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Sample records for euthanasia qualitative interviews

  1. What happens after a request for euthanasia is refused? Qualitative interviews with patients, relatives and physicians

    NARCIS (Netherlands)

    Pasman, H.R.W.; Willems, D.L.; Onwuteaka-Philipsen, B.D.

    2013-01-01

    Objective: Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused. Methods: In-depth interviews with nine patients whose EAS request was refused and seven physicians of these

  2. What happens after a request for euthanasia is refused? Qualitative interviews with patients, relatives and physicians.

    Science.gov (United States)

    Pasman, H Roeline W; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

    2013-09-01

    Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused. In-depth interviews with nine patients whose EAS request was refused and seven physicians of these patients, and with three relatives of patients who had died after a request was refused and four physicians of these patients. Interviews were conducted at least 6 months after the refusal. A wish to die remained in all patients after refusal, although it sometimes diminished. In most cases patient and physician stopped discussing this wish, and none of the physicians had discussed plans for the future with the patient or evaluated the patient's situation after their refusal. Physicians were aware of patients' continued wish to die. Patients who are refused EAS may subsequently be silent about a wish to die without abandoning it. Open communication about wishes to die is important, even outside the context of EAS, because if people feel unable to talk about them, their quality of life may be further diminished. Follow up appointments after refusal could give patients the opportunity to discuss their feelings and physicians to support them. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Concept of unbearable suffering in context of ungranted requests for euthanasia: qualitative interviews with patients and physicians

    NARCIS (Netherlands)

    Pasman, H. R. W.; Rurup, M. L.; Willems, D. L.; Onwuteaka-Philipsen, B. D.

    2009-01-01

    Objective To obtain in-depth information about the views of patients and physicians on suffering in patients who requested euthanasia in whom the request was not granted or granted but not performed. Design In-depth interviews with a topic list. Setting Patients' homes and physicians' offices.

  4. Suffering and euthanasia: a qualitative study of dying cancer patients' perspectives.

    Science.gov (United States)

    Karlsson, Marit; Milberg, Anna; Strang, Peter

    2012-05-01

    Although intolerable suffering is a core concept used to justify euthanasia, little is known about dying cancer patients' own interpretations and conclusions of suffering in relation to euthanasia. Sixty-six patients with cancer in a palliative phase were selected through maximum-variation sampling, and in-depth interviews were conducted on suffering and euthanasia. The interviews were analyzed using qualitative content analysis with no predetermined categories. The analysis demonstrated patients' different perspectives on suffering in connection to their attitude to euthanasia. Those advocating euthanasia, though not for themselves at the time of the study, did so due to (1) perceptions of suffering as meaningless, (2) anticipatory fears of losses and multi-dimensional suffering, or (3) doubts over the possibility of receiving help to alleviate suffering. Those opposing euthanasia did so due to (1) perceptions of life, despite suffering, as being meaningful, (2) trust in bodily or psychological adaptation to reduce suffering, a phenomenon personally experienced by informants, and (3) by placing trust in the provision of help and support by healthcare services to reduce future suffering. Dying cancer patients draw varying conclusions from suffering: suffering can, but does not necessarily, lead to advocations of euthanasia. Patients experiencing meaning and trust, and who find strategies to handle suffering, oppose euthanasia. In contrast, patients with anticipatory fears of multi-dimensional meaningless suffering and with lack of belief in the continuing availability of help, advocate euthanasia. This indicates a need for healthcare staff to address issues of trust, meaning, and anticipatory fears.

  5. Interviews in qualitative research.

    Science.gov (United States)

    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.

  6. Vulnerability and the 'slippery slope' at the end-of-life: a qualitative study of euthanasia, general practice and home death in The Netherlands.

    Science.gov (United States)

    Norwood, Frances; Kimsma, Gerrit; Battin, Margaret P

    2009-12-01

    One enduring criticism of the Dutch euthanasia policy is the 'slippery slope' argument that suggests that allowing physicians to conduct legal euthanasia or assisted suicide would eventually lead to patients being killed against their will. What we currently know about euthanasia and its practices in The Netherlands is predominantly based on retrospective quantitative or interview-based studies, but these studies fail to detail the mechanisms of day-to-day practice. To examine the practices that surround euthanasia, particularly among vulnerable patients, using qualitative observation-based data. A 15-month qualitative, observation-based study of home death and general practice in the greater Amsterdam region of The Netherlands. Study included observation and interviews with a sample of 15 (GPs and 650 of their patients, 192 of whom were living with terminal or life-threatening illness (with and without requests for euthanasia). Euthanasia practice typically involves extensive deliberations, the majority of which do not end in a euthanasia death. Euthanasia discussions or 'euthanasia talk' share at least two consequences: (i) the talk puts the onus on patients to continue discussions towards a euthanasia death and (ii) there is a socio-therapeutic component, which tends to affirm social bonds and social life. While this qualitative evidence cannot disprove existence of abuse, it suggests that euthanasia practices have evolved in such a way that patients are more likely to talk about euthanasia than to die a euthanasia death.

  7. What people close to death say about euthanasia and assisted suicide: a qualitative study.

    Science.gov (United States)

    Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

    2006-12-01

    To explore the experiences of people with a "terminal illness", focusing on the patients' perspective of euthanasia and assisted suicide. A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a "terminal" illness, malignant or non-malignant. That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death.

  8. What people close to death say about euthanasia and assisted suicide: a qualitative study

    Science.gov (United States)

    Chapple, A; Ziebland, S; McPherson, A; Herxheimer, A

    2006-01-01

    Objective To explore the experiences of people with a “terminal illness”, focusing on the patients' perspective of euthanasia and assisted suicide. Method A qualitative study using narrative interviews was conducted throughout the UK. The views of the 18 people who discussed euthanasia and assisted suicide were explored. These were drawn from a maximum variation sample, who said that they had a “terminal” illness, malignant or non‐malignant. Results That UK law should be changed to allow assisted suicide or voluntary euthanasia was felt strongly by most people. Those who had seen others die were particularly convinced that this should be a right. Some had multiple reasons, including pain and anticipated pain, fear of indignity, loss of control and cognitive impairment. Those who did not want to be a burden also had other reasons for wanting euthanasia. Suicide was contemplated by a few, who would have preferred a change in the law to allow them to end their lives with medical help and in the company of family or friends. The few who opposed a change in UK law, or who felt ambivalent, focused on involuntary euthanasia, cited religious reasons or worried that new legislation might be open to abuse. Conclusion Qualitative research conducted on people who know they are nearing death is an important addition to the international debate on euthanasia and assisted suicide. Those who had seen others die were particularly convinced that the law should be changed to allow assisted death. PMID:17145910

  9. Dying cancer patients' own opinions on euthanasia: an expression of autonomy? A qualitative study.

    Science.gov (United States)

    Karlsson, Marit; Milberg, Anna; Strang, Peter

    2012-01-01

    Deliberations on euthanasia are mostly theoretical, and often lack first-hand perspectives of the affected persons. Sixty-six patients suffering from cancer in a palliative phase were interviewed about their perspectives of euthanasia in relation to autonomy. The interviews were transcribed verbatim and analysed using qualitative content analysis with no predetermined categories. The informants expressed different positions on euthanasia, ranging from support to opposition, but the majority were undecided due to the complexity of the problem. The informants' perspectives on euthanasia in relation to autonomy focused on decision making, being affected by (1) power and (2) trust. Legalization of euthanasia was perceived as either (a) increasing patient autonomy by patient empowerment, or (b) decreasing patient autonomy by increasing the medical power of the health care staff, which could be frightening. The informants experienced dependence on others, and expressed various levels of trust in others' intentions, ranging from full trust to complete mistrust. Dying cancer patients perceive that they cannot feel completely independent, which affects true autonomous decision making. Further, when considering legalization of euthanasia, the perspectives of patients fearing the effects of legalization should also be taken into account, not only those of patients opting for it.

  10. Euthanasia in patients dying at home in Belgium: interview study on adherence to legal safeguards

    Science.gov (United States)

    Smets, Tinne; Bilsen, Johan; Van den Block, Lieve; Cohen, Joachim; Van Casteren, Viviane; Deliens, Luc

    2010-01-01

    Background Euthanasia became legal in Belgium in 2002. Physicians must adhere to legal due care requirements when performing euthanasia; for example, consulting a second physician and reporting each euthanasia case to the Federal Review Committee. Aim To study the adherence and non-adherence of GPs to legal due care requirements for euthanasia among patients dying at home in Belgium and to explore possible reasons for non-adherence. Design of study Large scale, retrospective study. Setting General practice in Belgium. Method A retrospective mortality study was performed in 2005–2006 using the nationwide Belgian Sentinel Network of General Practitioners. Each week GPs reported medical end-of-life decisions taken in all non-sudden deaths of patients in their practice. GP interviews were conducted for each euthanasia case occurring at home. Results Interviews were conducted for nine of the 11 identified euthanasia cases. Requirements concerning the patient's medical condition were met in all cases. Procedural requirements such as consultation of a second physician were sometimes ignored. Euthanasia cases were least often reported (n = 4) when the physician did not regard the decision as euthanasia, when only opioids were used to perform euthanasia, or when no second physician was consulted. Factors that may contribute to explaining non-adherence to the euthanasia law included: being unaware of which practices are considered to be euthanasia; insufficient knowledge of the euthanasia law; and the fact that certain procedures are deemed burdensome. Conclusion Substantive legal due care requirements for euthanasia concerning the patient's request for euthanasia and medical situation were almost always met by GPs in euthanasia cases. Procedural consultation and reporting requirements were not always met. PMID:20353662

  11. [Qualitative research about euthanasia concept, between Spanish doctors].

    Science.gov (United States)

    Cuervo Pinna, M Á; Rubio, M; Altisent Trota, R; Rocafort Gil, J; Gómez Sancho, M

    2016-01-01

    The decriminalisation of euthanasia and assisted medical suicide has generated a continuous debate. The terminological confusion is one of the main difficulties in obtaining medical practice consensus. The objective of this study was to determine whether the terms of Euthanasia and physician assisted suicide are used with the same meaning by doctors in Extremadura (Spain). A qualitative study was conducted using two focus groups in which doctors from different specialties who attended a large number of terminal patients participated. No other focus group was required due to saturation. The sessions were tape recorded and transcribed by two experts in qualitative methodology. Atlas.ti software was used for the analysis. We were advised by the "Health Care at the end of life" Group of the Organizacion Médica Colegial of Spain. Terminological confusion was verified in: 1) The mixture of etymological, functional and social concepts, 2) the term Passive Euthanasia, 3) the association between euthanasia and physician assisted suicide, 4) the confusion with the equivalent "wish to hasten death", and 5) the difficulty of differentiating sedation with Euthanasia. There was consensus on some aspects: a) Full voluntariness, b) the condition of terminal illness, and c) the condition of unbearable symptoms. Conceptual variability persists in relation to the concept of Euthanasia, and is particularly noticeable in the persistence of the concept of passive euthanasia. It would be desirable to achieve a common language to assign a precise meaning to these words to help doctors in their professional practice. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  12. Sensitive Interviewing in Qualitative Research.

    Science.gov (United States)

    Dempsey, Laura; Dowling, Maura; Larkin, Philip; Murphy, Kathy

    2016-12-01

    In this paper we focus on important considerations when planning and conducting qualitative interviews on sensitive topics. Drawing on experiences of conducting interviews with dementia caregivers, a framework of essential elements in qualitative interviewing was developed to emphasize study participants' needs while also providing guidance for researchers. Starting with a definition of sensitive research, the framework includes preparing for interviews, interacting with gatekeepers of vulnerable groups, planning for interview timing, and location, building relationships and conducting therapeutic interactions, protecting ethically vulnerable participants, and planning for disengagement. This framework has the potential to improve the effectiveness of sensitive interviewing with vulnerable groups. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. [Euthanasia].

    Science.gov (United States)

    Julesz, Máté

    2013-04-28

    The problem of euthanasia emerges again and again in today's Europe. The Dutch type of regulation of euthanasia could be introduced into the Hungarian legal system. Today, in Hungary, the ethical guidelines of the chamber of medicine, the criminal law and the administrative health law also forbid active euthanasia. In Hungary, the criminal code reform of 2012 missed to liberalise the regulation of euthanasia. Such liberalisation awaits bottom-up support from the part of the society. In Europe, active euthanasia is legal only in the Netherlands, Belgium, Luxemburg and Switzerland. In Hungary, a passive form of euthanasia is legal, i.e. a dying patient may, under strict procedural circumstances, refuse medical treatment. The patient is not allowed to refuse medical treatment, if she is pregnant and foreseeably capable to give birth to her child.

  14. Euthanasia

    Science.gov (United States)

    Franson, J.C.

    1999-01-01

    Euthanasia means to cause humane death. Some current euthanasia techniques may become unacceptable over time and be replaced by new techniques as more data are gathered and evaluated. The following information and recommendations are based largely on the 1993 report of the American Veterinary Medical Association (AVMA) Panel on Euthanasia. The recommendations in the panel report were intended to serve as guidelines, and they require the use of professional judgement for specific situations. Ultimately, it is the responsibility of those persons carrying out euthanasia to assure that it is done in the most humane manner possible.

  15. Euthanasia.

    Science.gov (United States)

    Brock, D W

    1992-01-01

    The principles of self-determination and individual well-being support the use of voluntary euthanasia by those who do not have moral or professional objections to it. Opponents of this posture cite the ethical wrongness of the act itself and the folly of any public or legal policy permitting euthanasia. Positive consequences of making euthanasia legally permissible respect the autonomy of competent patients desiring it, expand the population of patients who can choose the option, and release the dying patient from otherwise prolonged suffering and agony. Potentially bad consequences of permitting euthanasia include the undermining of the "moral center" of medicine by allowing physicians to kill, the weakening of society's commitment to provide optimal care for dying patients, and, of greatest concern, the "slippery slope" argument. The evaluation of the arguments leads to support for euthanasia, with its performance not incompatible with a physician's professional commitment.

  16. Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public.

    Science.gov (United States)

    Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; van Tol, Donald G; van de Vathorst, Suzanne; de Graeff, Nienke; Weyers, Heleen A M; van der Heide, Agnes; van Thiel, Ghislaine J M W

    2015-01-28

    The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

  17. Transitioning from Clinical to Qualitative Research Interviewing

    Directory of Open Access Journals (Sweden)

    Matthew R. Hunt BSc (PT, PhD

    2011-09-01

    Full Text Available In this paper one aspect of the transition that must be made by experienced clinicians who become involved in conducting qualitative health research is examined, specifically, the differences between clinical and research interviewing. A clinician who is skillful and comfortable carrying out a clinical interview may not initially apprehend the important differences between these categories and contexts of interviewing. This situation can lead to difficulties and diminished quality of data collection because the purpose, techniques and orientation of a qualitative research interview are distinct from those of the clinical interview. Appreciation of these differences between interview contexts and genres, and strategies for addressing challenges associated with these differences, can help clinician researchers to become successful qualitative interviewers.

  18. Qualitative interviewing: methodological challenges in Arab settings.

    Science.gov (United States)

    Hawamdeh, Sana; Raigangar, Veena

    2014-01-01

    To explore some of the main methodological challenges faced by interviewers in Arab settings, particularly during interviews with psychiatric nurses. Interviews are a tool used commonly in qualitative research. However, the cultural norms and practices of interviewees must be considered to ensure that an appropriate interviewing style is used, a good interviewee-interviewer relationship formed and consent for participation obtained sensitively. A study to explore the nature of psychiatric nurses' practices that used unstructured interviews. This is a methodology paper that discusses a personal experience of addressing many challenges that are specific to qualitative interviewing in Arab settings, supported by literature on the topic. Suggestions for improving the interview process to make it more culturally sensitive are provided and recommendations for future research are made. Openness, flexibility and a reflexive approach by the researcher can help manage challenges in Arab settings. Researchers should allow themselves to understand the cultural elements of a population to adapt interviewing methods with the aim of generating high quality qualitative research.

  19. Perspectives of decision-making in requests for euthanasia: a qualitative research among patients, relatives and treating physicians in the Netherlands.

