data were collected from semi-structured interviews with each participant. Six interview questions were designed by…

Family-centered depression treatment for older men in primary care: a qualitative study of stakeholder perspectives.

PubMed

Hinton, Ladson; Sciolla, Andrés F; Unützer, Jürgen; Elizarraras, Edward; Kravitz, Richard L; Apesoa-Varano, Ester Carolina

2017-09-29

Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively engage and include family members in depression treatment. However, including family in depression treatment may be difficult due to several factors, such as depression stigma and family conflicts. The objective of this study was to describe challenges in engaging family members in older men's depression treatment and potential strategies to overcome those challenges. A cross-sectional, qualitative descriptive interview study was conducted in a safety-net, Federally Qualified Health Center in California's Central Valley. A total of 37 stakeholders were recruited, including 15 depressed older (i.e. age ≥ 60) men, 12 family members, and 10 clinic staff. Depressed men were identified through mail outreach, waiting room screening, and referral. Depressed men identified family members who were later approached to participate. We also recruited a purposeful sample of clinic staff. Interviews explored stakeholder perspectives on family involvement in men's depression treatment as part of a primary care intervention. Interviews were conducted using a semi-structured interview guide, tape-recorded, transcribed verbatim, and translated if the interview was conducted in Spanish. Four themes were identified representing core challenges: engaging men at the right time; preserving men's sense of autonomy; managing privacy concerns; and navigating family tensions. Stakeholders also provided practical suggestions and advice about how each of these challenges might be addressed. While engaging family is a promising approach to strengthen depression care for older men in primary care settings, several potential challenges exist. Family- centered depression intervention development and clinical practice need to anticipate these challenges and to develop approaches and guidelines to address them.

Staff Knowledge, Awareness, Perceptions, and Beliefs About Infection Prevention in Pediatric Long-term Care Facilities

PubMed Central

Løyland, Borghild; Wilmont, Sibyl; Hessels, Amanda J.; Larson, Elaine

2016-01-01

Background The burden of healthcare-associated infection worldwide is considerable, and there is a need to improve surveillance and infection control practices such as hand hygiene. Objectives The aims of this study were to explore direct care providers’ knowledge about infection prevention and hand hygiene, their attitudes regarding their own and others’ hand hygiene practices, and their ideas and advice for improving infection prevention efforts. Methods This exploratory study included interviews with direct care providers in three pediatric long-term care facilities. Two trained nurse interviewers conducted semistructured interviews using an interview guide with open-ended questions. Two other nurse researchers independently transcribed the audio recordings and conducted a thematic analysis using a strategy adapted from the systematic text condensation approach. Results From 31 interviews, four major thematic categories with subthemes emerged from the analysis: (a) hand hygiene products; (b) knowledge, awareness, perceptions, and beliefs; (c) barriers to infection prevention practices; and (d) suggested improvements. There was confusion regarding hand hygiene recommendations, use of soap or sanitizer, and isolation precaution policies. There was a robust “us” and “them” mentality between professionals. Discussion One essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination. Further studies need to evaluate if personal sized containers of hand sanitizer (e.g., for the pocket, attached to a belt or lanyard) would facilitate improvement of hand hygiene in these facilities. PMID:26938362

Stigma of addiction and mental illness in healthcare: The case of patients’ experiences in dental settings

PubMed Central

2017-01-01

Objective To explore the ways in which stigma is experienced in healthcare and dental settings by patients with a history of addiction and mental illness. Methods Audio-recorded, semi-structured interviews with a purposefully selected convenience sample of residents from two community treatment centres in Vancouver, Canada were conducted. The interview guide contained questions about experiences while seeking health and dental care and was based on an existing framework of labeling, stereotyping, exclusion, discrimination, and power imbalance. Interviews were transcribed verbatim for coding and thematic analysis. Results Twenty-five participants between 23 and 67 years of age were interviewed; 17 were males. Most had a self-reported history of depression combined with use of alcohol and crack-cocaine; most of them only sought dental care for emergency purposes. Textual analysis of more than 300 pages of transcribed interviews revealed that participants perceived stigma when they were negatively stereotyped as ‘unworthy’, labeled as ‘different’, excluded from the decision-making process, discriminated against, ‘treated unfairly’, and felt powerless when interacting in the heath and dental care systems. Conversely, positive experiences were characterized by empathy, reassurance and good communication, which were empowering for patients. Conclusions When associated with stigma, mental illness and addictions have negative implications for accessing health and dental care. From our participants’ perspectives, it seems that the lack of understanding about their life conditions by the healthcare professionals was the origin of stigma. We suggest that an increased social awareness of these health issues be enhanced among current and future health and dental care professionals to help improve care experiences for this marginalized population. PMID:28531176

A qualitative study on feedback provided by students in nurse education.

PubMed

Chan, Zenobia C Y; Stanley, David John; Meadus, Robert J; Chien, Wai Tong

2017-08-01

This study aims to help nurse educators/academics understand the perspectives and expectations of students providing their feedback to educators about teaching performance and subject quality. The aim of this study is to reveal students' voices regarding their feedback in nurse education in order to shed light on how the current student feedback practice may be modified. A qualitative study using focus group inquiry. Convenience sampling was adopted and participants recruited from one school of nursing in Hong Kong. A total of 66 nursing students from two pre-registration programs were recruited for seven focus group interviews: one group of Year 1 students (n=21), two groups of Year 3 students (n=27), and four groups of Final Year students (n=18). The interviews were guided by a semi-structured interview guideline and the interview narratives were processed through content analysis. The trustworthiness of this study was guaranteed through peer checking, research meetings, and an audit trail. The participants' privacy was protected throughout the study. Four core themes were discerned based on the narratives of the focus group interviews: (1) "timing of collecting feedback at more than one time point"; (2) "modify the questions being asked in collecting student feedback"; (3) "are electronic means of collecting feedback good enough?; and (4) "what will be next for student feedback?". This study is significant in the following three domains: 1) it contributed to student feedback because it examined the issue from a student's perspective; 2) it explored the timing and channels for collecting feedback from the students' point of view; and 3) it showed the preferred uses of student feedback. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Innovation in the safety net: integrating community health centers through accountable care.

PubMed

Lewis, Valerie A; Colla, Carrie H; Schoenherr, Karen E; Shortell, Stephen M; Fisher, Elliott S

2014-11-01

Safety net primary care providers, including as community health centers, have long been isolated from mainstream health care providers. Current delivery system reforms such as Accountable Care Organizations (ACOs) may either reinforce the isolation of these providers or may spur new integration of safety net providers. This study examines the extent of community health center involvement in ACOs, as well as how and why ACOs are partnering with these safety net primary care providers. Mixed methods study pairing the cross-sectional National Survey of ACOs (conducted 2012 to 2013), followed by in-depth, qualitative interviews with a subset of ACOs that include community health centers (conducted 2013). One hundred and seventy-three ACOs completed the National Survey of ACOs. Executives from 18 ACOs that include health centers participated in in-depth interviews, along with leadership at eight community health centers participating in ACOs. Key survey measures include ACO organizational characteristics, care management and quality improvement capabilities. Qualitative interviews used a semi-structured interview guide. Interviews were recorded and transcribed, then coded for thematic content using NVivo software. Overall, 28% of ACOs include a community health center (CHC). ACOs with CHCs are similar to those without CHCs in organizational structure, care management and quality improvement capabilities. Qualitative results showed two major themes. First, ACOs with CHCs typically represent new relationships or formal partnerships between CHCs and other local health care providers. Second, CHCs are considered valued partners brought into ACOs to expand primary care capacity and expertise. A substantial number of ACOs include CHCs. These results suggest that rather than reinforcing segmentation of safety net providers from the broader delivery system, the ACO model may lead to the integration of safety net primary care providers.

Eliminating malaria in Malaysia: the role of partnerships between the public and commercial sectors in Sabah.

PubMed

Sanders, Kelly C; Rundi, Christina; Jelip, Jenarun; Rashman, Yusof; Smith Gueye, Cara; Gosling, Roly D

2014-01-21

Countries in the Asia Pacific region have made great progress in the fight against malaria; several are rapidly approaching elimination. However, malaria control programmes operating in elimination settings face substantial challenges, particularly around mobile migrant populations, access to remote areas and the diversity of vectors with varying biting and breeding behaviours. These challenges can be addressed through subnational collaborations with commercial partners, such as mining or plantation companies, that can conduct or support malaria control activities to cover employees. Such partnerships can be a useful tool for accessing high-risk populations and supporting malaria elimination goals. This observational qualitative case study employed semi-structured key informant interviews to describe partnerships between the Malaysian Malaria Control Programme (MCP), and private palm oil, rubber and acacia plantations in the state of Sabah. Semi-structured interview guides were used to examine resource commitments, incentives, challenges, and successes of the collaborations. Interviews with workers from private plantations and the state of Sabah MCP indicated that partnerships with the commercial sector had contributed to decreases in incidence at plantation sites since 1991. Several plantations contribute financial and human resources toward malaria control efforts and all plantations frequently communicate with the MCP to help monitor the malaria situation on-site. Management of partnerships between private corporations and government entities can be challenging, as prioritization of malaria control may change with annual profits or arrival of new management. Partnering with the commercial sector has been an essential operational strategy to support malaria elimination in Sabah. The successes of these partnerships rely on a common understanding that elimination will be a mutually beneficial outcome for employers and the general public. Best practices included consistent communication, developing government-staffed subsector offices for malaria control on-site, engaging commercial plantations to provide financial and human resources for malaria control activities, and the development of new worker screening programmes. The successes and challenges associated with partnerships between the public and commercial sector can serve as an example for other malaria-eliminating countries with large plantation sectors, and may also be applied to other sectors that employ migrant workers or have commercial enterprises in hard to reach areas.

Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol.

PubMed

Gould, Natalie J; Lorencatto, Fabiana; Stanworth, Simon J; Michie, Susan; Prior, Maria E; Glidewell, Liz; Grimshaw, Jeremy M; Francis, Jill J

2014-07-29

Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention. This study is part of a larger programme of work to promote the uptake of evidence-based transfusion practice. The objectives of this study are to design two theoretically enhanced audit and feedback interventions; one focused on content and one on delivery, and investigate the feasibility and acceptability. Study A (Content): A coding framework based on current evidence regarding audit and feedback, and behaviour change theory and frameworks will be developed and applied as part of a structured content analysis to specify the key components of existing feedback documents. Prototype feedback documents with enhanced content and also a protocol, describing principles for enhancing feedback content, will be developed. Study B (Delivery): Individual semi-structured interviews with healthcare professionals and observations of team meetings in four hospitals will be used to specify, and identify views about, current audit and feedback practice. Interviews will be based on a topic guide developed using the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. Analysis of transcripts based on these frameworks will form the evidence base for developing a protocol describing an enhanced intervention that focuses on feedback delivery. Study C (Feasibility and Acceptability): Enhanced interventions will be piloted in four hospitals. Semi-structured interviews, questionnaires and observations will be used to assess feasibility and acceptability. This intervention development work reflects the UK Medical Research Council's guidance on development of complex interventions, which emphasises the importance of a robust theoretical basis for intervention design and recommends systematic assessment of feasibility and acceptability prior to taking interventions to evaluation in a full-scale randomised study. The work-up includes specification of current practice so that, in the trials to be conducted later in this programme, there will be a clear distinction between the control (usual practice) conditions and the interventions to be evaluated.

Primary care physicians’ experiences with electronic medical records

PubMed Central

Ludwick, Dave; Manca, Donna; Doucette, John

2010-01-01

OBJECTIVE To understand how remuneration and care setting affect the implementation of electronic medical records (EMRs). DESIGN Semistructured interviews were used to illicit descriptions from community-based family physicians (paid on a fee-for-service basis) and from urban, hospital, and academic family physicians (remunerated via alternative payment models or sessional pay for activities pertaining to EMR implementation). SETTING Small suburban community and large urban-, hospital-, and academic-based family medicine clinics in Alberta. All participants were supported by a jurisdictional EMR certification funding mechanism. PARTICIPANTS Physicians who practised in 1 or a combination of the above settings and had experience implementing and using EMRs. METHODS Purposive and maximum variation sampling was used to obtain descriptive data from key informants through individually conducted semistructured interviews. The interview guide, which was developed from key findings of our previous literature review, was used in a previous study of community-based family physicians on this same topic. Field notes were analyzed to generate themes through a comparative immersion approach. MAIN FINDINGS Physicians in urban, hospital, and academic settings leverage professional working relationships to investigate EMRs, a resource not available to community physicians. Physicians in urban, hospital, and academic settings work in larger interdisciplinary teams with a greater need for interdisciplinary care coordination, EMR training, and technical support. These practices were able to support the cost of project management or technical support resources. These physicians followed a planned system rollout approach compared with community physicians who installed their systems quickly and required users to transition to the new system immediately. Electronic medical records did not increase, or decrease, patient throughput. Physicians developed ways of including patients in the note-taking process. CONCLUSION We studied physicians’ procurement approaches under various payment models. Our findings do not suggest that one remuneration approach supports EMR adoption any more than another. Rather, this study suggests that stronger physician professional networks used in information gathering, more complete training, and in-house technical support might be more influential than remuneration in facilitating the EMR adoption experience. PMID:20090083

Janus Job Interview Guide. Revised Edition.

ERIC Educational Resources Information Center

Livingstone, Arnold

Designed for below-average-reading-level students, the purpose of this interview guide is to help young job seekers prepare for the job interview process. The first three chapters explain the nature of the personal job interview, the steps to be followed in preparing for a job interview, and the do's and don't's of the interview itself. The…

Hypochondriasis Y-BOCS: a study of the psychometric properties of a clinician-administered semi-structured interview to assess hypochondriacal thoughts and behaviours.