    Science.gov (United States)

    Dees, Marianne K; Vernooij-Dassen, Myrra J; Dekkers, Wim J; Elwyn, Glyn; Vissers, Kris C; van Weel, Chris

    2013-01-01

    Euthanasia has been legally performed in the Netherlands since 2002. Respect for patient's autonomy is the underpinning ethical principal. However, patients have no right to euthanasia, and physicians have no obligation to provide it. Although over 3000 cases are conducted per year in the Netherlands, there is little known about how decision-making occurs and no guidance to support this difficult aspect of clinical practice. To explore the decision-making process in cases where patients request euthanasia and understand the different themes relevant to optimise this decision-making process. A qualitative thematic analysis of interviews with patients making explicit requests for euthanasia, most-involved relative(s) and treating physician. Thirty-two cases, 31 relatives and 28 treating physicians. Settings were patients' and relatives' homes and physicians' offices. Five main themes emerged: (1) initiation of sharing views and values about euthanasia, (2) building relationships as part of the negotiation, (3) fulfilling legal requirements, (4) detailed work of preparing and performing euthanasia and (5) aftercare and closing. A patient's request for euthanasia entails a complex process that demands emotional work by all participants. It is characterised by an intensive period of sharing information, relationship building and negotiation in order to reach agreement. We hypothesise that making decisions about euthanasia demands a proactive approach towards participants' preferences and values regarding end of life, towards the needs of relatives, towards the burden placed on physicians and a careful attention to shared decision-making. Future research should address the communicational skills professionals require for such complex decision-making.

  20. Ethics of Qualitative Interviewing with Grieving Families.

    Science.gov (United States)

    Rosenblatt, Paul C.

    1995-01-01

    Illustrations from a recent study of farm families who had lost a family member are used to illuminate some of the ethical challenges in qualitative bereavement research. Included in the exploration are ethics involved in interview recruitment, causing pain, informed consent, the boundaries of research and therapy, family dysfunction, and…

  1. Considerations on requests for euthanasia or assisted suicide; a qualitative study with Dutch general practitioners.

    Science.gov (United States)

    Ten Cate, Katja; van Tol, Donald G; van de Vathorst, Suzanne

    2017-11-16

    In the Netherlands, euthanasia or assisted suicide (EAS) is neither a right of the patient nor a duty of the physician. Beside the legal requirements, physicians can weigh their own considerations when they decide on a request for EAS. We aim at a better understanding of the considerations that play a role when physicians decide on a request for EAS. This was a qualitative study. We analysed 33 interviews held with general practitioners (GPs) from various regions in the Netherlands. The considerations found can be divided in three main types. (i) Perceived legal criteria, (ii) individual interpretations of the legal criteria and (iii) considerations unrelated to the legal criteria. Considerations of this 3rd type have not been mentioned so far in the literature and the debate on EAS. Examples are: the family should agree to EAS, the patient's attitude must reflect resignation, or conflicts must be resolved. Our study feeds the ethical discussion on the tension that can arise between a physician's own views on death and dying, and the views and preferences of his patients. When considerations like 'no unresolved conflicts' or 'enough resignation' influence the decision to grant a request for EAS this poses questions from an ethical and professional point of view. We hypothesise that these considerations reflect GPs' views on what 'good dying' entails and we advocate further research on this topic. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Dealing with requests for euthanasia: a qualitative study investigating the experience of general practitioners.

    Science.gov (United States)

    Georges, J-J; The, A M; Onwuteaka-Philipsen, B D; van der Wal, G

    2008-03-01

    Caring for terminally ill patients is a meaningful task, however the patient's suffering can be a considerable burden and cause of frustration. The aim of this study is to describe the experiences of general practitioners (GPs) in The Netherlands in dealing with a request for euthanasia from a terminally ill patient. The data, collected through in-depth interviews, were analysed according to the constant comparative method. Having to face a request for euthanasia when attempting to relieve a patient's suffering was described as a very demanding experience that GPs generally would like to avoid. Nearly half of the GPs (14/30) strive to avoid euthanasia or physician assisted suicide because it was against their own personal values or because it was emotional burdening to be confronted with this issue. They explained that by being directed on promoting a peaceful dying process, or the quality of end-of-life of a patient by caring and supporting the patient and the relatives it was mainly possible to shorten patient's suffering without "intentionally hastening a patient's death on his request". The other GPs (16/30) explained that as sometimes the suffering of a patient could not be lessened they were open to consider a patient's request for euthanasia or physician assisted suicide. They underlined the importance of a careful decision-making process, based on finding a balance between the necessity to shorten the patient's suffering through euthanasia and their personal values. Dealing with requests for euthanasia is very challenging for GPs, although they feel committed to alleviate a patient's suffering and to promote a peaceful death.

  3. Exploring the beliefs underlying attitudes to active voluntary euthanasia in a sample of Australian medical practitioners and nurses: a qualitative analysis.

    Science.gov (United States)

    White, Katherine M; Wise, Susi E; Young, Ross McD; Hyde, Melissa K

    A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values.

  4. Communication about euthanasia in general practice: opinions and experiences of patients and their general practitioners.

    OpenAIRE

    Borgsteede, S.D.; Deliens, L.; Graafland-Riedstra, C.; Francke, A.L.; Wal, G. van der; Willems, D.L.

    2007-01-01

    Public opinion and professional organisations dominate the euthanasia debate, and there is a need to understand the opinions of people confronted with euthanasia. The aim of this study was to investigate whether patients and their GPs talk about euthanasia, and if so, how they communicate about this. METHODS: Qualitative, semi-structured interviews were held with 20 GPs and 30 of their patients in primary care in the Netherlands, where euthanasia is legalised. The patients had a life expectan...

  5. Writing Interview Protocols and Conducting Interviews: Tips for Students New to the Field of Qualitative Research

    Science.gov (United States)

    Jacob, Stacy A.; Furgerson, S. Paige

    2012-01-01

    Students new to doing qualitative research in the ethnographic and oral traditions, often have difficulty creating successful interview protocols. This article offers practical suggestions for students new to qualitative research for both writing interview protocol that elicit useful data and for conducting the interview. This piece was originally…

  6. Sample size in qualitative interview studies

    DEFF Research Database (Denmark)

    Malterud, Kirsti; Siersma, Volkert Dirk; Guassora, Ann Dorrit Kristiane

    2016-01-01

    Sample sizes must be ascertained in qualitative studies like in quantitative studies but not by the same means. The prevailing concept for sample size in qualitative studies is “saturation.” Saturation is closely tied to a specific methodology, and the term is inconsistently applied. We propose...... the concept “information power” to guide adequate sample size for qualitative studies. Information power indicates that the more information the sample holds, relevant for the actual study, the lower amount of participants is needed. We suggest that the size of a sample with sufficient information power...... and during data collection of a qualitative study is discussed....

  7. Experience-based, body-anchored qualitative research interviewing

    DEFF Research Database (Denmark)

    Stelter, Reinhard

    2010-01-01

    -anchored interviewing, and second, by an interview guide that explores a research participant's personal experience with mindfulness meditation. An excerpt from an interview is discussed to illustrate the advantages of this interview form, namely its value as a methodological instrument for qualitative research...

  8. Trends of psychology-related research on euthanasia: a qualitative software-based thematic analysis of journal abstracts.

    Science.gov (United States)

    Caputo, Andrea

    2015-01-01

    Euthanasia has received increasing attention in both academic and public debates as one of the most controversial issues. However, the contribution of psychology-related themes to the topic has had little role on these ongoing debates. The aim of the present study is twofold: (1) to explore the main themes relating to euthanasia as provided by psychology-related research; (2) to analyze the temporal trends of psychology-related research on euthanasia over the last decades. A comprehensive search of academic literature was conducted on PsychINFO database. A qualitative software-based thematic analysis was carried out on 602 journal abstracts published from 1935 to 2014. This study highlighted four different thematic areas which characterized the scientific discourse on euthanasia: (1) moral values, in terms of religious, philosophical, and social implications concerning the individual's decision to die; (2) professional ethics, in terms of health and social workers' legal responsibility in death assistance; (3) end-of-life care, with regard to medical options provided to support individuals nearing death; and (4) patient's right to healthcare, in terms of access to palliative care and better quality of dying. Euthanasia discourse over the last decades seems to be overall characterized by two main dimensions: (1) the increasing trend of social legitimacy and acceptability of euthanasia over time, which moved from ethical to healthcare issues; and (2) the curvilinear temporal trend about the request/provision process in euthanasia, which moved from patient's decision for ending life (mainly characterizing the most past and recent research) to the role of health professionals (with a peak in the 1990s). The results suggest palliative care as a potential future research area which can provide healthcare providers with skills to 'connect' with patients, understand patients' hidden agendas, and grant a good quality of life and dying process.

  9. Bracketing as a skill in conducting unstructured qualitative interviews.

    Science.gov (United States)

    Sorsa, Minna Anneli; Kiikkala, Irma; Åstedt-Kurki, Päivi

    2015-03-01

    To provide an overview of bracketing as a skill in unstructured qualitative research interviews. Researchers affect the qualitative research process. Bracketing in descriptive phenomenology entails researchers setting aside their pre-understanding and acting non-judgementally. In interpretative phenomenology, previous knowledge is used intentionally to create new understanding. A literature search of bracketing in phenomenology and qualitative research. This is a methodology paper examining the researchers' impact in creating data in creating data in qualitative research. Self-knowledge, sensitivity and reflexivity of the researcher enable bracketing. Skilled and experienced researchers are needed to use bracketing in unstructured qualitative research interviews. Bracketing adds scientific rigour and validity to any qualitative study.

  10. Soldier Readiness: Insights from Qualitative Interviews

    Science.gov (United States)

    2018-01-10

    domains interact and influence performance. From January to May 2016, the research team conducted three qualitative studies with Soldiers including... Research Questions UNCLASSIFIED 9 • From January to May 2016, the research team conducted a series of qualitative studies with Soldiers from the 82nd...that the Army’s current approach for providing these types of training is not always ideal. Specifically, the train-the-trainer method or use of

  11. Portable MP3 players: innovative devices for recording qualitative interviews.

    Science.gov (United States)

    Fernandez, Ritin S; Griffiths, Rhonda

    2007-01-01

    Digital technology has provided a new way of recording qualitative interviews, surpassing the clarity, usability and storage capabilities of conventional tape recorders. Ritin Fernandez and Rhonda Griffiths examine a technological resource that pervades modern social life and which can be used effectively for digitally recording interviews for qualitative research.

  12. A critical review of qualitative interviews in applied linguistics

    OpenAIRE

    Mann, Steve J.

    2011-01-01

    This article asks what applied linguistics can learn from related disciplines with regard to the collection, analysis and representation of qualitative interviews. It assesses the contributions of qualitative sociology, anthropology, discursive psychology and outlines four ‘discourse dilemmas’ which might provide the basis for a more critical and reflective dimension to the use of qualitative interviews in applied linguistics. Summarizing important contributions that have already been made in...

  13. Dyadic Interviews as a Tool for Qualitative Evaluation

    Science.gov (United States)

    Morgan, David L.; Eliot, Susan; Lowe, Robert A.; Gorman, Paul

    2016-01-01

    Although evaluation researchers frequently make use of focus groups and individual interviews as sources of qualitative data, there has been far less attention to dyadic interviews that create a conversation between two research participants. This article describes dyadic interviews as a format that shares many of the advantages of focus groups,…

  14. African Primary Care Research: qualitative interviewing in primary care.

    Science.gov (United States)

    Reid, Steve; Mash, Bob

    2014-06-05

    This article is part of a series on African Primary Care Research and focuses on the topic of qualitative interviewing in primary care. In particular it looks at issues of study design, sample size, sampling and interviewing in relation to individual and focus group interviews.There is a particular focus on helping postgraduate students at a Masters level to write their research proposals.

  15. Advantages and disadvantages of four interview techniques in qualitative research

    NARCIS (Netherlands)

    Opdenakker, R.J.G.

    2006-01-01

    Face-to-face interviews have long been the dominant interview technique in the field of qualitative research. In the last two decades, telephone interviewing became more and more common. Due to the explosive growth of new communication forms, such as computer mediated communication (for example

  16. Advantages and Disadvantages of Four Interview Techniques in Qualitative Research

    Directory of Open Access Journals (Sweden)

    Raymond Opdenakker

    2006-09-01

    Full Text Available Face-to-face interviews have long been the dominant interview technique in the field of qualitative research. In the last two decades, telephone interviewing became more and more common. Due to the explosive growth of new communication forms, such as computer mediated communication (for example e-mail and chat boxes, other interview techniques can be introduced and used within the field of qualitative research. For a study in the domain of virtual teams, I used various communication possibilities to interview informants as well as face-to-face interviews. In this article a comparison will be made concerning the advantages and disadvantages of face-to-face, telephone, e-mail and MSN messenger interviews. By including telephone and MSN messenger interviews in the comparison, the scope of this article is broader than the article of BAMPTON and COWTON (2002. URN: urn:nbn:de:0114-fqs0604118

  17. Relatives' Perspective on the Terminally Ill Patients Who Died after Euthanasia or Physician-Assisted Suicide: A Retrospective Cross-Sectional Interview Study in the Netherlands

    Science.gov (United States)

    Georges, Jean-Jacques; Onwuteaka-Philipsen, Bregje D.; Muller, Martien T.; van der Wal, Gerrit; van der Heide, Agnes; van der Maas, Paul J.

    2007-01-01

    This study used retrospective interviews with 87 relatives to describe the experiences of patients who died by euthanasia or physician-assisted suicide (EAS) in the Netherlands. Most of the patients suffered from cancer (85%). The relatives were most often a partner (63%) or a child (28%) of the patient. Before explicitly requesting EAS most…

  18. Invited commentary on … When unbearable suffering incites psychiatric patients to request euthanasia: a qualitative study.

    Science.gov (United States)

    Pearce, Steve

    2017-10-01

    Although the paper in this issue by Verhofstadt et al sheds some light on the features of unbearable suffering stemming from psychiatric disorder leading to a request for euthanasia, this is limited. The bulk of the paper illustrates the particular ethical challenges posed by the policy of making euthanasia available in these circumstances. © The Royal College of Psychiatrists 2017.

  19. Skype interviewing: The new generation of online synchronous interview in qualitative research

    Directory of Open Access Journals (Sweden)

    Roksana Janghorban

    2014-04-01

    Full Text Available The most commonly used method for data collection in qualitative research is interviewing. With technology changes over the last few decades, the online interview has overcome time and financial constraints, geographical dispersion, and physical mobility boundaries, which have adversely affected onsite interviews. Skype as a synchronous online service offers researchers the possibility of conducting individual interviews as well as small focus groups, comparable to onsite types. This commentary presents the characteristics of the Skype interview as an alternative or supplemental choice to investigators who want to change their conventional approach of interviewing.

  20. Skype interviewing: the new generation of online synchronous interview in qualitative research.

    Science.gov (United States)

    Janghorban, Roksana; Latifnejad Roudsari, Robab; Taghipour, Ali

    2014-01-01

    The most commonly used method for data collection in qualitative research is interviewing. With technology changes over the last few decades, the online interview has overcome time and financial constraints, geographical dispersion, and physical mobility boundaries, which have adversely affected onsite interviews. Skype as a synchronous online service offers researchers the possibility of conducting individual interviews as well as small focus groups, comparable to onsite types. This commentary presents the characteristics of the Skype interview as an alternative or supplemental choice to investigators who want to change their conventional approach of interviewing.

  1. Ethical challenges embedded in qualitative research interviews with close relatives.

    Science.gov (United States)

    Haahr, Anita; Norlyk, Annelise; Hall, Elisabeth Oc

    2014-02-01

    Nurse researchers engaged in qualitative interviews with patients and spouses in healthcare may often experience being in unforeseen ethical dilemmas. Researchers are guided by the bioethical principles of justice, beneficence, non-maleficence, respect for human rights and respect for autonomy through the entire research process. However, these principles are not sufficient to prepare researchers for unanticipated ethical dilemmas related to qualitative research interviews. We describe and discuss ethically challenging and difficult moments embedded in two cases from our own phenomenological interview studies. We argue that qualitative interviews involve navigation between being guided by bioethics as a researcher, being a therapist/nurse and being a fellow human being or even a friend. The researchers' premises to react to unexpected situations and act in a sound ethical manner must be enhanced, and there is a need for an increased focus on the researchers' ethical preparation and to continually address and discuss cases from their own interviews.