PubMed

Greeven, Anja; Spinhoven, Philip; van Balkom, Anton J L M

2009-01-01

This study investigated the psychometric properties of the first clinician-administered semi-structured interview for assessing the severity of hypochondriacal symptoms. The Hypochondriasis Yale-Brown Obsessive-Compulsive Scale (H-YBOCS) consisted of three a priori dimensions: hypochondriacal obsessions, compulsions and avoidance. The 16-item interview was conducted with 112 participants with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, hypochondriasis. We analysed factor analytic structure, reliability, construct validity and sensitivity to change. Factor analysis supported a three-factor model similar to the a priori dimensions. Internal consistency ranged from satisfactory to good. Inter-rater reliability was excellent. The construct validity was low to moderate. The H-YBOCS was sensitive for measuring changes in symptom severity. The H-YBOCS is a (factorially) valid and coherent interview with a high level of agreement across different raters. The relatively low discriminant validity could be due to co-morbid anxiety and depressive disorders. Overall, the H-YBOCS seems to be a promising contribution to the assessment of hypochondriasis. *The hypochondriasis Y-BOCS is a feasible clinician rated interview to assess the severity of hypochondriacal complaints.

After the Liverpool Care Pathway—development of heuristics to guide end of life care for people with dementia: protocol of the ALCP study

PubMed Central

Davies, N; Manthorpe, J; Sampson, E L; Iliffe, S

2015-01-01

Introduction End of life care guidance for people with dementia is lacking and this has been made more problematic in England with the removal of one of the main end of life care guidelines which offered some structure, the Liverpool Care Pathway. This guidance gap may be eased with the development of heuristics (rules of thumb) which offer a fast and frugal form of decision-making. Objective To develop a toolkit of heuristics (rules of thumb) for practitioners to use when caring for people with dementia at the end of life. Method and analysis A mixed-method study using a co-design approach to develop heuristics in three phases. In phase 1, we will conduct at least six focus groups with family carers, health and social care practitioners from both hospital and community care services, using the ‘think-aloud’ method to understand decision-making processes and to develop a set of heuristics. The focus group topic guide will be developed from the findings of a previous study of 46 interviews of family carers about quality end-of-life care for people with dementia and a review of the literature. A multidisciplinary development team of health and social care practitioners will synthesise the findings from the focus groups to devise and refine a toolkit of heuristics. Phase 2 will test the use of heuristics in practice in five sites: one general practice, one community nursing team, one hospital ward and two palliative care teams working in the community. Phase 3 will evaluate and further refine the toolkit of heuristics through group interviews, online questionnaires and semistructured interviews. Ethics and dissemination This study has received ethical approval from a local NHS research ethics committee (Rec ref: 15/LO/0156). The findings of this study will be presented in peer-reviewed publications and national and international conferences. PMID:26338688

Sex and intimacy among patients with implantable left-ventricular assist devices.

PubMed

Marcuccilli, Linda; Casida, Jesus Jessie; Peters, Rosalind M; Wright, Susan

2011-01-01

Left-ventricular assist devices (LVADs) sustain and improve the quality of life of people living with an advanced stage of heart failure. Past research focused on the development and advancement of LVAD technology, complications, and survival rates. Limited research addressed the psychosocial aspects of living with an LVAD, yet research related to sexual functioning and intimacy is lacking. The purpose of this study was to explore and describe sex and intimacy among adults living with an LVAD. We used an interpretive phenomenological study to explore the experiences of adults living with a long-term implantable LVAD, including the effect of the LVAD on their intimate and sexual functioning. Semistructured interviews were conducted with 7 men and 2 women, 31 to 70 years of age, who had lived with the LVAD at home for at least 3 months. Interviews were audiorecorded and transcribed. The wholistic and selective approach by van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Albany, NY: SUNY Press; 1990) guided the analysis and interpretation of the transcribed interviews. Data were organized and coded into words and phrases using qualitative software. Three themes emerged from the data: (a) improved sexual relations with LVAD, (b) sexual adjustment, and (c) nonsexual intimacy. The themes identified were consistent with the concept of normalcy from the theory of self-care. Participants reported that as the LVAD improved their overall health, their sexual functioning also improved. Participants also reported an increased sense of connectedness and intimacy with their partners even in the absence of sexual intercourse. Participants discussed ways in which they continued to develop intimate relationships even in the presence of limitations in structural and functional integrity. The knowledge derived from this study can be used as a guide for healthcare providers in counseling LVAD recipients on psychosocial and sexual health essential for achieving an optimum quality of life.

Experiences With a Self-Reported Mobile Phone-Based System Among Patients With Colorectal Cancer: A Qualitative Study.

PubMed

Drott, Jenny; Vilhelmsson, Maria; Kjellgren, Karin; Berterö, Carina

2016-06-09

In cancer care, mobile phone-based systems are becoming more widely used in the assessment, monitoring, and management of side effects. To explore the experiences of patients with colorectal cancer on using a mobile phone-based system for reporting neurotoxic side effects. Eleven patients were interviewed (ages 44-68 years). A semistructured interview guide was used to perform telephone interviews. The interviews were transcribed verbatim and analyzed with qualitative content analysis. The patients' experiences of using a mobile phone-based system were identified and constructed as: "being involved," "pacing oneself," and "managing the questions." "Being involved" refers to their individual feelings. Patients were participating in their own care by being observant of the side effects they were experiencing. They were aware that the answers they gave were monitored in real time and taken into account by health care professionals when planning further treatment. "Pacing oneself" describes how the patients can have an impact on the time and place they choose to answer the questions. Answering the questionnaire was easy, and despite the substantial number of questions, it was quickly completed. "Managing the questions" pointed out that the patients needed to be observant because of the construction of the questions. They could not routinely answer all the questions. Patients understood that side effects can vary during the cycles of treatment and need to be assessed repeatedly during treatment. This mobile phone-based system reinforced the patients' feeling of involvement in their own care. The patients were comfortable with the technology and appreciated that the system was not time consuming.

Patient Disease Perceptions and Coping Strategies for Arthritis in a Developing Nation: A Qualitative Study

PubMed Central

2011-01-01

Background There is little prior research on the burden of arthritis in the developing world. We sought to document how patients with advanced arthritis living in the Dominican Republic are affected by and cope with their disease. Methods We conducted semi-structured, one-to-one interviews with economically disadvantaged Dominican patients with advanced knee and/or hip arthritis in the Dominican Republic. The interviews, conducted in Spanish, followed a moderator's guide that included topics such as the patients' understanding of disease etiology, their support networks, and their coping mechanisms. The interviews were audiotaped, transcribed verbatim in Spanish, and systematically analyzed using content analysis. We assessed agreement in coding between two investigators. Results 18 patients were interviewed (mean age 60 years, median age 62 years, 72% women, 100% response rate). Patients invoked religious and environmental theories of disease etiology, stating that their illness had been caused by God's will or through contact with water. While all patients experienced pain and functional limitation, the social effects of arthritis were gender-specific: women noted interference with homemaking and churchgoing activities, while men experienced disruption with occupational roles. The coping strategies used by patients appeared to reflect their beliefs about disease causation and included prayer and avoidance of water. Conclusions Patients' explanatory models of arthritis influenced the psychosocial effects of the disease and coping mechanisms used. Given the increasing reach of global health programs, understanding these culturally influenced perceptions of disease will be crucial in successfully treating chronic diseases in the developing world. PMID:21985605

Providing adolescent sexual health care in the pediatric emergency department: views of health care providers

PubMed Central

Miller, Melissa K.; Mollen, Cynthia J.; O’Malley, Donna; Owens, Rhea L.; Maliszewski, Genevieve A.; Goggin, Kathy; Patricia, Kelly