  2. Interviewing Objects: Including Educational Technologies as Qualitative Research Participants

    Science.gov (United States)

    Adams, Catherine A.; Thompson, Terrie Lynn

    2011-01-01

    This article argues the importance of including significant technologies-in-use as key qualitative research participants when studying today's digitally enhanced learning environments. We gather a set of eight heuristics to assist qualitative researchers in "interviewing" technologies-in-use (or other relevant objects), drawing on concrete…

  3. A Critical Review of Qualitative Interviews in Applied Linguistics

    Science.gov (United States)

    Mann, Steve

    2011-01-01

    This article asks what applied linguistics can learn from related disciplines with regard to the collection, analysis and representation of qualitative interviews. It assesses the contributions of qualitative sociology, anthropology, discursive psychology and outlines four "discourse dilemmas" which might provide the basis for a more critical and…

  4. Ethical Challenges embedded in qualitative research interviews with close relatives

    DEFF Research Database (Denmark)

    Haahr, Anita; Norlyk, Annelise; Hall, Elisabeth

    2013-01-01

    Nurse researchers engaged in qualitative interviews with patients and spouses in healthcare may often experience being in unforseen ethical dilemmas. Researchers are guided by the bioethical principles of justice, beneficence, non-maleficence respect for human rights and respect for autonomy...... through the entire research process. However, these principles are not sufficient to prepare researchers for unanticipated ethical dilemmas related to qualitative researchs interviews. We describe and discuss ethically challenging and difficult moments embedded in two cases from our own phenomenological...... interview studies. We argue that qualitative interviews involve navigation between being guided by bioethics as a researcher, being a therapist/nurse and being a fellow human being or even a friend. The researchers' premises to react to unexpected situations and act in a sound ethical manner must...

  5. Characteristic Interviews, Different Strategies: Methodological Challenges in Qualitative Interviewing among Respondents with Mild Intellectual Disabilities

    Science.gov (United States)

    Sigstad, Hanne Marie Høybråten

    2014-01-01

    Conducting qualitative research interviews among individuals with intellectual disabilities, including cognitive limitations and difficulties in communication, presents particular research challenges. One question is whether the difficulties that informants encounter affect interviews to such an extent that the validity of the results is weakened.…

  6. Is there a bias against telephone interviews in qualitative research?

    Science.gov (United States)

    Novick, Gina

    2008-08-01

    Telephone interviews are largely neglected in the qualitative research literature and, when discussed, they are often depicted as a less attractive alternative to face-to-face interviewing. The absence of visual cues via telephone is thought to result in loss of contextual and nonverbal data and to compromise rapport, probing, and interpretation of responses. Yet, telephones may allow respondents to feel relaxed and able to disclose sensitive information, and evidence is lacking that they produce lower quality data. This apparent bias against telephone interviews contrasts with a growing interest in electronic qualitative interviews. Research is needed comparing these modalities, and examining their impact on data quality and their use for studying varying topics and populations. Such studies could contribute evidence-based guidelines for optimizing interview data. 2008 Wiley Periodicals, Inc

  7. Comparing appropriateness and equivalence of email interviews to phone interviews in qualitative research on reproductive decisions.

    Science.gov (United States)

    Hershberger, Patricia E; Kavanaugh, Karen

    2017-10-01

    Despite an increasing use of qualitative email interviews by nurse researchers, there is little understanding about the appropriateness and equivalence of email interviews to other qualitative data collection methods, especially on sensitive topics research. The purpose is to describe our procedures for completing asynchronous, email interviews and to evaluate the appropriateness and equivalency of email interviews to phone interviews in two qualitative research studies that examined reproductive decisions. Content analysis guided the methodological appraisal of appropriateness and equivalency of in-depth, asynchronous email interviews to single phone interviews. Appropriateness was determined by: (a) participants' willingness to engage in email or phone interviews, (b) completing data collection in a timely period, and (c) participants' satisfaction with the interview. Equivalency was evaluated by: (a) completeness of the interview data, and (b) insight obtained from the data. Of the combined sample in the two studies (N=71), 31% of participants chose to participate via an email interview over a phone interview. The time needed to complete the email interviews averaged 27 to 28days and the number of investigator probe-participant response interchanges was 4 to 5cycles on average. In contrast, the phone interviews averaged 59 to 61min in duration. Most participants in both the email and phone interviews reported they were satisfied or very satisfied with their ability to express their true feelings throughout the interview. Regarding equivalence, 100% of the email and phone interviews provided insight into decision processes. Although insightful, two of the email and one phone interview had short answers or, at times, underdeveloped responses. Participants' quotes and behaviors cited within four published articles, a novel evaluation of equivalency, revealed that 20% to 37.5% of the citations about decision processes were from email participants, which is

  8. When unbearable suffering incites psychiatric patients to request euthanasia: qualitative study†

    Science.gov (United States)

    Verhofstadt, Monica; Thienpont, Lieve; Peters, Gjalt-Jorn Ygram

    2017-01-01

    Background The concept of ‘unbearable suffering’ is central to legislation governing whether euthanasia requests may be granted, but remains insufficiently understood, especially in relation to psychiatric patients. Aims To provide insights into the suffering experiences of psychiatric patients who have made a request for euthanasia. Method Testimonials from 26 psychiatric patients who requested euthanasia were analysed using QualiCoder software. Results Five domains of suffering were identified: medical, intrapersonal, interpersonal, societal and existential. Hopelessness was confirmed to be an important contributor. The lengthy process of applying for euthanasia was a cause of suffering and added to experienced hopelessness, whereas encountering physicians who took requests seriously could offer new perspectives on treatment. Conclusions The development of measurement instruments to assess the nature and extent of suffering as experienced by psychiatric patients could help both patients and physicians to better navigate the complicated and sensitive process of evaluating requests in a humane and competent way. Some correlates of suffering (such as low income) indicate the need for a broad medical, societal and political debate on how to reduce the burden of financial and socioeconomic difficulties and inequalities in order to reduce patients' desire for euthanasia. Euthanasia should never be seen (or used) as a means of resolving societal failures. PMID:28970302

  9. When unbearable suffering incites psychiatric patients to request euthanasia: qualitative study.

    Science.gov (United States)

    Verhofstadt, Monica; Thienpont, Lieve; Peters, Gjalt-Jorn Ygram

    2017-10-01

    Background The concept of 'unbearable suffering' is central to legislation governing whether euthanasia requests may be granted, but remains insufficiently understood, especially in relation to psychiatric patients. Aims To provide insights into the suffering experiences of psychiatric patients who have made a request for euthanasia. Method Testimonials from 26 psychiatric patients who requested euthanasia were analysed using QualiCoder software. Results Five domains of suffering were identified: medical, intrapersonal, interpersonal, societal and existential. Hopelessness was confirmed to be an important contributor. The lengthy process of applying for euthanasia was a cause of suffering and added to experienced hopelessness, whereas encountering physicians who took requests seriously could offer new perspectives on treatment. Conclusions The development of measurement instruments to assess the nature and extent of suffering as experienced by psychiatric patients could help both patients and physicians to better navigate the complicated and sensitive process of evaluating requests in a humane and competent way. Some correlates of suffering (such as low income) indicate the need for a broad medical, societal and political debate on how to reduce the burden of financial and socioeconomic difficulties and inequalities in order to reduce patients' desire for euthanasia. Euthanasia should never be seen (or used) as a means of resolving societal failures. © The Royal College of Psychiatrists 2017.

  10. Narrative interviews: an important resource in qualitative research.

    Science.gov (United States)

    Muylaert, Camila Junqueira; Sarubbi, Vicente; Gallo, Paulo Rogério; Neto, Modesto Leite Rolim

    2014-12-01

    Objetives This methodological study explain and emphasize the extent and fertility of the narrative interview in qualitative research. Methods To describe the narrative method within the qualitative research. Results The qualitative research method is characterized by addressing issues related to the singularities of the field and individuals investigated, being the narrative interviews a powerful method for use by researchers who aggregate it. They allow the deepening of research, the combination of life stories with socio-historical contexts, making the understanding of the senses that produce changes in the beliefs and values that motivate and justify the actions of possible informants. Conclusion The use of narrative is an advantageous investigative resource in qualitative research, in which the narrative is a traditional form of communication whose purpose is to serve content from which the subjective experiences can be transmitted.

  11. Being a quantitative interviewer: qualitatively exploring interviewers' experiences in a longitudinal cohort study

    Directory of Open Access Journals (Sweden)

    Derrett Sarah

    2011-12-01

    Full Text Available Abstract Background Many studies of health outcomes rely on data collected by interviewers administering highly-structured (quantitative questionnaires to participants. Little appears to be known about the experiences of such interviewers. This paper explores interviewer experiences of working on a longitudinal study in New Zealand (the Prospective Outcomes of injury Study - POIS. Interviewers administer highly-structured questionnaires to participants, usually by telephone, and enter data into a secure computer program. The research team had expectations of interviewers including: consistent questionnaire administration, timeliness, proportions of potential participants recruited and an empathetic communication style. This paper presents results of a focus group to qualitatively explore with the team of interviewers their experiences, problems encountered, strategies, support systems used and training. Methods A focus group with interviewers involved in the POIS interviews was held; it was audio-recorded and transcribed. The analytical method was thematic, with output intended to be descriptive and interpretive. Results Nine interviewers participated in the focus group (average time in interviewer role was 31 months. Key themes were: 1 the positive aspects of the quantitative interviewer role (i.e. relationships and resilience, insights gained, and participants' feedback, 2 difficulties interviewers encountered and solutions identified (i.e. stories lost or incomplete, forgotten appointments, telling the stories, acknowledging distress, stories reflected and debriefing and support, and 3 meeting POIS researcher expectations (i.e. performance standards, time-keeping, dealing exclusively with the participant and maintaining privacy. Conclusions Interviewers demonstrated great skill in the way they negotiated research team expectations whilst managing the relationships with participants. Interviewers found it helpful to have a research protocol in

  12. Expected consequences of convenience euthanasia perceived by veterinarians in Quebec.

    Science.gov (United States)

    Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

    2017-07-01

    In companion animal practice, convenience euthanasia (euthanasia of a physically and psychologically healthy animal) is recognized as one of the most difficult situations. There is little published on veterinary perceptions of the consequences of convenience euthanasia. A qualitative study on the subject based on interviews with 14 veterinarians was undertaken. The animal's interests in the dilemma of convenience euthanasia was taken into consideration, strictly from the point of view of the physical suffering and stress related to the procedure. The veterinarian's goal was to respect the animal's interests by controlling physical pain. Most often, veterinarians made their own interests and those of the owners a priority when considering the consequences of their decision to perform or refuse convenience euthanasia.

  13. Expected consequences of convenience euthanasia perceived by veterinarians in Quebec

    Science.gov (United States)

    Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

    2017-01-01

    In companion animal practice, convenience euthanasia (euthanasia of a physically and psychologically healthy animal) is recognized as one of the most difficult situations. There is little published on veterinary perceptions of the consequences of convenience euthanasia. A qualitative study on the subject based on interviews with 14 veterinarians was undertaken. The animal’s interests in the dilemma of convenience euthanasia was taken into consideration, strictly from the point of view of the physical suffering and stress related to the procedure. The veterinarian’s goal was to respect the animal’s interests by controlling physical pain. Most often, veterinarians made their own interests and those of the owners a priority when considering the consequences of their decision to perform or refuse convenience euthanasia. PMID:28698691

  14. Using the senses in qualitative interview research: Practical strategies

    NARCIS (Netherlands)

    Guillemin, M.; Harris, A.

    2014-01-01

    In the social sciences, there has been an increasing level of interest in the five senses, especially in disciplines such as anthropology, sociology, architecture and human geography. In this case study, we focus on using the senses in qualitative research interviews. We discuss a research method

  15. Qualitative Research Interviews of Children with Communication Disorders: Methodological Implications

    Science.gov (United States)

    Bedoin, D.; Scelles, R.

    2015-01-01

    This study focuses on the qualitative research interview, an essential tool frequently used in the human and social sciences, conducted with children having communication disorders. Two distinct populations are addressed--children with intellectual disability and deaf children without related disabilities--with the aim of identifying the main…

  16. Characteristic interviews, different strategies: Methodological challenges in qualitative interviewing among respondents with mild intellectual disabilities.

    Science.gov (United States)

    Sigstad, Hanne Marie Høybråten

    2014-06-01

    Conducting qualitative research interviews among individuals with intellectual disabilities, including cognitive limitations and difficulties in communication, presents particular research challenges. One question is whether the difficulties that informants encounter affect interviews to such an extent that the validity of the results is weakened. This article focuses on voluntary informed consent and the specific challenges with the greatest effects on such interviews. The discussion shows that complementary and meaningful descriptions from informants imply the need to employ alternative strategies and methods that may, in other contexts, challenge the traditional understanding of what is acceptable in research. © The Author(s) 2014.

  17. Considerations on requests for euthanasia or assisted suicide; a qualitative study with Dutch general practitioners

    NARCIS (Netherlands)

    ten Cate, Katja; van Tol, Donald G.; van de Vathorst, Suzanne

    2017-01-01

    Background. In the Netherlands, euthanasia or assisted suicide (EAS) is neither a right of the patient nor a duty of the physician. Beside the legal requirements, physicians can weigh their own considerations when they decide on a request for EAS. Objective. We aim at a better understanding of the

  18. Underdeveloped Themes in Qualitative Research: Relationship With Interviews and Analysis.

    Science.gov (United States)

    Connelly, Lynne M; Peltzer, Jill N

    2016-01-01

    In this methodological article, the authors address the problem of underdeveloped themes in qualitative studies they have reviewed. Various possible reasons for underdeveloped themes are examined, and suggestions offered. Each problem area is explored, and literature support is provided. The suggestions that are offered are supported by the literature as well. The problem with underdeveloped themes in certain articles is related to 3 interconnected issues: (a) lack of clear relationship to the underlying research method, (b) an apparent lack of depth in interviewing techniques, and (c) lack of depth in the analysis. Underdeveloped themes in a qualitative study can lead to a lack of substantive findings that have meaningful implications for practice, research, and the nursing profession, as well as the rejection of articles for publication. Fully developed themes require knowledge about the paradigm of qualitative research, the methodology that is proposed, the effective techniques of interviewing that can produce rich data with examples and experiences, and analysis that goes beyond superficial reporting of what the participants have said. Analytic problem areas include premature closure, anxiety about how to analyze, and confusion about categories and themes. Effective qualitative research takes time and effort and is not as easy as is sometimes presumed. The usefulness of findings depends on researchers improving their research skills and practices. Increasingly researchers are using qualitative research to explore clinically important issues. As consumers of research or members of a research team, clinical nurse specialists need to understand the nature of this research that can provide in-depth insight and meaning.

  19. Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study

    Science.gov (United States)

    2014-01-01

    Background Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. Methods A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Results Interviewees described the added value of qualitative research for the trial, explaining how it solved problems at the pretrial stage, explained findings, and helped to increase the utility of the evidence generated by the trial. From the interviews, we identified three models of relationship of the qualitative research to the trial. In ‘the peripheral’ model, the trial was an opportunity to undertake qualitative research, with no intention that it would add value to the trial. In ‘the add-on’ model, the qualitative researcher understood the potential value of the qualitative research but it was viewed as a separate and complementary endeavour by the trial lead investigator and wider team. Interviewees described how this could limit the value of the qualitative research to the trial. Finally ‘the integral’ model played out in two ways. In ‘integral-in-theory’ studies, the lead investigator viewed the qualitative research as essential to the trial. However, in practice the qualitative research was under-resourced relative to the trial, potentially limiting its ability to add value to the trial. In ‘integral-in-practice’ studies, interviewees described how the qualitative research was planned from the beginning of the study, senior qualitative expertise was on the team from beginning to end, and staff and time were dedicated to the qualitative research. In these studies interviewees described the qualitative research adding value to the trial although this value was not necessarily visible beyond the original research team due

  20. Getting added value from using qualitative research with randomized controlled trials: a qualitative interview study.

    Science.gov (United States)

    O'Cathain, Alicia; Goode, Jackie; Drabble, Sarah J; Thomas, Kate J; Rudolph, Anne; Hewison, Jenny

    2014-06-09

    Qualitative research is undertaken with randomized controlled trials of health interventions. Our aim was to explore the perceptions of researchers with experience of this endeavour to understand the added value of qualitative research to the trial in practice. A telephone semi-structured interview study with 18 researchers with experience of undertaking the trial and/or the qualitative research. Interviewees described the added value of qualitative research for the trial, explaining how it solved problems at the pretrial stage, explained findings, and helped to increase the utility of the evidence generated by the trial. From the interviews, we identified three models of relationship of the qualitative research to the trial. In 'the peripheral' model, the trial was an opportunity to undertake qualitative research, with no intention that it would add value to the trial. In 'the add-on' model, the qualitative researcher understood the potential value of the qualitative research but it was viewed as a separate and complementary endeavour by the trial lead investigator and wider team. Interviewees described how this could limit the value of the qualitative research to the trial. Finally 'the integral' model played out in two ways. In 'integral-in-theory' studies, the lead investigator viewed the qualitative research as essential to the trial. However, in practice the qualitative research was under-resourced relative to the trial, potentially limiting its ability to add value to the trial. In 'integral-in-practice' studies, interviewees described how the qualitative research was planned from the beginning of the study, senior qualitative expertise was on the team from beginning to end, and staff and time were dedicated to the qualitative research. In these studies interviewees described the qualitative research adding value to the trial although this value was not necessarily visible beyond the original research team due to the challenges of publishing this research

  1. Confucianism and Qualitative Interviewing: Working Seoul to Soul

    Directory of Open Access Journals (Sweden)

    Sunghee Park

    2015-03-01

    Full Text Available With the internationalization of higher education, research settings and researcher backgrounds are becoming increasingly complex, further complicating disciplinary assumptions, traditions and techniques. This article highlights key practical and conceptual issues that arose during planning fieldwork, fieldwork conduct, subsequent analysis and writing up of a qualitative study carried out within a Confucian setting. Drawing on the experience with a detailed research study of a pay for performance scheme (involving 31 in-depth interviews undertaken by a South Korean researcher, this article explores conceptual and practical issues that emerged between Anglophone methods and countries with a Confucian heritage. It is discussed how processes of sampling/recruitment, ethics, fieldwork conduct (including insider relations, power hierarchies, and translation are complicated in such settings. The article seeks to expand our understandings of qualitative research vis-à-vis contemporary Confucian cultures, something which has previously not been well addressed and which is part of the ongoing project of "globalizing qualitative research." URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs150274

  2. Dental Hygienists' Experiences with Motivational Interviewing: A Qualitative Study.

    Science.gov (United States)

    Curry-Chiu, Margaret E; Catley, Delwyn; Voelker, Marsha A; Bray, Kimberly Krust

    2015-08-01

    The effectiveness of Motivational Interviewing (MI) to change health behaviors is well documented. Previous studies support use of MI to change oral health behaviors in the areas of early childhood caries and periodontal diseases, but research is limited due to the sparse number of oral health care providers with training in MI. The University of Missouri-Kansas City (UMKC) formally integrated MI training into its dental hygiene curriculum five years ago. Summative program evaluation of UMKC's MI training shows that it effectively equips graduates with MI skills. The aim of this qualitative study was to use semi-structured interviews with nine program alumni to provide insight into the experiences of MI-trained dental hygienists in clinical practice. All interviews were captured with a digital voice recorder, were transcribed, and were resubmitted to the interviewees for checking. Five themes emerged from the data analysis: salience, best practices, barriers, facilitators, and lessons learned. These dental hygienists strongly valued and embraced the spirit of MI. They reported feeling strongly that it should be part of all dental hygiene curricula, and they upheld MI as a best practice. The participants approved of their MI instruction as a whole but felt it was difficult and sometimes not viable in practice. They reported that MI training had improved their communication skills and increased treatment acceptance. Time, difficulty, and managing patient resistance were the most often cited barriers, while a supportive climate and creating a routine were the most often cited facilitators.

  3. 77 FR 50548 - Agency Information Collection: (PACT Qualitative Evaluation: Patient & Caregiver Interviews...

    Science.gov (United States)

    2012-08-21

    ... Collection: (PACT Qualitative Evaluation: Patient & Caregiver Interviews); Comment Request AGENCY: Veterans... ``OMB Control No. 2900-New (Patient & Caregiver). SUPPLEMENTARY INFORMATION: Title: PACT Qualitative Evaluation: Patient & Caregiver Interviews. OMB Control Number: 2900--New Type of Review: New data collection...

  4. Family-focused dementia care - a qualitative interview study

    DEFF Research Database (Denmark)

    Mohrsen Busted, Laila; Nielsen, Dorthe; Birkelund, Regner

    to decrease the experienced burden that relatives to persons with dementia experience. The qualitative research project consists of three parts; 1) An interview study to investigate the problem area as experienced by 24 relatives. 2) Initiate family intervention, conducted by professional caregivers......Relatives to persons with dementia are in the literature described as the "invisible second patients." They get a more burdensome responsibility to the family’s everyday life and relation within the family. Furthermore, relatives as caregivers provide most of the assistance and supervision...... to fulfill the basic needs of the person with dementia. The experience of being close to a person with dementia may seem as a burden that involves emotional chaos and uncertainty which can lead to stress and depressions. Family health therapeutic conversations may be an intervention to relieve the suffering...

  5. Voluntary euthanasia.

    Science.gov (United States)

    Brewin, Thurstan B

    1986-05-10

    Brewin comments upon James Rachels' The End of Life (Oxford University Press; 1986) and Voluntary Euthanasia (Peter Owen; 1986), a compilation edited by A.B. Downing and B. Smoker that is an expanded version of a 1969 work by Britain's Voluntary Euthanasia Society. Rachels maintains that it is illogical to distinguish between active and passive euthanasia. In Voluntary Euthanasia, 17 contributors argue the pros and cons of the issue. The Voluntary Euthanasia Society proposes that mentally competent persons be allowed by law to request euthanasia, either when taken ill or by advance directive. Brewin says he is almost but not quite convinced by the arguments for legalized voluntary euthanasia. He is concerned about the "slippery slope," the uncertainties of prognosis and quality of life judgments, the pressures to which the terminally ill or aged might be subjected, and the potentially negative impact of euthanasia on the physician patient relationship.

  6. Locum physicians' professional ethos: a qualitative interview study from Germany.

    Science.gov (United States)

    Salloch, Sabine; Apitzsch, Birgit; Wilkesmann, Maximiliane; Ruiner, Caroline

    2018-05-08

    In contrast to other countries, the appearance of locum physicians as independent contractors constitutes a rather new phenomenon in the German health care system and emerged out of a growing economization and shortage of medical staff in the hospital sector. Locums are a special type of self-employed professionals who are only temporally embedded in organisational contexts of hospitals, and this might have consequences for their professional practice. Therefore, questions arise regarding how locums perceive their ethical duties as medical professionals. In this first qualitative study on German locum physicians, the locums' own perspective is complemented by the viewpoint of permanently employed physician colleagues. Eighteen semi-structured interviews were conducted in 2014 to explore the professional practice of locum physicians from both groups' perspectives with respect to doctor-patient-relationship, cooperation with colleagues and physicians' role in society. The data were analysed using qualitative content analysis, including a deductive application and an inductive development of codes. The results were related to key tenets of medical professionalism with respect to the question: how far do locums fulfil their ethical duties towards patients, colleagues and the society? The study indicates that although ethical requirements are met broadly, difficulties remain with respect to close doctor-patient contact and the sustainability of hiring locums as a remedy in times of staff shortage. Further qualitative and quantitative research on locum physicians' professional practice, including patient perspectives and economic health care system analyses, is needed to better understand the ethical impact of hiring independent contractors in the hospital sector.

  7. Patient expectations of emergency dental services: a qualitative interview study.

    Science.gov (United States)

    Anderson, R

    2004-09-25

    To describe the expectations of walk-in patients seeking emergency dental care out-of-hours. Consecutive patients attending two emergency dental clinics at weekends were interviewed prior to seeing the dentist. The audio-recorded interview transcripts were analysed using the "framework" method of applied qualitative data analysis. Forty-four walk-in emergency dental patients at a community-based dental clinic and a dental hospital emergency clinic at the weekend. In addition to symptom relief, the main desired outcome for emergency dental patients may be informational and psychological--especially reassurance that the problem is not serious, and reduced uncertainty about the cause of the pain. In general, patients' stated expectations for specific treatments (such as antibiotics, or tooth extraction) were not absolute: rather, they implied these expectations were conditional upon the dentist deciding they were necessary. Emergency dental services, some of which are still dominantly treatment-focused, should reflect that many emergency dental attenders want advice and reassurance as much as relief from symptoms. This reinforces the importance of effective and sympathetic dentist-patient communication within emergency or out-of-hours consultations. It also implies that dentists' skills in listening, explaining and reassuring should be captured in any patient satisfaction or outcome measure designed for this patient group.

  8. Maintaining patients' dignity during clinical care: a qualitative interview study.

    Science.gov (United States)

    Lin, Yea-Pyng; Tsai, Yun-Fang

    2011-02-01

    This article is a report of a study undertaken to understand how nurses maintain patients' dignity in clinical practice. Dignity is a core concept in nursing care and maintaining patients' dignity is critical to their recovery. In Western countries, measures to maintain dignity in patients' care include maintaining privacy of the body, providing spatial privacy, giving sufficient time, treating patients as a whole person and allowing patients to have autonomy. However, this is an under-studied topic in Asian countries. For this qualitative descriptive study, data were collected in Taiwan in 2009 using in-depth interviews with a purposive sample of 30 nurses from a teaching hospital in eastern Taiwan. The audiotaped interviews were transcribed verbatim and analysed using content analysis. Nurses' measures to maintain dignity in patient care were captured in five themes: respect, protecting privacy, emotional support, treating all patients alike and maintaining body image. Participants did not mention beneficence, a crucial element achieved through the professional care of nurses that can enhance the recovery of patients. In-service education to help nurses enhance dignity in patient care should emphasize emotional support, maintaining body image and treating all patients alike. Our model for maintaining dignity in patient care could be used to develop a clinical care protocol for nurses to use in clinical practice. © 2010 Blackwell Publishing Ltd.

  9. Understanding delayed access to antenatal care: a qualitative interview study

    Science.gov (United States)

    2014-01-01

    Background Delayed access to antenatal care ('late booking’) has been linked to increased maternal and fetal mortality and morbidity. The aim of this qualitative study was to understand why some women are late to access antenatal care. Methods 27 women presenting after 19 completed weeks gestation for their first hospital booking appointment were interviewed, using a semi-structured format, in community and maternity hospital settings in South Yorkshire, United Kingdom. Interviews were transcribed verbatim and entered onto NVivo 8 software. An interdisciplinary, iterative, thematic analysis was undertaken. Results The late booking women were diverse in terms of: age (15–37 years); parity (0–4); socioeconomic status; educational attainment and ethnicity. Three key themes relating to late booking were identified from our data: 1) 'not knowing’: realisation (absence of classic symptoms, misinterpretation); belief (age, subfertility, using contraception, lay hindrance); 2) 'knowing’: avoidance (ambivalence, fear, self-care); postponement (fear, location, not valuing care, self-care); and 3) 'delayed’ (professional and system failures, knowledge/empowerment issues). Conclusions Whilst vulnerable groups are strongly represented in this study, women do not always fit a socio-cultural stereotype of a 'late booker’. We report a new taxonomy of more complex reasons for late antenatal booking than the prevalent concepts of denial, concealment and disadvantage. Explanatory sub-themes are also discussed, which relate to psychological, empowerment and socio-cultural factors. These include poor reproductive health knowledge and delayed recognition of pregnancy, the influence of a pregnancy 'mindset’ and previous pregnancy experience, and the perceived value of antenatal care. The study also highlights deficiencies in early pregnancy diagnosis and service organisation. These issues should be considered by practitioners and service commissioners in order to promote

  10. On ‘False, Collusive Objectification’: Becoming Attuned to Self-Censorship, Performance and Interviewer Biases in Qualitative Interviewing

    Science.gov (United States)

    Yanos, Philip T.; Hopper, Kim

    2010-01-01

    In this paper, we discuss a problem in qualitative interviewing labeled by Bourdieu as ‘false, collusive objectification’. As described by Bourdieu, interviews where this occurs appear authentic because they often echo social science concepts and terminology and therefore may please the interviewer; however, they are actually unusable. We evaluate Bourdieu’s claim for the existence of ‘false’ interviews in light of the predominant postmodern position in qualitative research, offer examples from our own research on people diagnosed with mental illness and raise the issue of whether, when and how qualitative researchers should concern themselves with the shortcomings of interviews. We conclude with suggestions derived from Bourdieu’s view on how to address the problem he described. PMID:21132071

  11. On 'False, Collusive Objectification': Becoming Attuned to Self-Censorship, Performance and Interviewer Biases in Qualitative Interviewing.

    Science.gov (United States)

    Yanos, Philip T; Hopper, Kim

    2008-07-01

    In this paper, we discuss a problem in qualitative interviewing labeled by Bourdieu as 'false, collusive objectification'. As described by Bourdieu, interviews where this occurs appear authentic because they often echo social science concepts and terminology and therefore may please the interviewer; however, they are actually unusable. We evaluate Bourdieu's claim for the existence of 'false' interviews in light of the predominant postmodern position in qualitative research, offer examples from our own research on people diagnosed with mental illness and raise the issue of whether, when and how qualitative researchers should concern themselves with the shortcomings of interviews. We conclude with suggestions derived from Bourdieu's view on how to address the problem he described.

  12. Distrust and patients in intercultural healthcare: A qualitative interview study.

    Science.gov (United States)

    Alpers, Lise-Merete

    2018-05-01

    The importance of trust between patients and healthcare personnel is emphasised in nurses' and physicians' ethical codes. Trust is crucial for an effective healthcare personnel-patient relationship and thus for treatment and treatment outcomes. Cultural and linguistic differences may make building a trusting and positive relationship with ethnic minority patients particularly challenging. Although there is a great deal of research on cultural competence, there is a conspicuous lack of focus on the concepts of trust and distrust concerning ethnic minority patients, particularly in relation to the concept of 'othering'. To study which factors help build trust or create distrust in encounters between healthcare professionals and hospitalised ethnic minority patients, as well as study the dynamic complexities inherent within the process of 'othering'. Qualitative design, in-depth interviews and hermeneutic analysis. Participants and research context: The interviewees were 10 immigrant patients (six women and four men - eight Asians, two Africans - ages 32-85 years) recruited from a south-eastern Norwegian hospital. Ethical considerations: Study approval was obtained from the hospital's Privacy Ombudsman for Research and the hospital's leadership. Participation was voluntary and participants signed an informed consent form. Distrust and othering may be caused by differences in belief systems, values, perceptions, expectations, and style of expression and behaviour. Othering is a reciprocal phenomenon in minority ethnic patient-healthcare personnel encounters, and it influences trust building negatively. Besides demonstrating general professional skill and competence, healthcare personnel require cultural competence to create trust.

  13. Analysing the significance of silence in qualitative interviewing: questioning and shifting power relations

    DEFF Research Database (Denmark)

    Bengtsson, Tea Torbenfeldt; Fynbo, Lars

    2017-01-01

    In this article we analyse the significance of silence in qualitative interviews with 36 individuals interviewed about high-risk, illegal activities. We describe how silence expresses a dynamic power relationship between interviewer and interviewee. In the analysis, we focus on two different types...... significant data. We conclude that silence constitutes possibilities for interviewees and interviewers to handle the complex power at play in qualitative interviewing either by maintaining or by losing control of the situation....

  14. [Reflections on qualitative research. Interview of Luisa Saiani with Luigina Mortari].

    Science.gov (United States)

    Mortari, Luigina; Saiani, Luisa

    2013-01-01

    Reflections on qualitative research. Interview of Luisa Saiani to Luigina Mortari. Luigina Mortari, an internationally known expert of epistemology and qualitative research, was interviewed to explore her thoughts on issues relevant for qualitative research: when a research question can be considered relevant; key methodological elements; ethical issues.