2014-01-01

Objective The purpose of this study was to explore health care providers’ (HCPs) attitudes and beliefs about adolescent sexual health care provision in the emergency department (ED) and to identify barriers to a role of a health educator-based intervention. Methods We conducted focused, semi-structured interviews of HCPs from the ED and Adolescent Clinic of a children’s hospital. The interview guide was based on the Theory of Planned Behavior and its constructs: attitudes, subjective norms, perceived behavioral control, and intention to facilitate care. We used purposive sampling and enrollment continued until themes were saturated. Interviews were recorded and transcribed. Transcripts were analyzed using directed content analysis. Results Twenty-nine interviews were required for saturation. Participants were 12 physicians, 12 nurses, 3 nurse practitioners and 2 social workers; the majority (83%) were female. Intention to facilitate care was influenced by HCP perception of 1) their professional role, 2) the role of the ED (focused vs. expanded care), and 3) need for patient safety. HCPs identified three practice referents: patients/families, peers and administrators, and professional organizations. HCPs perceived limited behavioral control over care delivery because of time constraints, confidentiality issues, and comfort level. There was overall support for a health educator and many felt the educator could help overcome barriers to care. Conclusion Despite challenges unique to the ED, HCPs were supportive of the intervention and perceived the health educator as a resource to improve adolescent care and services. Future research should evaluate efficacy and costs of a health educator in this setting. PMID:24457494

Perinatal Experiences of Women With Physical Disabilities and Their Recommendations for Clinicians

PubMed Central

Smeltzer, Suzanne C.; Mitra, Monika; Iezzoni, Lisa I.; Long-Bellil, Linda; Smith, Lauren D.

2016-01-01

Objective To explore the perinatal experiences of women with physical disabilities (WWPD) and their associated recommendations for maternity care clinicians to improve care. Design A mixed-method study was conducted using a semi-structured interview guide to identify the experiences of WWPD. This qualitative descriptive study is part of a larger study and was conducted to examine the perceptions of WWPD about their interactions with maternity care clinicians and their recommendations for maternity care clinicians to improve care. Participants Twenty-five women with physical disabilities who gave birth within the last 10 years and were 21–55 years of age were recruited and agreed to participate in the study. Methods Participants were asked about their interactions with clinicians during pregnancy and their recommendations for clinicians to improve perinatal care for women with physical disabilities. Transcribed interviews were analyzed using content analysis. Themes that emerged from analysis of the interviews were identified and coded. Kurasaski’s coding was used to establish the reliability of the coding. Results Three themes emerged from analysis of the interview data: clinicians’ lack of knowledge about pregnancy-related needs of WWPD; clinicians’ failure to consider knowledge, experience, and expertise of women about their own disabilities; and clinicians’ lack of awareness of reproductive concerns of WWPD. Women provided recommendations that warrant attention by clinicians who provide perinatal care for women who live with physical disabilities. Conclusion Participants experienced problematic interactions with clinicians related to pregnancy and identified recommendations for maternity care clinicians to address those problems with the goal of improving perinatal health care for WWPD. PMID:27619410

Asthma management experiences of Australians who are native Arabic speakers.

PubMed

Alzayer, Reem; Chaar, Betty; Basheti, Iman; Saini, Bandana

2017-08-11

The aim of this study was to explore the asthma management experiences of people with asthma within the Arabic-speaking community in Australia. Semi-structured interviews guided by a schedule of questions were conducted with 25 Arabic-speaking women with asthma\\carer of a child with asthma, recruited from medical practices and community centers in Melbourne, Australia. Twenty-five Arabic-speaking participants with asthma or caring for those with asthma were interviewed. Interviews lasted on average 25 minutes. Most participants or those they were caring for did not have well-controlled asthma. Thematic analyses of the interview transcripts highlighted five key emergent themes: stigma, health literacy, non-adherence, expectations, and coping styles. Findings indicated that many participants were not conversant about local information avenues or healthcare or facilities such as the Asthma Foundation or availability of Arabic translators during general practitioner (GP) consults. Many recent migrants were generally non-adherent with treatment; preferring to follow traditional folk medicine rather than consulting a GP or pharmacist. Some unrealistic expectations from doctors/treatment goals were expressed by a few participants. Some parents of children with asthma reported disappointment with the fact that their children did not grow out of asthma. Low health literacy and in particular knowledge about asthma, cultural beliefs, language, and migration-related issues may all be affecting the level of asthma control in the Arabic-speaking population in Australia. Measures to enhance asthma and health system literacy designed to be culturally concordant with the beliefs, expectations, and experiences of such populations may be key to improving asthma management.

Views on a brief mindfulness intervention among patients with long-term illness.

PubMed

Howarth, Ana; Perkins-Porras, Linda; Copland, Claire; Ussher, Michael

2016-11-15

Chronic illness is the leading cause of death in the UK and worldwide. Psychological therapies to support self-management have been shown to play an important role in helping those with chronic illness cope; more recently, the therapeutic benefits of mindfulness approaches have become evident for managing depression and other distressing emotions. Brief guided mindfulness interventions, are more convenient than intensive traditional programmes requiring regular attendance but have been less explored. This study assessed views on a brief (i.e., 10 min) mindfulness intervention for those with specific long-term illnesses. Semi-structured interviews and focus groups were conducted with chronic illness patient groups (i.e., chronic obstructive pulmonary disease, chronic pain and cardiovascular disease), designed to capture the acceptability and feasibility of the intervention. The interviews were conducted after use of a mindfulness based audio in clinic and, one week later, after use in the patient's own environment. Interviews were recorded, transcribed and analysed using thematic analysis. In total, a combination of 18 interviews and focus groups were conducted among 14 patients. Recruitment was most successful with chronic pain patients. All patients reported benefits such as feelings of relaxation and improved coping with symptoms. While the wording and content of the audio were generally well received, it was suggested that the length could be increased, as it felt rushed, and that more guidance about the purpose of mindfulness, and when to use it, was needed. A brief mindfulness intervention was well accepted among patients with long-term illness. The intervention may benefit by being lengthened and by offering further guidance on its use.

Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

PubMed

Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

2018-05-15

MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

Oncofertility resources at NCI-designated comprehensive cancer centers.

PubMed

Clayman, Marla L; Harper, Maya M; Quinn, Gwendolyn P; Reinecke, Joyce; Shah, Shivani

2013-12-01

NCI-designated comprehensive cancer centers (CCCs) set the standard for providing exemplary patient care. Quality cancer care includes discussions about fertility and referrals to fertility specialists for patients at risk for sterility. This study sought to determine what fertility preservation (FP) resources are available in CCCs and how well those are integrated into patient care. Leaders at each CCC received a letter requesting a short telephone interview with individuals who could provide information about the institution's FP resources. A semi-structured interview guide was used and responses were audio-recorded. Data were analyzed using content and thematic analysis. Interviews were conducted with 30 of the 39 CCCs that see adult patients (77%). The remaining institutions included 4 nonresponders, 3 that referred the interviewers to childhood cancer survivorship clinics, 1 that refused, and 1 that could not identify any FP resources. Participants were primarily affiliated with reproductive endocrinology (n=15) or hematology/oncology divisions (n=10). Institutional policies regarding consistent provision of FP information were rare (n=4), although most sites (n=20) either had some services on-site or had referral programs (n=8). However, only 13 had some experimental services, such as ovarian tissue cryopreservation. Respondents reported barriers to provision of FP, including oncologists' identification of patients at risk, low referral rates, and perceptions of patient prognosis. Only 8 (27%) sites had staff with time dedicated to FP. CCCs vary widely in implementing FP-recommended practice to their patients. CCCs are positioned to provide exemplary oncofertility care, but most need to better integrate FP information and referral into practice.

Factors that influence effective perioperative temperature management by anesthesiologists: a qualitative study using the Theoretical Domains Framework.

PubMed

Boet, Sylvain; Patey, Andrea M; Baron, Justine S; Mohamed, Karim; Pigford, Ashlee-Ann E; Bryson, Gregory L; Brehaut, Jamie C; Grimshaw, Jeremy M

2017-06-01

Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period. After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital. An interview guide based on the Theoretical Domains Framework (TDF) was used to capture 14 theoretical domains that may influence temperature management. The interview transcripts were coded using direct content analysis to generate specific beliefs and to identify relevant TDF domains perceived to influence temperature management behaviour. Data saturation was achieved after 15 interviews. The following nine theoretical domains were identified as relevant to designing an intervention for practices in perioperative temperature management: knowledge, beliefs about capabilities, beliefs about consequences, reinforcement, memory/attention/decision-making, environmental context and resources, social/professional role/identity, social influences, and behavioural regulation. Potential target areas to improve temperature management practices include interventions that address information needs about individual temperature management behaviour as well as patient outcome (feedback), increasing awareness of possible temperature management strategies and guidelines, and a range of equipment and surgical team dynamics that influence temperature management. This study identified several potential target areas for future interventions from nine of the TDF behavioural domains that anesthesiologists perceive to drive their temperature management practices. Future interventions that aim to close the evidence-practice gap in perioperative temperature management may include these targets.

'The onus is on me': primary care patient views of Medicare-funded team care in chronic disease management in Australia.

PubMed

Foster, Michele M; Mitchell, Geoffrey K

2015-10-01

This study investigated the views of primary care patients in receipt of Medicare-funded team care for chronic disease management (CDM) in Australia. A qualitative study using a repeat in-depth interview design. Twenty-three patients (17 female), aged 32-89, were recruited over a six-month period from two purposively selected general practices: one urban and one regional practice in Queensland, Australia. Semi-structured interviews were conducted with participants 6 months apart. An interview guide was used to ensure consistency of topics explored. Interviews were recorded and transcribed, and a thematic analysis was conducted. Patients in this study viewed the combined contributions of a GP and other health professionals in team care as thorough and reassuring. In this case of Medicare-funded team care, patients also saw obligations within the structured care routine which cultivated a personal ethics of CDM. This was further influenced by how patients viewed their role in the health-care relationship. Aside from personal obligations, Medicare funding got patients engaged in team care by providing financial incentives. Indeed, this was a defining factor in seeing allied health professionals. However, team care was also preferential due to patients' valuations of costs and benefits. Patients are likely to engage with a structured team care approach to CDM if there is a sense of personal obligation and sufficient financial incentive. The level of engagement in team care is likely to be optimized if patient expectations and preferences are considered in decisions. © 2013 Blackwell Publishing Ltd.

Understanding decision-making in cardiac imaging: determinants of appropriate use.

PubMed

Fonseca, Ricardo; Jose, Kim; Marwick, Thomas H

2018-03-01

Appropriate Use Criteria (AUC) for echocardiography were developed in 2007 to facilitate decision-making, reduce variability in test utilization, and encourage rational use of imaging. However, there is little evidence that the AUC have favourably influenced ordering behaviour. This study explores the factors that contribute to clinicians requesting echocardiograms with a focus on appropriate use. Semi-structured face-to-face interviews with cardiologists and non-cardiologists who had requested echocardiograms were conducted at an Australian tertiary hospital. The interview guide included hypothetical clinical scenarios to better understand decision-making in ordering echocardiograms and the actions they could take when receiving test reports. Interviews underwent thematic analysis. Seventeen clinicians were interviewed, ten of whom were cardiologists. All participants ordered echocardiograms to support their clinical decision-making. Awareness of the AUC was low. The categorization of tests as 'appropriate' or 'inappropriate' was considered ineffective as it failed to reflect the decision-making process. The decision to request echocardiograms was influenced by a number of personal and systemic factors as well as guidelines and protocols. Training and experience, patients' expectations, and management of uncertainty were key personal factors. Systemic factors involved the accessibility of services and health insurance status of the patient. Factors that influenced the ordering of echocardiograms by clinicians at a tertiary care hospital did not appear to be amenable to control with AUC. Alternative approaches may be more effective than the AUC in addressing the overuse of echocardiography. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Patients' views of teamwork in the emergency department offer insights about team performance.

PubMed

Henry, Beverly W; McCarthy, Danielle M; Nannicelli, Anna P; Seivert, Nicholas P; Vozenilek, John A

2016-06-01

Research into efforts to engage patients in the assessment of health-care teams is limited. To explore, through qualitative methods, patient awareness of teamwork-related behaviours observed during an emergency department (ED) visit. Researchers used semi-structured question guides for audio-recorded interviews and analysed their verbatim transcripts. Researchers conducted individual phone interviews with 6 teamwork subject matter experts (SMEs) and held 5 face-to-face group interviews with patients and caregivers (n = 25) about 2 weeks after discharge from the emergency department (ED). SMEs suggested that a range of factors influence patient perspectives of teams. Many patients perceived the health-care team within the context of their expectations of an ED visit and their treatment plan. Four themes emerged: (i) patient-centred views highlight gaps in coordination and communication; (ii) team processes do concern patients; (iii) patients are critical observers of ways that team members present their team roles; (iv) patients' observations of team members relate to patients' views of team effectiveness. Analysis also indicated that patients viewed health-care team members' interactions with each other as proxy for how team members actually felt about patients. Results from both sets of interviews (SME and patient) indicated that patient observations of teamwork could add to assessment of team processes/frameworks. Patients' understanding about teamwork organization seemed helpful and witnessed interteam communication appeared to influence patient confidence in the team. Patients perspectives are an important part of assessment in health care and suggest potential areas for improvement through team training. © 2013 John Wiley & Sons Ltd.

'It was like he was in the room with us': patients' and carers' perspectives of telemedicine in acute stroke.

PubMed

Gibson, Josephine; Lightbody, Elizabeth; McLoughlin, Alison; McAdam, Joanna; Gibson, Alison; Day, Elaine; Fitzgerald, Jane; May, Carl; Price, Chris; Emsley, Hedley; Ford, Gary A; Watkins, Caroline

2016-02-01

Telemedicine can facilitate delivery of thrombolysis in acute stroke. The aim of this qualitative study was to explore patients' and carers' views of their experiences of using a stroke telemedicine system in order to contribute to the development of reliable and acceptable telemedicine systems and training for health-care staff. We recruited patients who had, and carers who were present at, recent telemedicine consultations for acute stroke in three hospitals in NW England. Semi-structured interviews were conducted using an interview guide based on normalization process theory (NPT). Thematic analysis was undertaken. We conducted 24 interviews with 29 participants (16 patients; 13 carers). Eleven interviews pertained to 'live' telemedicine assessments (at the time of admission); nine had mock-up telemedicine assessments (within 48 h of admission); four had both assessments. Using the NPT domains as a framework for analysis, factors relating to coherence (sense making) included people's knowledge and understanding of telemedicine. Cognitive participation (relational work) included interaction between staff and with patients and carers. Issues relating to collective action (operational work) included information exchange and support, and technical matters. Findings relating to reflexive monitoring (appraisal) included positive and negative impressions of the telemedicine process, and emotional reactions. Although telemedicine was well accepted by many participants, its use added an additional layer of complexity to the acute stroke consultation. The 'remote' nature of the consultation posed challenges for some patients. These issues may be ameliorated by clear information for patients and carers, staff interpersonal skills, and teamworking. © 2015 John Wiley & Sons Ltd.