  15. GPs' perceptions of workload in England: a qualitative interview study.

    Science.gov (United States)

    Croxson, Caroline Hd; Ashdown, Helen F; Hobbs, Fd Richard

    2017-02-01

    GPs report the lowest levels of morale among doctors, job satisfaction is low, and the GP workforce is diminishing. Workload is frequently cited as negatively impacting on commitment to a career in general practice, and many GPs report that their workload is unmanageable. To gather an in-depth understanding of GPs' perceptions and attitudes towards workload. All GPs working within NHS England were eligible. Advertisements were circulated via regional GP e-mail lists and national social media networks in June 2015. Of those GPs who responded, a maximum-variation sample was selected until data saturation was reached. Semi-structured, qualitative interviews were conducted. Data were analysed thematically. In total, 171 GPs responded, and 34 were included in this study. GPs described an increase in workload over recent years, with current working days being long and intense, raising concerns over the wellbeing of GPs and patients. Full-time partnership was generally not considered to be possible, and many participants felt workload was unsustainable, particularly given the diminishing workforce. Four major themes emerged to explain increased workload: increased patient needs and expectations; a changing relationship between primary and secondary care; bureaucracy and resources; and the balance of workload within a practice. Continuity of care was perceived as being eroded by changes in contracts and working patterns to deal with workload. This study highlights the urgent need to address perceived lack of investment and clinical capacity in general practice, and suggests that managing patient expectations around what primary care can deliver, and reducing bureaucracy, have become key issues, at least until capacity issues are resolved. © British Journal of General Practice 2017.

  16. Analysis of qualitative interviews with online language teachers

    DEFF Research Database (Denmark)

    Levinsen, Karin; Meyer, Bente

    At the kick-off meeting in Vienna October 2005 it was agreed that partners would conduct a limited number of interviews to make an initial survey of issues that would be relevant for the production of the manual & guide. It was therefore the objective of the interviews to produce knowledge about...... technological skills specifically required for live online language teaching define need for qualification of the live online language teacher The Danish team conducted 4 semi-structured interviews with teachers. The interviews were made on the basis of an interview guide discussed by all partners in December...

  17. Traveler Information Services in Rural Tourism Areas. Appendix B: Qualitative Interviews and Focus Groups

    Science.gov (United States)

    2000-06-30

    Qualitative interviews were conducted with key informants and with tourists in northwest Arizona in Flagstaff and near the Grand Canyon National Park, Arizona, and in Branson, Missouri, in August and September 1998 (respectively). The interviews aske...

  18. Linguistic analysis of face-to-face interviews with patients with an explicit request for euthanasia, their closest relatives, and their attending physicians: the use of modal verbs in Dutch.

    Science.gov (United States)

    Dieltjens, Sylvain M; Heynderickx, Priscilla C; Dees, Marianne K; Vissers, Kris C

    2014-04-01

    The literature, field research, and daily practice stress the need for adequate communication in palliative care. Although language is of the utmost importance in communication, linguistic analysis of end-of-life discussions is scarce. Our aim is 2-fold: We want to determine what the use of 4 significant Dutch modal verbs expressing volition, obligation, possibility, and permission reveals about the concept of unbearable suffering and about physicians' communicative style. We quantitatively (TextStat) and qualitatively (bottom-up approach) analyzed the use of the modal verbs in 15 interviews, with patients requesting euthanasia or physician-assisted suicide, their physicians, and their closest relatives. An essential element of unbearable suffering is the patient's incapacity to perform certain tasks. Further, the physician's preference for particular modal verbs reveals whether his attitude toward patients is more or less patronizing and more or less appreciative. Linguistic analysis can help medical professionals to better understand their communicative skills, styles, and approach to patients in end-of-life situations. We have shown how linguistic analysis can contribute to a better understanding of physician-patient interaction. Moreover, we have illustrated the usefulness of interdisciplinary research in the medical domain. © 2013 World Institute of Pain.

  19. Descriptions of euthanasia as social representations: comparing the views of Finnish physicians and religious professionals.

    Science.gov (United States)

    Jylhänkangas, Leila; Smets, Tinne; Cohen, Joachim; Utriainen, Terhi; Deliens, Luc

    2014-03-01

    In many western societies health professionals play a powerful role in people's experiences of dying. Religious professionals, such as pastors, are also confronted with the issues surrounding death and dying in their work. It is therefore reasonable to assume that the ways in which death-related topics, such as euthanasia, are constructed in a given culture are affected by the views of these professionals. This qualitative study addresses the ways in which Finnish physicians and religious professionals perceive and describe euthanasia and conceptualises these descriptions and views as social representations. Almost all the physicians interviewed saw that euthanasia does not fit the role of a physician and anchored it to different kinds of risks such as the slippery slope. Most of the religious and world-view professionals also rejected euthanasia. In this group, euthanasia was rejected on the basis of a religious moral code that forbids killing. Only one of the religious professionals - the freethinker with an atheist world-view - accepted euthanasia and described it as a personal choice, as did the one physician interviewed who accepted it. The article shows how the social representations of euthanasia are used to protect professional identities and to justify their expert knowledge of death and dying. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  20. Practical Qualitative Research Strategies: Training Interviewers and Coders.

    Science.gov (United States)

    Goodell, L Suzanne; Stage, Virginia C; Cooke, Natalie K

    2016-09-01

    The increased emphasis on incorporating qualitative methodologies into nutrition education development and evaluation underscores the importance of using rigorous protocols to enhance the trustworthiness of the findings. A 5-phase protocol for training qualitative research assistants (data collectors and coders) was developed as an approach to increase the consistency of the data produced. This training provides exposure to the core principles of qualitative research and then asks the research assistant to apply those principles through practice in a setting structured on critical reflection. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  1. Sample Size in Qualitative Interview Studies: Guided by Information Power.

    Science.gov (United States)

    Malterud, Kirsti; Siersma, Volkert Dirk; Guassora, Ann Dorrit

    2015-11-27

    Sample sizes must be ascertained in qualitative studies like in quantitative studies but not by the same means. The prevailing concept for sample size in qualitative studies is "saturation." Saturation is closely tied to a specific methodology, and the term is inconsistently applied. We propose the concept "information power" to guide adequate sample size for qualitative studies. Information power indicates that the more information the sample holds, relevant for the actual study, the lower amount of participants is needed. We suggest that the size of a sample with sufficient information power depends on (a) the aim of the study, (b) sample specificity, (c) use of established theory, (d) quality of dialogue, and (e) analysis strategy. We present a model where these elements of information and their relevant dimensions are related to information power. Application of this model in the planning and during data collection of a qualitative study is discussed. © The Author(s) 2015.

  2. Substance Abuse and Prison Recidivism: Themes from Qualitative Interviews

    Science.gov (United States)

    Phillips, Lindsay A.

    2010-01-01

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

  3. Analysis of qualitative interviews with Action Research Trainees, February 2007

    DEFF Research Database (Denmark)

    Meyer, Bente; Levinsen, Karin

    Interviews with trainees were conducted after the Action Research period (November-December 2006), when LBs 1-4 were tested on trainees. The aim of the interviews was to understand how teachers learn to teach and to relate to the online environment through the specific context of the Lancelot live...... online course.  The focus of the interviews was on the one hand the ability of the course to support this learning process and on the other hand the correction and adjustment of the syllabus for the spring pilot testing phase (beginning March 2007)....

  4. Exploring Performativity and Resistance in Qualitative Research Interviews: A Play in Four Acts

    Science.gov (United States)

    Beaunae, Cathrine; Wu, Chiu-Hui; Koro-Ljungberg, Mirka

    2011-01-01

    This play describes how the authors become aware of the complexities of resistance and performativity in the qualitative interview process. It also illustrates how this awareness and subsequent acquisition of knowledge changed and informed the way they viewed qualitative research interviewing. More specifically, performativity is put into work in…

  5. Exploring Culture from a Distance: The Utility of Telephone Interviews in Qualitative Research

    Science.gov (United States)

    Lechuga, Vicente M.

    2012-01-01

    Qualitative studies that utilize telephone interviews, as a primary data collection mode, often are not discussed in the qualitative research literature. Data excerpts from a study that sought to understand the culture of for-profit universities are used to illustrate the types of data that can be garnered through telephone interviews. In…

  6. Validity in qualitative research: Interview and the appearance of truth through dialogue

    Directory of Open Access Journals (Sweden)

    Marja Kuzmanić

    2009-07-01

    Full Text Available This paper addresses several issues related to validity in qualitative research and, more specifically, explores the ways in which validity has been discussed and applied in research with qualitative interviews. The central question is to what extent, if at all, traditional positivist validity criteria are applicable, but also relevant, for evaluation of research with qualitative interviewing. The qualitative interview has been chosen as the focal point of this paper because of its peculiarity in terms of the relationship between the interviewer and the interviewee or, in other words, the ways in which during an interview meaning and narrative are constructed through discourse between the participants. The importance of the relationship (with its characteristics between research participants (interviewer and interviewee for the outcome of a qualitative interview cannot be overemphasized and is as such of particular interest for the assessment of its validity. I introduce and summarize the main approaches to the study and establishment of validity and scrutinize their significance for the example of qualitative interviewing and research in particular. This paper shows the importance of considering research context (in this instance interview for any assessment of validity, if validity at all ought to assume the same role in qualitative and quantitative research. As alternatives to the positivist notion of validity concepts such as reflexivity, transparency and credibility throughout the research process are introduced and advocated.

  7. Engaging men with penile cancer in qualitative research: reflections from an interview-based study.

    Science.gov (United States)

    Witty, Karl; Branney, Peter; Bullen, Kate; White, Alan; Evans, Julie; Eardley, Ian

    2014-01-01

    To explore the challenges of engaging men with penile cancer in qualitative interview research. Qualitative interviewing offers an ideal tool for exploring men's experiences of illness, complementing and providing context to gendered health inequalities identified in epidemiological research on men. But conducting interviews with men can be challenging and embarking on a qualitative interview study with males can feel like a daunting task, given the limited amount of practical, gender-sensitive guidance for researchers. Reflecting on a researcher's experience of conducting qualitative research on men with penile cancer, this paper explores the potential challenges of interviewing this group, but also documents how engagement and data collection were achieved. This is a reflective paper, informed by the experiences of a male researcher (KW) with no nurse training, who conducted 28 interviews with men who had been treated for penile cancer. The researcher's experiences are reported in chronological order, from the methodological challenges of recruitment to those of conducting the interview. The paper offers a resource for the novice researcher, highlighting some advantages and disadvantages of conducting qualitative interview research as a nurse researcher, as well as recommendations on how to overcome challenges. Engaging men with penile cancer in qualitative interview raises practical, methodological, ethical and emotional challenges for the researcher. However, when these challenges are met, men will talk about their health. Methodological procedures must enable an open and ongoing dialogue with clinical gatekeepers and potential participants to promote engagement. Support from colleagues is essential for any interviewer, no matter how experienced the researcher is.

  8. [Quality control and assessment of qualitative interview in health care research].

    Science.gov (United States)

    Xie, Yan-ming; Liao, Xing

    2008-07-01

    It is not finally concluded how to standardize the use of qualitative research in the world. Qualitative researchers disagree with each other about this issue. As we know, there have been a large number of articles written in different ways about qualitative research due to the "flexibility", one of its features. Qualitative research is quite different from quantitative research which is easy to control its quality and quality assessment. A series of criteria has been set up for quantitative research. However qualitative research needs to be improved in these aspects, in which qualitative interviews are mostly used at home and abroad at present. Hence, it becomes an important and urgent issue for qualitative researchers to standardly control and assess the quality of qualitative interview.

  9. Communication about euthanasia in general practice: opinions and experiences of patients and their general practitioners.

    Science.gov (United States)

    Borgsteede, Sander D; Deliens, Luc; Graafland-Riedstra, Corrie; Francke, Anneke L; van der Wal, Gerrit; Willems, Dick L

    2007-05-01

    Public opinion and professional organisations dominate the euthanasia debate, and there is a need to understand the opinions of people confronted with euthanasia. The aim of this study was to investigate whether patients and their GPs talk about euthanasia, and if so, how they communicate about this. Qualitative, semi-structured interviews were held with 20 GPs and 30 of their patients in primary care in the Netherlands, where euthanasia is legalised. The patients had a life expectancy of less than 6 months, and cancer, heart failure or chronic obstructive pulmonary disease as underlying disease. Many patients did not communicate about euthanasia with their GP. Neither the patient nor the GP were clear in formulating their expectations concerning future decision making. The initial patient-GP communication consisted of an exchange of opinions about situations in which euthanasia would be desirable. GPs had different opinions about who should initiate communication, and found it difficult to judge the right moment to talk. It is essential to pay attention to education in communication about dying and euthanasia and to train the GPs to gain insight in the patient's end-of-life preferences, and to direct care at the best possible quality of life.

  10. How do healthcare consumers process and evaluate comparative healthcare information? A qualitative study using cognitive interviews.

    NARCIS (Netherlands)

    Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.; Groenewegen, P.

    2009-01-01

    Background: To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods: Using semi-structured cognitive interviews, interviewees

  11. How do healthcare consumers process and evaluate comparative healthcare information? A qualitive study using cognitive interviews

    NARCIS (Netherlands)

    Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.M.J.; Groenewegen, P.P.

    2009-01-01

    Background: To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods: Using semi-structured cognitive interviews, interviewees

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

    Science.gov (United States)

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

    2016-12-01

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

  13. The Impact of a Qualitative Research Interview on Workers' Views of Their Situation

    Science.gov (United States)

    Butterfield, Lee D.; Borgen, William A.; Amundson, Norman E.

    2009-01-01

    The purpose of this research was to explore whether qualitative research interviews impacted participants' views of their situations. Forty-five workers who reported handling well changes that affected their work were interviewed to explore their experiences of change, factors that helped and hindered their ability to handle change, and assess the…

  14. Dutch surgeons' views on the volume-outcome mechanism in surgery: A qualitative interview study

    NARCIS (Netherlands)

    Mesman, R.; Faber, M.J.; Westert, G.P.; Berden, H.

    2017-01-01

    Objective: To contribute to a better understanding of volume-outcome relationships in surgery by exploring Dutch surgeons' views on the underlying mechanism. Design: A qualitative study based on face-to-face semi structured interviews and an inductive content analysis approach. Setting: Interviews

  15. Teaching Qualitative Research: Experiential Learning in Group-Based Interviews and Coding Assignments

    Science.gov (United States)

    DeLyser, Dydia; Potter, Amy E.

    2013-01-01

    This article describes experiential-learning approaches to conveying the work and rewards involved in qualitative research. Seminar students interviewed one another, transcribed or took notes on those interviews, shared those materials to create a set of empirical materials for coding, developed coding schemes, and coded the materials using those…

  16. [Active euthanasia].

    Science.gov (United States)

    Folker, A P; Hvidt, N

    1995-02-20

    The growing interest in the subject of active euthanasia in connection with the debate regarding legalization of such practices in Denmark necessitates taking a definite standpoint. The difference in concept between active and passive euthanasia is stressed, and the Dutch guidelines are reviewed. The article discusses how far the patient's autonomy should go, as it regards the consideration of self-determination as being too narrow a criterion in itself. The discussion on the quality of life is included, and the consequences of the process of expulsion as a sociological concept are considered--the risk of a patient feeling guilty for being alive and therefore feeling compelled to request active euthanasia. The changed function of the physician is underlined, and it is discussed whether active euthansia will cause a breach of confidence between the physician and his patient. In connection with the debate the following tendencies in society are emphasized: lack of clarity, increasing medicalization and utilitarian priorities.

  17. Euthanasia and physician-assisted suicide in dementia: A qualitative study of the views of former dementia carers.

    Science.gov (United States)

    Tomlinson, Emily; Spector, Aimee; Nurock, Shirley; Stott, Joshua

    2015-09-01

    Despite media and academic interest on assisted dying in dementia, little is known of the views of those directly affected. This study explored the views of former carers on assisted dying in dementia. This was a qualitative study using thematic analysis. A total of 16 former carers of people with dementia were recruited through national dementia charities and participated in semi-structured interviews. While many supported the individual's right to die, the complexity of assisted dying in dementia was emphasized. Existential, physical, psychological and psychosocial aspects of suffering were identified as potential reasons to desire an assisted death. Most believed it would help to talk with a trained health professional if contemplating an assisted death. Health workers should be mindful of the holistic experience of dementia at the end of life. The psychological and existential aspects of suffering should be addressed, as well as relief of physical pain. Further research is required. © The Author(s) 2015.

  18. Euthanasia Acceptance as Related to Afterlife and Other Attitudes.

    Science.gov (United States)

    Klopfer, Frederick J.; Price, William F.