Acceptability and use of a dapivirine vaginal ring in a phase III trial

PubMed Central

Montgomery, Elizabeth T.; van der Straten, Ariane; Chitukuta, Miria; Reddy, Krishnaveni; Woeber, Kubashni; Atujuna, Millicent; Bekker, Linda-Gail; Etima, Juliane; Nakyanzi, Teopista; Mayo, Ashley J.; Katz, Ariana; Laborde, Nicole; Grossman, Cynthia I.; Soto-Torres, Lydia; Palanee-Phillips, Thesla; Baeten, Jared M.

2017-01-01

Background The MTN-020/ASPIRE trial evaluated the safety and effectiveness of the dapivirine vaginal ring for prevention of HIV-1 infection among African women. A nested qualitative component was conducted at six of 15 study sites in Uganda, Malawi, Zimbabwe and South Africa to evaluate acceptability of and adherence to the ring. Method Qualitative study participants (n = 214) were interviewed with one of three modalities: single in-depth interview, up to three serial interviews or an exit Focus Group Discussion. Using semistructured guides administered in local languages, 280 interviews were audio-recorded, transcribed, translated, coded and analyzed. Results We identified three key findings: first, despite initial fears about the ring's appearance and potential side effects, participants grew to like it and developed a sense of ownership of the ring once they had used it. Second, uptake and sustained adherence challenges were generally overcome with staff and peer support. Participants developed gradual familiarity with ring use through trial progression, and most reported that it was easy to use and integrate into their lives. Using the ring in ASPIRE was akin to joining a team and contributing to a broader, communal good. Third, the actual or perceived dynamics of participants' male partner relationship(s) were the most consistently described influence (which ranged from positive to negative) on participants' acceptability and use of the ring. Conclusion It is critical that demonstration projects address challenges during the early adoption stages of ring diffusion to help achieve its potential public health impact as an effective, long-acting, female-initiated HIV prevention option addressing women's disproportionate HIV burden. PMID:28441175

Acceptability and use of a dapivirine vaginal ring in a phase III trial.

PubMed

Montgomery, Elizabeth T; van der Straten, Ariane; Chitukuta, Miria; Reddy, Krishnaveni; Woeber, Kubashni; Atujuna, Millicent; Bekker, Linda-Gail; Etima, Juliane; Nakyanzi, Teopista; Mayo, Ashley J; Katz, Ariana; Laborde, Nicole; Grossman, Cynthia I; Soto-Torres, Lydia; Palanee-Phillips, Thesla; Baeten, Jared M

2017-05-15

The MTN-020/ASPIRE trial evaluated the safety and effectiveness of the dapivirine vaginal ring for prevention of HIV-1 infection among African women. A nested qualitative component was conducted at six of 15 study sites in Uganda, Malawi, Zimbabwe and South Africa to evaluate acceptability of and adherence to the ring. Qualitative study participants (n = 214) were interviewed with one of three modalities: single in-depth interview, up to three serial interviews or an exit Focus Group Discussion. Using semistructured guides administered in local languages, 280 interviews were audio-recorded, transcribed, translated, coded and analyzed. We identified three key findings: first, despite initial fears about the ring's appearance and potential side effects, participants grew to like it and developed a sense of ownership of the ring once they had used it. Second, uptake and sustained adherence challenges were generally overcome with staff and peer support. Participants developed gradual familiarity with ring use through trial progression, and most reported that it was easy to use and integrate into their lives. Using the ring in ASPIRE was akin to joining a team and contributing to a broader, communal good. Third, the actual or perceived dynamics of participants' male partner relationship(s) were the most consistently described influence (which ranged from positive to negative) on participants' acceptability and use of the ring. It is critical that demonstration projects address challenges during the early adoption stages of ring diffusion to help achieve its potential public health impact as an effective, long-acting, female-initiated HIV prevention option addressing women's disproportionate HIV burden.

Treatment Seeking and Self-Constructed Explanations of Pain and Pain Management Strategies Among Adolescents with Temporomandibular Disorder Pain.

PubMed

Nilsson, Ing-Marie; Willman, Ania

2016-01-01

To explore adolescents' explanations of their temporomandibular disorder (TMD) pain, their pain management strategies for TMD pain, and their treatment-seeking behavior. One-on-one interviews were conducted with 21 adolescents aged 15 to 19 years who had TMD pain and followed a semistructured interview guide. Subjects were strategically selected from patients referred to an orofacial pain clinic. All participants had been examined and received a pain diagnosis based on the Research Diagnostic Criteria for TMD. The interviews focused on the adolescents' experiences of TMD pain, their strategies for handling pain, and how they seek care. The interviews were recorded, transcribed verbatim, and analyzed using qualitative manifest content analysis. Qualitative manifest content analysis revealed two categories: (1) self-constructed explanations, with three subcategories (situation-based explanatory model, physical/biologic model, and psychological explanatory model); and (2) pain management strategies, with four subcategories (social support, treatment, relaxation/rest, and psychological strategies). Adolescents used physical activities and psychological and pharmacologic treatment to manage pain. Reasons for seeking treatment were to be cured, to obtain an explanation for their pain, and because their symptoms bother others. Adolescents living with TMD pain develop self-constructed explanations and pain management strategies. With access to these descriptions, dentists can be better prepared to have a dialogue with their adolescent patients about their own explanations of pain, the nature of pain, and in which situations the pain appears. Dentists can also explore adolescent patients' pain management strategies and perhaps also suggest new treatment strategies at an earlier stage.

Opioid Prescribing After Curative-Intent Surgery: A Qualitative Study Using the Theoretical Domains Framework.

PubMed

Lee, Jay S; Parashar, Vartika; Miller, Jacquelyn B; Bremmer, Samantha M; Vu, Joceline V; Waljee, Jennifer F; Dossett, Lesly A

2018-07-01

Excessive opioid prescribing is common after curative-intent surgery, but little is known about what factors influence prescribing behaviors among surgeons. To identify targets for intervention, we performed a qualitative study of opioid prescribing after curative-intent surgery using the Theoretical Domains Framework, a well-established implementation science method for identifying factors influencing healthcare provider behavior. Prior to data collection, we constructed a semi-structured interview guide to explore decision making for opioid prescribing. We then conducted interviews with surgical oncology providers at a single comprehensive cancer center. Interviews were recorded, transcribed verbatim, then independently coded by two investigators using the Theoretical Domains Framework to identify theoretical domains relevant to opioid prescribing. Relevant domains were then linked to behavior models to select targeted interventions likely to improve opioid prescribing. Twenty-one subjects were interviewed from November 2016 to May 2017, including attending surgeons, resident surgeons, physician assistants, and nurses. Five theoretical domains emerged as relevant to opioid prescribing: environmental context and resources; social influences; beliefs about consequences; social/professional role and identity; and goals. Using these domains, three interventions were identified as likely to change opioid prescribing behavior: (1) enablement (deploy nurses during preoperative visits to counsel patients on opioid use); (2) environmental restructuring (provide on-screen prompts with normative data on the quantity of opioid prescribed); and (3) education (provide prescribing guidelines). Key determinants of opioid prescribing behavior after curative-intent surgery include environmental and social factors. Interventions targeting these factors are likely to improve opioid prescribing in surgical oncology.