    1978-01-01

    Information on euthanasia attitudes was obtained from fixed-schedule interviews gathered from 331 respondents. It was found that a favorable attitude toward euthanasia coincided with (1) belief in an afterlife; (2) a less favorable attitude toward euthanasia if relatives make the decision; and (3) younger respondents. (Author)

  19. Conceptualization of convenience euthanasia as an ethical dilemma for veterinarians in Quebec.

    Science.gov (United States)

    Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

    2017-03-01

    Companion animal welfare in our society has become increasingly important, yet many healthy animals are euthanized in veterinary facilities. How is it possible to explain the simultaneous presence of these opposing views of obligation toward animals? The goal of this study was to describe convenience euthanasia of companion animals as experienced by veterinarians in order to understand their thought processes. A qualitative study was undertaken to analyze the results of interviews of 14 veterinarians. The study showed that veterinarians interviewed assessed convenience euthanasia based mainly on their subjective evaluation of the owner-animal bond. As most owner-animal bonds stem from an anthropocentric point of view, decisions on convenience euthanasia were taken mostly by considering the veterinarian's and the client/owner's interests.

  20. Movie making as a cognitive distraction for paediatric patients receiving radiotherapy treatment: qualitative interview study

    OpenAIRE

    Shrimpton, Bradley J M; Willis, David J; Tongs, C?thal D; Rolfo, Aldo G

    2013-01-01

    Objectives To establish the outcomes achieved by using an innovative movie-making programme designed to reduce fear of radiotherapy among paediatric patients. Design Qualitative descriptive evaluation based on semistructured, qualitative interviews with purposeful sampling and thematic analysis. Setting Tertiary Cancer Centre. Participants 20 parents of paediatric patients who had produced a movie of their radiation therapy experience and were in a follow-up phase of cancer management. Result...

  1. Sampling in interview-based qualitative research: A theoretical and practical guide

    OpenAIRE

    Robinson, Oliver

    2014-01-01

    Sampling is central to the practice of qualitative methods, but compared with data collection and analysis, its processes are discussed relatively little. A four-point approach to sampling in qualitative interview-based research is presented and critically discussed in this article, which integrates theory and process for the following: (1) Defining a sample universe, by way of specifying inclusion and exclusion criteria for potential participation; (2) Deciding upon a sample size, through th...

  2. Euthanasia and physician-assisted suicide not meeting due care criteria in the Netherlands: a qualitative review of review committee judgements.

    Science.gov (United States)

    Miller, David Gibbes; Kim, Scott Y H

    2017-10-25

    ObjectivesTo assess how Dutch regional euthanasia review committees (RTE) apply the euthanasia and physician-assisted suicide (EAS) due care criteria in cases where the criteria are judged not to have been met ('due care not met' (DCNM)) and to evaluate how the criteria function to set limits in Dutch EAS practice. A qualitative review using directed content analysis of DCNM cases in the Netherlands from 2012 to 2016 published on the RTE website (https://www.euthanasiecommissie.nl/) as of 31 January 2017. Of 33 DCNM cases identified (occurring 2012-2016), 32 cases (97%) were published online and included in the analysis. 22 cases (69%) violated only procedural criteria, relating to improper medication administration or inadequate physician consultation. 10 cases (31%) failed to meet substantive criteria, with the most common violation involving the no reasonable alternative (to EAS) criterion (seven cases). Most substantive cases involved controversial elements, such as EAS for psychiatric disorders or 'tired of life', in incapacitated patients or by physicians from advocacy organisations. Even in substantive criteria cases, the RTE's focus was procedural. The cases were more about unorthodox, unprofessional or overconfident physician behaviours and not whether patients should have received EAS. However, in some cases, physicians knowingly pushed the limits of EAS law. Physicians from euthanasia advocacy organisations were over-represented in substantive criteria cases. Trained EAS consultants tended to agree with or facilitate EAS in DCNM cases. Physicians and families had difficulty applying ambiguous advance directives of incapacitated patients. As a retrospective review of physician self-reported data, the Dutch RTEs do not focus on whether patients should have received EAS, but instead primarily gauge whether doctors conducted EAS in a thorough, professional manner. To what extent this constitutes enforcement of strict safeguards, especially when cases contain

  3. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    Directory of Open Access Journals (Sweden)

    Shipman Cathy

    2008-04-01

    Full Text Available Abstract Background Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview. Methods A descriptive qualitative study. The data were collected in the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study. Results The interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible. Conclusion The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview.

  4. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    Science.gov (United States)

    Gysels, Marjolein; Shipman, Cathy; Higginson, Irene J

    2008-04-24

    Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview. A descriptive qualitative study. The data were collected in the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study. The interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible. The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview.

  5. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    Science.gov (United States)

    Gysels, Marjolein; Shipman, Cathy; Higginson, Irene J

    2008-01-01

    Background Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a research interview. Methods A descriptive qualitative study. The data were collected in the context of two studies exploring the experiences of care of palliative care patients and carers. The interviews ended with questions about patients' and carers' thoughts on participating in the studies and whether this had been a distressing or helpful event. We used a qualitative descriptive analysis strategy generated from the interviews and the observational and interactional data obtained in the course of the study. Results The interviews were considered helpful: sharing problems was therapeutic and being able to contribute to research was empowering. However, thinking about the future was reported to be the most challenging. Consent forms were sometimes read with apprehension and being physically unable to sign was experienced as upsetting. Interviewing patients and carers separately was sometimes difficult and not always possible. Conclusion The open interview enables the perspectives of patients and carers to be heard, unfettered from the structure of closed questions. It also enables those patients or carers to take part who would be unable to participate in other study designs. The context is at least as important as the format of the research interview taking into account the relational circumstances with carers and appropriate ways of obtaining informed consent. Retrospective consent could be a solution to enhancing participants control over the interview. PMID:18435846

  6. Neonatal euthanasia.

    Science.gov (United States)

    Kon, Alexander A

    2009-12-01

    Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate.

  7. The Influence of Power Shifts in Data Collection and Analysis Stages: A Focus on Qualitative Research Interview

    Science.gov (United States)

    Anyan, Frederick

    2013-01-01

    This paper analyzes the power relation between the interviewer and the interviewee in the qualitative research interview methodology. The paper sets out to grapple with the extent to which the dynamisms in power shifts influence data collection and analysis in the interview methodology. The exploration of power shifts in the qualitative research…

  8. From Assessment to Implementation: Using Qualitative Interviews to Inform Distance Learning Library Services

    Science.gov (United States)

    Wharton, Lindsey N.

    2017-01-01

    While broad assessment projects are often used to steer library strategic planning initiatives, this article will present the benefits of qualitative interviews with distance learning constituents as a framework for developing a focused vision and targeted services. This article will describe the planning and execution of an assessment project…

  9. Quantitative Analysis of Qualitative Information from Interviews: A Systematic Literature Review

    Science.gov (United States)

    Fakis, Apostolos; Hilliam, Rachel; Stoneley, Helen; Townend, Michael

    2014-01-01

    Background: A systematic literature review was conducted on mixed methods area. Objectives: The overall aim was to explore how qualitative information from interviews has been analyzed using quantitative methods. Methods: A contemporary review was undertaken and based on a predefined protocol. The references were identified using inclusion and…

  10. Focus Group Interview in Family Practice Research: Implementing a qualitative research method

    OpenAIRE

    Wood, Marjorie L.

    1992-01-01

    Focus group interviews, described as a qualitative research method with good potential in family medicine, are traced from their origins in market research to their growing role in sociology and medicine. Features of this method are described, including design, conduct, and analysis. Both proven and potential areas for primary care research using focus groups are outlined.

  11. Using Email Interviews in Qualitative Educational Research: Creating Space to Think and Time to Talk

    Science.gov (United States)

    James, Nalita

    2016-01-01

    The article explores how the Internet and email offer space for participants to think and make sense of their experiences in the qualitative research encounter. It draws on a research study that used email interviewing to generate online narratives to understand academic lives and identities through research encounters in virtual space. The…

  12. 77 FR 24685 - Proposed Information Collection; Comment Request; Client Focus Groups and Qualitative Interviews

    Science.gov (United States)

    2012-04-25

    ... Request; Client Focus Groups and Qualitative Interviews AGENCY: International Trade Administration (ITA... ``Quality Assurance Surveys'' to collect feedback from the U.S. business clients it serves. These surveys ask the client to evaluate the U.S. Commercial Service on its customer service provision. Results from...

  13. Cognitive Interviewing: A Qualitative Tool for Improving Questionnaires in Sport Science

    Science.gov (United States)

    Dietrich, Hanno; Ehrlenspiel, Felix

    2010-01-01

    Cognitive models postulate that respondents to a questionnaire follow a four-stage process when answering a question: comprehension, memory retrieval, decision, and response. Cognitive interviewing is a qualitative tool to gain insight into this process by means of letting respondents think aloud or asking them specific questions (Willis, 2005).…

  14. The limitations of language: male participants, stoicism, and the qualitative research interview.

    Science.gov (United States)

    Affleck, William; Glass, Kc; Macdonald, Mary Ellen

    2013-03-01

    The semistructured, open-ended interview has become the gold standard for qualitative health research. Despite its strengths, the long interview is not well suited for studying topics that participants find difficult to discuss, or for working with those who have limited verbal communication skills. A lack of emotional expression among male research participants has repeatedly been described as a significant and pervasive challenge by health researchers in a variety of different fields. This article explores several prominent theories for men's emotional inexpression and relates them to qualitative health research. The authors argue that investigators studying emotionally sensitive topics with men should look beyond the long interview to methods that incorporate other modes of emotional expression. This article concludes with a discussion of several such photo-based methods, namely, Photovoice, Photo Elicitation, and Visual Storytelling.

  15. Interview-Based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting

    Science.gov (United States)

    Ranney, Megan L.; Meisel, Zachary; Choo, Esther K.; Garro, Aris; Sasson, Comilla; Morrow, Kathleen

    2015-01-01

    Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. PMID:26284572

  16. Interview-based Qualitative Research in Emergency Care Part II: Data Collection, Analysis and Results Reporting.

    Science.gov (United States)

    Ranney, Megan L; Meisel, Zachary F; Choo, Esther K; Garro, Aris C; Sasson, Comilla; Morrow Guthrie, Kate

    2015-09-01

    Qualitative methods are increasingly being used in emergency care research. Rigorous qualitative methods can play a critical role in advancing the emergency care research agenda by allowing investigators to generate hypotheses, gain an in-depth understanding of health problems or specific populations, create expert consensus, and develop new intervention and dissemination strategies. In Part I of this two-article series, we provided an introduction to general principles of applied qualitative health research and examples of its common use in emergency care research, describing study designs and data collection methods most relevant to our field (observation, individual interviews, and focus groups). Here in Part II of this series, we outline the specific steps necessary to conduct a valid and reliable qualitative research project, with a focus on interview-based studies. These elements include building the research team, preparing data collection guides, defining and obtaining an adequate sample, collecting and organizing qualitative data, and coding and analyzing the data. We also discuss potential ethical considerations unique to qualitative research as it relates to emergency care research. © 2015 by the Society for Academic Emergency Medicine.

  17. Co-interviewing across gender and culture: expanding qualitative research methods in Melanesia.

    Science.gov (United States)

    Redman-MacLaren, Michelle L; Api, Unia K; Darius, Matupit; Tommbe, Rachael; Mafile'o, Tracie A; MacLaren, David J

    2014-09-06

    The social and cultural positions of both researchers and research participants influence qualitative methods and study findings. In Papua New Guinea (PNG), as in other contexts, gender is a key organising characteristic and needs to be central to the design and conduct of research. The colonial history between researcher and participant is also critical to understanding potential power differences. This is particularly relevant to public health research, much of which has emerged from a positivist paradigm. This paper describes our critical reflection of flexible researcher responses enacted during qualitative research in PNG. Led by a senior male HIV researcher from PNG, a male from a PNG university and a female from an Australian university conducted qualitative interviews about faith-based responses to HIV in PNG. The two researchers planned to conduct one-on-one interviews matching gender of participants and interviewer. However, while conducting the study, four participants explicitly requested to be interviewed by both researchers. This experience led us to critically consider socially and culturally situated ways of understanding semi-structured interviewing for public health research in Melanesia. New understandings about public health research include: (i) a challenge to the convention that the researcher holds more power than the research participant, (ii) the importance of audience in Melanesia, (iii) cultural safety can be provided when two people co-interview and (iv) the effect an esteemed leader heading the research may have on people's willingness to participate. Researchers who occupy insider-outsider roles in PNG may provide participants new possibilities to communicate key ideas. Our recent experience has taught us public health research methods that are gender sensitive and culturally situated are pivotal to successful research in Melanesia. Qualitative research requires adaptability and reflexivity. Public health research methods must continue

  18. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries

    Science.gov (United States)

    Rietjens, Judith; Bruinsma, Sophie; Deliens, Luc; Sterckx, Sigrid; Mortier, Freddy; Brown, Jayne; Mathers, Nigel; van der Heide, Agnes

    2015-01-01

    Background: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. Methods: Qualitative case studies using interviews. Setting: Hospitals, the domestic home and hospices or palliative care units. Participants: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer patients. Results: UK respondents reported a continuum of practice from the provision of low doses of sedatives to control terminal restlessness to rarely encountered deep sedation. In contrast, Belgian respondents predominantly described the use of deep sedation, emphasizing the importance of responding to the patient’s request. Dutch respondents emphasized making an official medical decision informed by the patient’s wish and establishing that a refractory symptom was present. Respondents employed rationales that showed different stances towards four key issues: the preservation of consciousness, concerns about the potential hastening of death, whether they perceived continuous sedation until death as an ‘alternative’ to euthanasia and whether they sought to follow guidelines or frameworks for practice. Conclusion: This qualitative analysis suggests that there is systematic variation in end-of-life care sedation practice and its conceptualization in the United Kingdom, Belgium and the Netherlands. PMID:25062816

  19. Euthanasia Acceptance: An Attitudinal Inquiry.

    Science.gov (United States)

    Klopfer, Fredrick J.; Price, William F.

    The study presented was conducted to examine potential relationships between attitudes regarding the dying process, including acceptance of euthanasia, and other attitudinal or demographic attributes. The data of the survey was comprised of responses given by 331 respondents to a door-to-door interview. Results are discussed in terms of preferred…

  20. Interview

    CERN Multimedia

    Association du personnel

    2007-01-01

    New column in ECHO The editorial team would like to give the â€ワpeople at CERN” the chance to have their say. Through regular interviews, it wishes to highlight the particularities of those who help CERN remain a centre of excellence.