Mothers' beliefs and barriers about childhood diarrhea and its management in Morang district, Nepal.

PubMed

Ansari, Mukhtar; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi; Shankar, P Ravi; Koirala, Arun; Thapa, Noor Jang

2012-10-24

In developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers' beliefs and barriers about diarrhea and its management. Qualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis. Twenty mothers participated in the interviews and most (80%) of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US$ 60.92). Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers' beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit traditional healers. There were varied beliefs among the mothers about the types, causes and severity of diarrhea, classification of foods/fluids and beliefs and barriers about preventing or treating diarrhea.

Exploring the role of practical nursing wisdom in the care of patients with urinary problems at the end of life: a qualitative interview study.

PubMed

Farrington, Naomi; Fader, Mandy; Richardson, Alison; Sartain, Samantha

2015-10-01

This study examined how nurses understand urinary problems at the end of life, and identified sources of evidence upon which they base their practice through semi-structured qualitative interviews. The aim was to decide whether research or interventions (such as formulation of best practice guidelines) could improve continence care at the end of life. There is little evidence in nursing literature to indicate how nurses should manage urinary problems at the end of life. Evidence is particularly lacking regarding the insertion of indwelling urinary catheters. This was an applied qualitative interview study which used the 'guided interview' approach. Twelve participants who worked in two hospital wards and one hospice were interviewed about management of patients with urinary problems approaching the end of life. The transcribed interviews were organised using the qualitative analysis software qsr NVivo version 10 (QSR International, Melbourne, Australia). Constant comparison was used to analyse the interviews. The patient and their family were a key concern of all interviewees. Participants focused on processes including: giving care, making decisions, managing uncertainty and assimilating knowledge. These processes are mediated by 'phronesis' or practical wisdom. Within each of the processes (giving care, making decisions, managing uncertainty and assimilating knowledge), participants approached each patient as an individual, using experience, patient wishes, available resources, clinical knowledge and advice from colleagues to provide care. A generalised set of guidelines on managing urinary problems at the end of life would probably not be useful. There is uncertainty about what constitutes best practice in specific areas of continence care at the end of life such as indwelling urinary catheter insertion. A careful approach is needed to ensure that the intellectual and moral knowledge that constitutes practical wisdom is shared and developed throughout teams. © 2015 John Wiley & Sons Ltd.

Oral Academic Discourse Socialisation: Challenges Faced by International Undergraduate Students in a Malaysian Public University

ERIC Educational Resources Information Center

Mahfoodh, Omer Hassan Ali

2014-01-01

This paper reports a qualitative study which examines the challenges faced by six international undergraduate students in their socialisation of oral academic discourse in a Malaysian public university. Data were collected employing interviews. Students' presentations were also collected. Semi-structured interviews were transcribed verbatim and…

Cultural Background Variables in Dance Talent Development: Findings from the UK Centres for Advanced Training

ERIC Educational Resources Information Center

Sanchez, Erin N.; Aujla, Imogen J.; Nordin-Bates, Sanna

2013-01-01

This study is a qualitative enquiry into cultural background variables--social support, values, race/ethnicity and economic means--in the process of dance talent development. Seven urban dance students in pre-vocational training, aged 15-19, participated in semi-structured interviews. Interviews were inductively analysed using QSR International…

How Teachers Develop Their Professional Knowledge in English Study Group in Taiwan

ERIC Educational Resources Information Center

Huang, Yi-Ching

2007-01-01

The purpose of this qualitative research was to understand the perceptions of Taiwanese teachers of the effects of a study group on their professional growth in the workplace. This case study employed the following data collection techniques: (1) informal observations and interviews, (2) focus group interview, (3) semi-structured individual…

Does Russia Need Sex Education? The Views of Stakeholders in Three Russian Regions

ERIC Educational Resources Information Center

Gevorgyan, Ruzanna; Schmidt, Elena; Wall, Martin; Garnett, Geoffrey; Atun, Rifat; Maksimova, Svetlana; Davidenko, Ludmila; Renton, Adrian

2011-01-01

Objective: To investigate the attitudes of the main stakeholders towards the introduction of sex education in schools in Russia. Design: Qualitative semi-structured interview study. Setting: Altai Krai, Volgograd Oblast, Moscow, Russian Federation. Participants: One hundred and fifty-three interviews with Intersectoral HIV/AIDS Committee members,…

Creating a Positive School Culture in Newly Opened Schools

ERIC Educational Resources Information Center

Holmes, Michael Todd

2009-01-01

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

Contributions to the Development of State FFA Officers

ERIC Educational Resources Information Center

Hoover, Tracy S.; Bruce, Jacklyn A.

2006-01-01

What are the long term consequences associated with serving as a state FFA officer? Using a semi-structured interview format, selected state FFA officers from a twenty year time span were interviewed to assess their perceptions of and assets attributed to their experiences as a state officer. Results indicated that past state officers, regardless…

Parents' Perspectives of Using a Therapeutic Listening Program with Their Children with Sensory Processing Difficulties: A Qualitative Study

ERIC Educational Resources Information Center

Wink, Sarah; McKeown, Laura; Casey, Jackie

2017-01-01

This phenomenological study explored parents' perspectives of Therapeutic Listening (TL) implemented as a home program to treat their children with sensory processing difficulties. Ten parents participated in semistructured interviews. Interviews were transcribed verbatim and analyzed thematically. Parents were concerned about their child's…

Students' Experiences of Attending an Innovative Occupational Therapy Professional Practice Placement in a Childcare Setting

ERIC Educational Resources Information Center

Yu, Mong-lin; Brown, Ted; Etherington, Jamie

2018-01-01

This study investigated occupational therapy students' experiences of their alternative fieldwork placement at one childcare center where there was no established occupational therapy service. A semi-structured focus group interview explored four students' placement experiences. The interview was audio-recorded, transcribed verbatim, and content…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

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

Motivators, Facilitators, and Barriers to Physical Activity in Older Adults: A Qualitative Study.

PubMed

Miller, Wendy; Brown, Patrick R

In this descriptive, qualitative research study, the researchers used semistructured interviews with older adults who engaged in regular physical activity to identify common motivators, facilitators, and barriers to participating in regular exercise. The authors used these interviews to identify major themes and discuss implications for population health.