  1. Eutanasia Euthanasia

    Directory of Open Access Journals (Sweden)

    C. R. Gherardi

    2003-01-01

    Full Text Available Los avances de la medicina en el área tecnológica respecto de la aplicación de métodos de soporte vital en el paciente crítico y las modificaciones culturales que se han operado en la sociedad contemporánea con relación al derecho de los pacientes a decidir sobre el final de sus vidas, hacen imprescindible disponer de una definición de eutanasia que atienda la vigencia de este nuevo escenario. La exclusión de las llamadas formas pasivas y en general de la omisión como procedimiento o conducta posible para la provocación de la muerte y la necesidad de la voluntariedad explícita del paciente delimitarían muy concretamente el concepto de eutanasia. Del mismo modo, una referencia concreta sobre el modo de provocar la muerte debería integrar obligatoriamente su definición. Así, la eutanasia significaría básicamente provocar la muerte de un paciente portador de una enfermedad mortal, a su requerimiento y en su propio beneficio, por medio de la administración de un tóxico o veneno en dosis mortal. Esta definición muy restrictiva separaría la eutanasia de los casos de rechazo de tratamiento, aunque se produjera la muerte como resultado del mismo, y también de las situaciones en que la abstención o el retiro de un soporte vital en el paciente crítico permite la llegada de la muerte.Technological progress in medicine regarding the application of life-sustaining treatment in the critical patient and the cultural changes that have taken place in contemporary society with respect to the patients' right to decide over the end of their lives, demand the existence of a definition of euthanasia that will acknowledge this new scenario. The concept of euthanasia would be very specifically limited by the exclusion of so-called passive forms of euthanasia and of omission as a possible procedure to cause death and the need for the explicit request of the patient involved. Likewise, the definition of euthanasia should include a specific

  2. Sample Size and Saturation in PhD Studies Using Qualitative Interviews

    Directory of Open Access Journals (Sweden)

    Mark Mason

    2010-08-01

    Full Text Available A number of issues can affect sample size in qualitative research; however, the guiding principle should be the concept of saturation. This has been explored in detail by a number of authors but is still hotly debated, and some say little understood. A sample of PhD studies using qualitative approaches, and qualitative interviews as the method of data collection was taken from theses.com and contents analysed for their sample sizes. Five hundred and sixty studies were identified that fitted the inclusion criteria. Results showed that the mean sample size was 31; however, the distribution was non-random, with a statistically significant proportion of studies, presenting sample sizes that were multiples of ten. These results are discussed in relation to saturation. They suggest a pre-meditated approach that is not wholly congruent with the principles of qualitative research. URN: urn:nbn:de:0114-fqs100387

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

    Science.gov (United States)

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

    2013-05-01

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

  4. Perspectives of decision-making in requests for euthanasia: A qualitative research among patients, relatives and treating physicians in the Netherlands

    NARCIS (Netherlands)

    Dees, M.K.; Vernooij-Dassen, M.J.F.J.; Dekkers, W.J.M.; Elwyn, G.; Vissers, K.C.P.; Weel, C. van

    2013-01-01

    Background: Euthanasia has been legally performed in the Netherlands since 2002. Respect for patient's autonomy is the underpinning ethical principal. However, patients have no right to euthanasia, and physicians have no obligation to provide it. Although over 3000 cases are conducted per year in

  5. Video elicitation interviews: a qualitative research method for investigating physician-patient interactions.

    Science.gov (United States)

    Henry, Stephen G; Fetters, Michael D

    2012-01-01

    We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants' associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care.

  6. Video Elicitation Interviews: A Qualitative Research Method for Investigating Physician-Patient Interactions

    Science.gov (United States)

    Henry, Stephen G.; Fetters, Michael D.

    2012-01-01

    We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants’ associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care. PMID:22412003

  7. Interview

    DEFF Research Database (Denmark)

    Kvale, Steinar; Brinkmann, Svend

    Interviewet spiller en afgørende rolle i en stor del kvalitativ forskning. Men det er samtidig en kompleks disciplin, der rummer mange faldgruber og kræver fintfølende analytiske kompetencer. I denne bog giver Steinar Kvale og Svend Brinkmann en introduktion til de teoretiske og praktiske aspekte...... disciplin gennem en præsentation af dets syv stadier, hvor forfatterne klæder læseren fagligt på til at planlægge og foretage interviews....

  8. [Suffering at work among medical students: qualitative study using semi-structured interviews].

    Science.gov (United States)

    Le Provost, A-S; Loddé, B; Pietri, J; De Parscau, L; Pougnet, L; Dewitte, J-D; Pougnet, R

    2018-01-01

    Suffering at work among health professionals is a hot topic. Medical students, doctors of tomorrow, are far from being spared. Prevalence of anxiety and mood disorders range from 20.3 to 69 % for the former and from 12 to 30 % for the latter. The purpose of this article is to determine these factors by qualitative research, according to medical students' points of view. It is a qualitative study using semistructured interviews. The analysis is done according to the Grounded Theory. 12 medical students are interviewed. They expressed difficulties at work and positive factors. Three major themes are identified in selective coding: occupational factors, " study " factors and individual factors. All themes are both a source of well-being and ill-being according to the situations specified in the results. Studying medicine includes positive and negative aspects. Abandonment issues, lack of recognition and insufficient coaching emerge from our study. Screening of suffering at work should be systematic for medical students.

  9. Why patients self-refer to the Emergency Department: A qualitative interview study.

    Science.gov (United States)

    Kraaijvanger, Nicole; Rijpsma, Douwe; Willink, Lisa; Lucassen, Peter; van Leeuwen, Henk; Edwards, Michael

    2017-06-01

    There have been multiple studies investigating reasons for patients to self-refer to the Emergency Department (ED). The majority made use of questionnaires and excluded patients with urgent conditions. The goal of this qualitative study is to explore what motives patients have to self-refer to an ED, also including patients in urgent triage categories. In a large teaching hospital in the Netherlands, a qualitative interview study focusing on reasons for self-referring to the ED was performed. Self-referred patients were included until no new reasons for attending the ED were found. Exclusion criteria were as follows: not mentally able to be interviewed or not speaking Dutch. Patients who were in need of urgent care were treated first, before being asked to participate. Interviews followed a predefined topic guide. Practicing cyclic analysis, the interview topic guide was modified during the inclusion period. Interviews were recorded on an audio recorder, transcribed verbatim, and anonymized. Two investigators independently coded the information and combined the codes into meaningful clusters. Subsequently, these were categorized into themes to build a framework of reasons for self-referral to the ED. Characteristic quotes were used to illustrate the acquired theoretical framework. Thirty self-referred patients were interviewed. Most of the participants were male (63%), with a mean age of 46 years. Two main themes emerged from the interviews that are pertinent to the patients' decisions to attend the ED: (1) health concerns and (2) practical issues. This study found that there are 2 clearly distinctive reasons for self-referral to the ED: health concerns or practical motives. Self-referral because of practical motives is probably most suitable for strategies that aim to reduce inappropriate ED visits. © 2016 John Wiley & Sons, Ltd.

  10. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers?

    OpenAIRE

    Shipman Cathy; Gysels Marjolein; Higginson Irene J

    2008-01-01

    Abstract Background Contradictory evidence exists about the emotional burden of participating in qualitative research for palliative care patients and carers and this raises questions about whether this type of research is ethically justified in a vulnerable population. This study aimed to investigate palliative care patients' and carers' perceptions of the benefits and problems associated with open interviews and to understand what causes distress and what is helpful about participation in a...

  11. How do healthcare consumers process and evaluate comparative healthcare information? A qualitative study using cognitive interviews.

    OpenAIRE

    Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.; Groenewegen, P.

    2009-01-01

    Abstract Background To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods Using semi-structured cognitive interviews, interviewees (n = 20) were asked to think aloud and answer questions, as they were prompted with three Dutch web pages providing comparative healthcare information. Results We identified twelve themes fr...

  12. Problematizing qualitative educational research: reading observations and interviews through rhizoanalysis and multiple literacies

    Directory of Open Access Journals (Sweden)

    Diana Masny

    2015-06-01

    Full Text Available This article problematizes conventional qualitative educational research through a process of reading observation and interview in rhizomatic research. Such an approach to doing research brings together Multiple Literacies Theory and rhizoanalysis, innovative practices with transdisciplinary implications. This article contributes to on-going research regarding the emergence of multiple literacies and rhizoanalysis as a way to experiment in disrupting conventional research concepts, in this case, observations and interviews. Rhizoanalysis is proposed because of its non-hierarchical and non-linear perspective to conducting qualitative research. In a similar manner, Multiple Literacies Theory seeks to release school-based literacy from its privileged position and unfold literacy as multiple and non-hierarchical. This theoretical and practical stance to educational research is deployed in an assemblage that includes a study of multiple writing systems with 5- to 8 –year- old multilingual children. Reading observation and interviews through the lens of rhizoanalysis and Multiple Literacies Theory becomes an exploration in reconceptualization of qualitative research.

  13. Strategies in Using a Qualitative Database for the Analysis of Problem-centered Interviews

    Directory of Open Access Journals (Sweden)

    Thomas Kühn

    2000-12-01

    Full Text Available On the basis of several examples from our longitudinal study "Transitions to Employment," dealing with the shaping of biography of young adults and typical transition-patterns from education to employment, we discuss the use of a text databank in the evaluation of problem-centered interviews. First, we explain the structure of the project's "databank of biographical interviews with young adults" which is founded on a thematic and temporarily differentiating system of categories recording job- and family-related actions and orientations. We present different ways of using the databank in qualitative evaluation. The manner how certain cases and categories of the databank are selected and included in the analysis depends on the objective and the problem's complexity. Our examples show that the use of a databank is an important possibility to support the evaluation of qualitative interviews, facilitating a thematic directed access and thus allowing the handling of data which are particularly extensive. URN: urn:nbn:de:0114-fqs0003183

  14. The Use of Videoconferencing as a Medium for the Qualitative Interview

    Directory of Open Access Journals (Sweden)

    Monique Sedgwick RN, PhD

    2009-03-01

    Full Text Available Qualitative data collection, especially conducting in-person interviews, presents challenges for researchers whose participants are geographically dispersed. Often alternative means of interviewing using communication technology are necessary. This was true for this focused ethnographic research exploring the experiences of participants who were connected to a particular cultural group by virtue of their similar experience but who were not located in the same geographical area. The purpose of this paper is to present the experience of using videoconferencing technology to collect experiential data from undergraduate nursing students and preceptors who were dispersed over a 640,000 square kilometer area in western and northern Canada during a rural hospital-based preceptorship. Recommendations for using videoconferencing as a medium for conducting in-depth qualitative interviews include using a high-bandwidth connection such as SuperNet or Web conferencing, and evaluating whether the type of information sought is likely to be shared in other than in-person face-to-face situations.

  15. From challenges to advanced practice registered nursing role development: Qualitative interview study.

    Science.gov (United States)

    Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija

    2015-12-01

    The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.

  16. Euthanasia and criminal law

    OpenAIRE

    Ullrichová, Petra

    2008-01-01

    71 8. Summary- Euthanasia and criminal law Euthanasia is often regarded as a controversial topic that is being discussed all around the world. The legislative rules differ among the countries to various extent. The scope of this work is to offer a summary of legal regulations in euthanasia, particulary in the area of criminal law and a several examples of these regulations in Europe, USA and Australia. In the first chapter, the term of euthanasia is defined which is necessary for the purpose ...

  17. Interviews with the dead: using meta-life qualitative analysis to validate Hippocrates' theory of humours

    Science.gov (United States)

    Secretion, F; Conjur, G S; Attitude, S P

    1998-01-01

    BACKGROUND: Hippocrates devised his theory of the 4 humours (blood, phlegm, black bile and yellow bile) 24 centuries ago. Since then, medicine has evolved into a complex body of confusing and sometimes contradictory facts. The authors, seeing a need to determine the validity of his theory, hired a psychic. METHODS: The psychic interviewed 4 eminent ancient physicians, including Hippocrates. A randomized double-blind cross-over design was used for this meta-life qualitative analysis. RESULTS: All of the interviewees agreed that the theory of humours is an accurate model to explain disease and personality. INTERPRETATION: Hiring a psychic to conduct after-death interviews with key informants is a useful way to validate scientific theories. PMID:9875254

  18. Attitudes toward euthanasia among Swedish medical students.

    Science.gov (United States)

    Karlsson, Marit; Strang, Peter; Milberg, Anna

    2007-10-01

    Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and fifth-year medical students. Data were analysed using qualitative content analysis with no predetermined categories. The students' arguments opposing euthanasia were based on opinions of 1. euthanasia being morally wrong, 2. fear of possible negative effects on society, 3. euthanasia causing strain on physicians and 4. doubts about the true meaning of requests of euthanasia from patients. Arguments supporting euthanasia were based on 1. patients' autonomy and 2. the relief of suffering, which could be caused by severe illnesses, reduced integrity, hopelessness, social factors and old age. There are several contradictions in the students' arguments and the results indicate a possible need for education focusing on the possibility of symptom control in palliative care and patients' perceived quality of life.

  19. Sample size and saturation in PhD studies using qualitative interviews

    OpenAIRE

    Mason, Mark

    2010-01-01

    Sample-Größen sind in qualitativen Forschungsarbeiten von verschiedenen Einflüssen abhängig. Das Leitprinzip sollte jedoch immer die Sättigung, bezogen auf das jeweilige Forschungsthema sein. Diese Frage, mit der sich viele Autor/innen beschäftigt haben, wird weiter heiß diskutiert und – so einige – kaum hinreichend verstanden. Für eine eigene Untersuchung habe ich ein Sample von PhD-Studien, in denen qualitative Interviews als Erhebungsmethode genutzt wurde, aus theses.com gezogen und ...

  20. From the world of children to the world of adults - a qualitative interview study

    DEFF Research Database (Denmark)

    Raunsbæk Knudsen, Line; Bjerrum, Merete

    using inductive content analysis. Results: Seven main categories described experiences with transition: The first encounter with the adult ward, The experience of an inadequate preparation for the transition, Differences between the child and adult world, The impression of and collaboration with doctors...... on transition for adolescents with JIA. Objectives: To explore the transition from the paediatric to the adult setting from the perspective of adolescents with JIA, and to discover important factors in successful transition. Methods: Qualitative interviews with three adolescents with JIA. Data was analysed...

  1. How do patients at risk portray candidates for coronary heart disease? A qualitative interview study

    DEFF Research Database (Denmark)

    Frich, J.C.; Malterud, K.; Fugelli, P.

    2007-01-01

    OBJECTIVE: To explore how patients at risk of coronary heart disease (CHD) portray candidates for CHD. DESIGN: Qualitative interview study. SETTING: Norway. SUBJECTS: A total of 20 men and 20 women diagnosed with heterozygous familial hypercholesterolemia (FH) recruited through a lipid clinic. MAIN...... considered their notions to be valid for assessing people's risk of CHD, others questioned how valid their notions were. CONCLUSION: Doctors should recognize that distancing is a way patients cope with risk and that such a strategy may have psychological and moral reasons. When communicating about risk...

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

    Science.gov (United States)

    Mazanderani, Fadhila; Paparini, Sara

    2015-04-01

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

  3. Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study.

    Science.gov (United States)

    Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna; Andrade, Jackie

    2018-05-03

    Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. The aim of this study was to explore participants' qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot's head sensor. Evaluations were content-analyzed utilizing Boyatzis' steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for change. Some participants felt that the

  4. Experiences of a Motivational Interview Delivered by a Robot: Qualitative Study

    Science.gov (United States)

    Galvão Gomes da Silva, Joana; Kavanagh, David J; Belpaeme, Tony; Taylor, Lloyd; Beeson, Konna

    2018-01-01

    Background Motivational interviewing is an effective intervention for supporting behavior change but traditionally depends on face-to-face dialogue with a human counselor. This study addressed a key challenge for the goal of developing social robotic motivational interviewers: creating an interview protocol, within the constraints of current artificial intelligence, which participants will find engaging and helpful. Objective The aim of this study was to explore participants’ qualitative experiences of a motivational interview delivered by a social robot, including their evaluation of usability of the robot during the interaction and its impact on their motivation. Methods NAO robots are humanoid, child-sized social robots. We programmed a NAO robot with Choregraphe software to deliver a scripted motivational interview focused on increasing physical activity. The interview was designed to be comprehensible even without an empathetic response from the robot. Robot breathing and face-tracking functions were used to give an impression of attentiveness. A total of 20 participants took part in the robot-delivered motivational interview and evaluated it after 1 week by responding to a series of written open-ended questions. Each participant was left alone to speak aloud with the robot, advancing through a series of questions by tapping the robot’s head sensor. Evaluations were content-analyzed utilizing Boyatzis’ steps: (1) sampling and design, (2) developing themes and codes, and (3) validating and applying the codes. Results Themes focused on interaction with the robot, motivation, change in physical activity, and overall evaluation of the intervention. Participants found the instructions clear and the navigation easy to use. Most enjoyed the interaction but also found it was restricted by the lack of individualized response from the robot. Many positively appraised the nonjudgmental aspect of the interview and how it gave space to articulate their motivation for

  5. Social Network Analysis and Qualitative Interviews for Assessing Geographic Characteristics of Tourism Business Networks.

    Directory of Open Access Journals (Sweden)

    Ilan Kelman

    Full Text Available This study integrates quantitative social network analysis (SNA and qualitative interviews for understanding tourism business links in isolated communities through analysing spatial characteristics. Two case studies are used, the Surselva-Gotthard region in the Swiss Alps and Longyearbyen in the Arctic archipelago of Svalbard, to test the spatial characteristics of physical proximity, isolation, and smallness for understanding tourism business links. In the larger Surselva-Gotthard region, we found a strong relationship between geographic separation of the three communities on compartmentalization of the collaboration network. A small set of businesses played a central role in steering collaborative decisions for this community, while a group of structurally 'peripheral' actors were less influential. By contrast, the business community in Svalbard showed compartmentalization that was independent of geographic distance between actors. Within towns of similar size and governance scale, Svalbard is more compartmentalized, and those compartments are not driven by geographic separation of the collaboration clusters. This compartmentalization in Svalbard was reflected in a lower density of formal business collaboration ties compared to the communities of the Alps. We infer that the difference is due to Svalbard having higher cultural diversity and population turnover than the Alps communities. We propose that integrating quantitative network analysis from simple surveys with qualitative interviews targeted from the network results is an efficient general approach to identify regionally specific constraints and opportunities for effective governance.