Methodologies for Teaching English to Adult Students in Spanish Vocational Education Programs

ERIC Educational Resources Information Center

Castañeda, Sergio Bernal

2016-01-01

This paper explores strategies used by teachers of English in Spain to compensate for learning limitations associated with student age. As part of a qualitative study of multiple cases, twenty teachers from different vocational programs volunteered to participate in semi-structured interviews. The interviews revealed the difficulties that older…

Perceived Educational Values of Omani School Principals

ERIC Educational Resources Information Center

Al-Ani, Wajeha Thabit; Al-Harthi, Aisha Salim

2017-01-01

This qualitative study investigated the perceived educational values of Omani school principals. Data were collected using a semi-structured interview form which focused on the core values of school administration as perceived by a sample of 44 school principals; a focus group interview was also held. Data were analysed using Nvivo software. The…

Transitional Services for Youth with Developmental Disabilities: Living in College Dorms

ERIC Educational Resources Information Center

Kirkendall, Abbie; Doueck, Howard J.; Saladino, Albert

2009-01-01

This study evaluates the impact of a college-based dormitory program on transitioning youth with intellectual disabilities. A qualitative study, with interviews at pre and post, was conducted to evaluate the program's impact. Data were collected with semistructured interviews from young adults with intellectual disabilities who participated in a…

The Characteristics of a Good Mathematics Teacher in Terms of Students, Mathematics Teachers, and School Administrators

ERIC Educational Resources Information Center

Yesildere-Imre, Sibel

2017-01-01

This qualitative research aims to examine the opinions of school administrators, teachers, and middle school students about what makes a good mathematics teacher. Interviews were conducted with thirty-five participants: ten school administrators, ten mathematics teachers, and fifteen middle school students. A semi-structured interview form…

Latino Parent and Adolescent Perceptions of Hoped-for and Feared Possible Selves for Adolescents

ERIC Educational Resources Information Center

Halfond, Raquel; Corona, Rosalie; Moon, Anya

2013-01-01

The authors examined Latino parent and adolescent reports of hoped-for and feared possible selves for adolescents. Twenty-nine Latino parents (18 mothers, 11 fathers) and their 18 adolescents participated in semistructured individual interviews. Interviews were digitally recorded, transcribed, and coded for themes via content analysis. Themes that…

The Importance of Using Games in EFL Classrooms

ERIC Educational Resources Information Center

Gozcu, Emine; Caganaga, Cagda Kivanc

2016-01-01

This paper aims to find out how games are important and effective when used in EFL classrooms. Two different kinds of qualitative research methods: semi-structured interviews and observation were conducted in this study. Multi-method triangulation is used throughout the study. The data was carried out through audio-recorded interview and…

Revealing a Child's Pathology: Physicians' Experiences

ERIC Educational Resources Information Center

Scelles, Regine; Aubert-Godard, Anne; Gargiulo, Marcela; Avant, Monique; Gortais, Jean

2010-01-01

In this study, 12 physicians and 12 care-givers were interviewed using semi-structured interviews. We explored physicians' experiences when they revealed a diagnosis. We also tried to understand which family members the physician was thinking of, with whom they identified themselves, and their first choice of the person to whom they prefer to…

Health and Social Care Practitioners' Experiences of Assessing Mental Capacity in a Community Learning Disability Team

ERIC Educational Resources Information Center

Ratcliff, Daniel; Chapman, Melanie

2016-01-01

Background: The study explored experiences of health and social care practitioners within a community learning disability team in undertaking mental capacity assessments with people with learning disabilities. Materials and Methods: Eight practitioners were interviewed using a semi-structured interview schedule. Results: The information gained was…

Identifying Future Scientists: Predicting Persistence into Research Training

ERIC Educational Resources Information Center

McGee, Richard; Keller, Jill L.

2007-01-01

This study used semistructured interviews and grounded theory to look for characteristics among college undergraduates that predicted persistence into Ph.D. and M.D./Ph.D. training. Participants in the summer undergraduate and postbaccalaureate research programs at the Mayo Clinic College of Medicine were interviewed at the start, near the end,…

The Effect of Suspension as a Deterrent to Student Misconduct

ERIC Educational Resources Information Center

Jackson, Angela Coleman

2014-01-01

The purpose of this study was to examine the effect of suspension as a deterrent to student misconduct. A mixed methods approach using both qualitative (interviews of administrators and teachers) and quantitative (discipline records of identified sixth graders) were utilized. In this case study approach, one-on-one semi-structured interviews were…

Taiwanese-Canadian Mothers' Beliefs about Personal Freedom for Their Young Children

ERIC Educational Resources Information Center

Chuang, Susan S.

2006-01-01

This study examined Taiwanese-Canadian mothers' conceptions of personal freedom in everyday situations for their children and the influence of acculturation on their beliefs. Forty mothers of six- to eight-year-old children participated in a semistructured interview and sorting task. Interview responses revealed that, regardless of acculturation,…

Satisfaction with Communicative Participation as Defined by Adults with Multiple Sclerosis: A Qualitative Study

ERIC Educational Resources Information Center

Yorkston, Kathryn M.; Baylor, Carolyn R.; Klasner, Estelle R.; Deitz, Jean; Dudgeon, Brian J.; Eadie, Tanya; Miller, Robert M.; Amtmann, Dagmar

2007-01-01

Purpose: This study examined satisfaction with communicative participation as reported by adults with multiple sclerosis (MS). Method: Eight community-dwelling adults with MS participated in semi-structured interviews. They were asked to discuss their satisfaction with their communication in a variety of situations. Interviews were analyzed using…

Assessing Readiness for Change in Adolescents with Eating Disorders

ERIC Educational Resources Information Center

Geller, Josie; Brown, Krista E.; Zaitsoff, Shannon L.; Menna, Rosanne; Bates, Mollie E.; Dunn, Erin C.

2008-01-01

The Readiness and Motivation Interview (RMI) is a semistructured interview measure of readiness and motivation to change that can be used for all eating disorder diagnoses. The RMI has demonstrated excellent psychometric properties and has both clinical and predictive utility in adult samples. This study examined the psychometric properties of the…

Investigating Secondary Science Teachers' Beliefs about Multiculturalism and Its Implementation in the Classroom

ERIC Educational Resources Information Center

Petty, Lori L.; Narayan, Ratna

2012-01-01

The purpose of this qualitative study was to explore secondary science teachers' beliefs about multiculturalism and its implementation in their classrooms. Participants included nine secondary science teachers, with experience ranging from 1 to 15 years of teaching. Data were collected through interviews, using a semi-structured interview protocol…

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

ERIC Educational Resources Information Center

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

2006-01-01

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

Teacher Behavior Unwanted According to Student's Perceptions

ERIC Educational Resources Information Center

Yildirim, Isa; Akan, Durdagi; Yalçin, Sinan

2016-01-01

This study was conducted in the aim of revealing the misbehaviors of the teachers according to the perceptions of the students. In the study, semi-structured interview was done with 8th grade 45 students, 20 males and 25 females, from three secondary school determined through purposive sampling. The interviews were analyzed with content analysis,…

Fearful Reformers: The Institutionalization of the Christian Right in American Politics

ERIC Educational Resources Information Center

Cibulka, James G.; Myers, Nathan

2008-01-01

This research article analyzes the ways that the Christian right uses fear as an instrument in the politics of education. The main source of data for this analysis draws from source-protected interviews with directors in state-level Christian right organizations. A semistructured, elite interviewing approach was used. The authors reframe the…