  6. Social Network Analysis and Qualitative Interviews for Assessing Geographic Characteristics of Tourism Business Networks.

    Science.gov (United States)

    Kelman, Ilan; Luthe, Tobias; Wyss, Romano; Tørnblad, Silje H; Evers, Yvette; Curran, Marina Martin; Williams, Richard J; Berlow, Eric L

    2016-01-01

    This study integrates quantitative social network analysis (SNA) and qualitative interviews for understanding tourism business links in isolated communities through analysing spatial characteristics. Two case studies are used, the Surselva-Gotthard region in the Swiss Alps and Longyearbyen in the Arctic archipelago of Svalbard, to test the spatial characteristics of physical proximity, isolation, and smallness for understanding tourism business links. In the larger Surselva-Gotthard region, we found a strong relationship between geographic separation of the three communities on compartmentalization of the collaboration network. A small set of businesses played a central role in steering collaborative decisions for this community, while a group of structurally 'peripheral' actors were less influential. By contrast, the business community in Svalbard showed compartmentalization that was independent of geographic distance between actors. Within towns of similar size and governance scale, Svalbard is more compartmentalized, and those compartments are not driven by geographic separation of the collaboration clusters. This compartmentalization in Svalbard was reflected in a lower density of formal business collaboration ties compared to the communities of the Alps. We infer that the difference is due to Svalbard having higher cultural diversity and population turnover than the Alps communities. We propose that integrating quantitative network analysis from simple surveys with qualitative interviews targeted from the network results is an efficient general approach to identify regionally specific constraints and opportunities for effective governance.

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

    Science.gov (United States)

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

    2016-04-01

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

  8. Social Network Analysis and Qualitative Interviews for Assessing Geographic Characteristics of Tourism Business Networks

    Science.gov (United States)

    Luthe, Tobias; Wyss, Romano; Tørnblad, Silje H.; Evers, Yvette; Curran, Marina Martin; Williams, Richard J.; Berlow, Eric L.

    2016-01-01

    This study integrates quantitative social network analysis (SNA) and qualitative interviews for understanding tourism business links in isolated communities through analysing spatial characteristics. Two case studies are used, the Surselva-Gotthard region in the Swiss Alps and Longyearbyen in the Arctic archipelago of Svalbard, to test the spatial characteristics of physical proximity, isolation, and smallness for understanding tourism business links. In the larger Surselva-Gotthard region, we found a strong relationship between geographic separation of the three communities on compartmentalization of the collaboration network. A small set of businesses played a central role in steering collaborative decisions for this community, while a group of structurally ‘peripheral’ actors were less influential. By contrast, the business community in Svalbard showed compartmentalization that was independent of geographic distance between actors. Within towns of similar size and governance scale, Svalbard is more compartmentalized, and those compartments are not driven by geographic separation of the collaboration clusters. This compartmentalization in Svalbard was reflected in a lower density of formal business collaboration ties compared to the communities of the Alps. We infer that the difference is due to Svalbard having higher cultural diversity and population turnover than the Alps communities. We propose that integrating quantitative network analysis from simple surveys with qualitative interviews targeted from the network results is an efficient general approach to identify regionally specific constraints and opportunities for effective governance. PMID:27258007

  9. The meaning and experience of bereavement support: A qualitative interview study of bereaved family caregivers.

    Science.gov (United States)

    Kirby, Emma; Kenny, Katherine; Broom, Alex; MacArtney, John; Good, Phillip

    2017-06-21

    Experiences of bereavement can be stressful and are frequently complicated by emotional, familial, and financial issues. Some-though not all-caregivers may benefit from bereavement support. While considered standard within palliative care services in Australia, bereavement support is not widely utilized by family caregivers. There is little research focused on the forms of bereavement support desired or required by family caregivers, how such care is viewed, and/or how bereavement support is experienced. This study examined the experiences of bereaved family caregivers and their impressions of and interactions with bereavement support. This paper reports on one aspect of a broader study designed to explore a range of experiences of patients and caregivers to and through palliative care. Focusing on experiences of bereavement, it draws on qualitative semistructured interviews with 15 family caregivers of palliative care patients within a specialist palliative care unit of an Australian metropolitan hospital. The interviews for this stage of the study were initiated 3-9 months after an initial interview with a family caregiver, during which time the palliative patient had died, and they covered family caregivers' experiences of bereavement and bereavement support. Interviews were digitally audiotaped and transcribed in full. A thematic analysis was conducted utilizing the framework approach wherein interview transcripts were reviewed, key themes identified, and explanations developed. The research identified four prevalent themes: (1) sociocultural constructions of bereavement support as for the incapable or socially isolated; (2) perceptions of bereavement support services as narrow in scope; (3) the "personal" character of bereavement and subsequent incompatibility with formalized support, and (4) issues around the timing and style of approaches to being offered support. Systematic pre-bereavement planning and careful communication about the services offered by

  10. InterviewStreamliner, a minimalist, free, open source, relational approach to computer-assisted qualitative data analysis software

    NARCIS (Netherlands)

    H.D. Pruijt (Hans)

    2010-01-01

    textabstractInterviewStreamliner is a free, open source, minimalist alternative to complex computer-assisted qualitative data analysis packages. It builds on the flexibility of relational database management technology.

  11. What factors influence the production of orthopaedic research in East Africa? A qualitative analysis of interviews.

    Science.gov (United States)

    Elliott, Iain S; Sonshine, Daniel B; Akhavan, Sina; Slade Shantz, Angelique; Caldwell, Amber; Slade Shantz, Jesse; Gosselin, Richard A; Coughlin, R Richard

    2015-06-01

    Research addressing the burden of musculoskeletal disease in low- and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low- and middle-income countries. We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the

  12. Factors associated with Taiwanese lesbians' breast health-care behavior and intentions: Qualitative interview findings.

    Science.gov (United States)

    Wang, Ya-Ching; Griffiths, Jane; Grande, Gunn

    2017-09-01

    This article presents the qualitative findings of a mixed-methods study that explored factors influencing lesbians' breast health-care behavior and intentions. A total of 37 semi-structured face-to-face interviews were conducted among women who self-identified as lesbians or women who partnered with the same gender who were aged 20 years or above in four areas of Taiwan (North, Central, South, and East Taiwan) between August 2012 and October 2012. Interviews were audio recorded with participants' consent. The interviews were analyzed using constant comparative analysis with Nvivo audio-coding support. Four themes were identified to be strongly associated with the lesbians' breast health-care behavior and their intentions, namely, gender identity, gender role expression, partners' support, and concerns about health-care providers' reactions. Important barriers to the women's breast health-care behavior and intentions were masculine identity ("T-identity" in Taiwan), masculine appearance, concerns about health-care providers' lack of knowledge of multiple gender diversity, and their attitudes toward lesbians. Conversely, their partners' support was a factor facilitating the women's breast health-care behavior and intentions, particularly for the T-identity lesbians. These findings suggest the significance of and need for culturally competent care and are important for improving Taiwanese lesbians' breast health.

  13. Parental views on childhood vaccination against viral gastroenteritis-a qualitative interview study.

    Science.gov (United States)

    Lugg, Fiona V; Butler, Christopher C; Evans, Meirion R; Wood, Fiona; Francis, Nick A

    2015-08-01

    Gastroenteritis (GE) causes significant morbidity, especially in young children. A vaccine against rotavirus, a common cause of viral GE (vGE), was added to the childhood immunization schedule in the UK in July 2013 and further related vaccines are under development. To explore parents' beliefs about vGE and their attitudes towards vaccinating. Qualitative interview study with parents of children who had recently experienced an episode of GE. Twenty-eight semi-structured interviews were conducted over the phone with parents. Interviews were audio-recorded, transcribed and analysed using standard thematic approaches. Parents varied in their perception of the threat posed by GE, and parents who did not perceive GE as serious were less enthusiastic about vaccines. Other parents were supportive of vaccines in general and considered benefits to their child, their family and the wider community. Many parents said that they lacked knowledge about efficacy and effectiveness of GE vaccines but their underlying belief about the seriousness of illness motivated their attitudes. Acceptability of GE vaccines to parents could be improved by providing more information on both the burden of illness and the impact of rotavirus vaccine in other comparable countries. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach.

    Science.gov (United States)

    Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; Schermer, Maartje H N; van Thiel, Ghislaine J M W; Trappenburg, Margo J; van de Vathorst, Suzanne; van der Vegt, Bea J; Vezzoni, Cristiano; Weyers, Heleen; van Tol, Donald G; van der Heide, Agnes

    2013-03-01

    The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed. To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS. A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed. Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act. Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.

  15. Qualitative analysis of interviews of future non-affective psychotic disorder patients and non-psychiatric controls: preliminary results

    Directory of Open Access Journals (Sweden)

    Katya Rubinstein

    2014-03-01

    Conclusions: The findings of this unique historical-prospective qualitative analysis of interviews performed before the onset of psychosis, confirmed previous findings of premorbid abnormality of future non-affective psychosis patients. Using qualitative analysis enabled obtaining a more in-depth understanding of the real-life experience of the premorbid period among patients with non-affective psychotic disorders.

  16. Prescribing of Electronic Activity Monitors in Cardiometabolic Diseases: Qualitative Interview-Based Study.

    Science.gov (United States)

    Bellicha, Alice; Macé, Sandrine; Oppert, Jean-Michel

    2017-09-23

    The prevalence of noncommunicable diseases, including those such as type 2 diabetes, obesity, dyslipidemia, and hypertension, so-called cardiometabolic diseases, is high and is increasing worldwide. Strong evidence supports the role of physical activity in management of these diseases. There is general consensus that mHealth technology, including electronic activity monitors, can potentially increase physical activity in patients, but their use in clinical settings remains limited. Practitioners' requirements when prescribing electronic activity monitors have been poorly described. The aims of this qualitative study were (1) to explore how specialist physicians prescribe electronic activity monitors to patients presenting with cardiometabolic conditions, and (2) to better understand their motivation for and barriers to prescribing such monitors. We conducted qualitative semistructured interviews in March to May 2016 with 11 senior physicians from a public university hospital in France with expertise in management of cardiometabolic diseases (type 1 and type 2 diabetes, obesity, hypertension, and dyslipidemia). Interviews lasted 45 to 60 minutes and were audiotaped, transcribed verbatim, and analyzed using directed content analysis. We report our findings following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Most physicians we interviewed had never prescribed electronic activity monitors, whereas they frequently prescribed blood glucose or blood pressure self-monitoring devices. Reasons for nonprescription included lack of interest in the data collected, lack of evidence for data accuracy, concern about work overload possibly resulting from automatic data transfer, and risk of patients becoming addicted to data. Physicians expected future marketing of easy-to-use monitors that will accurately measure physical activity duration and intensity and provide understandable motivating feedback. Features of electronic activity monitors

  17. The experience of sleep in chronic fatigue syndrome: A qualitative interview study with patients.

    Science.gov (United States)

    Gotts, Zoe M; Newton, Julia L; Ellis, Jason G; Deary, Vincent

    2016-02-01

    Sleep disturbances are common in chronic fatigue syndrome (CFS), and one of the key symptom complaints, yet it has been neglected by previous qualitative research. The aim was to explore the specific role of sleep in patients' experience of their illness. A qualitative semi-structured interview format facilitated a detailed and open exploration of sleep, and the extent to which its management and problems were linked to the lived experience of CFS. Eleven semi-structured interviews were conducted with individuals with CFS. Data were transcribed verbatim and analysed thematically, to explore and describe patients' experience of their sleep, and its impact on their condition. Sleep emerged as a key aspect of the illness experience, and its management and effect on daytime functioning was a central pre-occupation for all 11 participants; all of them saw sleep as playing a critical role in their illness through either maintaining or exacerbating existing symptoms. Exploration of individual experiences presented three overarching themes: (1) sleep pattern variability over illness course and from day to day; (2) effect of sleep on daytime functioning; and (3) attempts at coping and sleep management. Each patient with CFS has a unique experience of sleep. Despite the differing narratives regarding the role of sleep in CFS, all participants held the belief that sleep is a vital process for health and well-being which has had a direct bearing on the course and progression of their CFS. Also, every participant regarded their sleep as in some way 'broken' and in need of management/repair. Patients' insights demonstrate sleep-specific influences on their CFS, and the impact of disturbed sleep should be a consideration for clinical and research work. What is already known on this subject? Sleep disturbances are common in CFS, and one of the key symptom complaints, yet it has been neglected by previous qualitative research. Ontology of CFS is a matter of dispute, with models

  18. Usability of geographic information -- factors identified from qualitative analysis of task-focused user interviews.

    Science.gov (United States)

    Harding, Jenny

    2013-11-01

    Understanding user needs for geographic information and the factors which influence the usability of such information in diverse user contexts is an essential part of user centred development of information products. There is relatively little existing research focused on the design and usability of information products in general. This paper presents a research approach based on semi structured interviews with people working with geographic information on a day to day basis, to establish a reference base of qualitative data on user needs for geographic information with respect to context of use. From this reference data nine key categories of geographic information usability are identified and discussed in the context of limited existing research concerned with geographic information usability. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  19. Walking the walk? Community participation in HIA A qualitative interview study

    International Nuclear Information System (INIS)

    Kearney, Matthew

    2004-01-01

    Although community participation is seen as central to the practice of health impact assessment (HIA), effective engagement of local people is notoriously difficult to achieve and risks being tokenistic. This qualitative study, set in a deprived estate in northwest England, examined how community participation in the proposed HIA of a Regeneration Masterplan would be affected by the attitudes and experiences of key stakeholders. In-depth interviews were conducted with 12 stakeholders drawn from officials, representatives and local residents linked to the regeneration programme. The results suggest that there may be a large gap between professional rhetoric and the reality of community participation, and that barriers to community participation in HIA may be substantial and institutionalised. If these barriers are to be overcome, it is essential to acknowledge the existence of this rhetoric-reality gap and to address the training and resource needs of both professionals and community members

  20. Experiences of intervertebral motion palpation in osteopathic practice - A qualitative interview study among Swedish osteopaths.

    Science.gov (United States)

    Sposato, Niklas S; Bjerså, Kristofer

    2017-01-01

    Assessment in manual therapy includes quantitative and qualitative procedures, and intervertebral motion palpation (IMP) is one of the core assessment methods in osteopathic practice. The aim of this study was to explore osteopathic practitioners' experiences of clinical decision-making and IMP as a diagnostic tool for planning and evaluation of osteopathic interventions. The study was conducted with semi-structured interviews that included eight informants. Content analysis was used as the analytical procedure. In total, three categories emerged from the analysis: strategic decision-making, diagnostic usability of IMP, and treatment applicability of IMP. The study indicated that IMP was considered relevant and was given particular importance in cases where IMP findings confirmed clinical information attained from other stages in the diagnostic process as a whole. However, IMP findings were experienced as less important if they were not correlated to other findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. The patient's perspective on the link between ADHD and substance use: a qualitative interview study.

    Science.gov (United States)

    Nehlin, Christina; Nyberg, Fred; Öster, Caisa

    2015-04-01

    The primary aim of this study was to investigate how adult individuals with ADHD perceive the role of alcohol and drugs in their lives. A secondary aim was to identify factors that those individuals consider useful in the treatment and prevention of co-occurring ADHD and substance use disorders (SUDs). A qualitative interview study with ADHD outpatients (n = 14) at a psychiatric clinic. Data were analyzed based on pre-defined areas of interest using a deductive content analysis method. The yearning for belongingness was identified as an important driving force underlying substance use. The participants felt that alcohol/drugs helped them being normal and thus respected and accepted. Early diagnosis of ADHD was perceived essential to avoid SUD. Adults with ADHD may have strong rational and emotional reasons for the use of alcohol and drugs. When planning for the treatment of adult ADHD, investigation of personal reasons for alcohol/drug use deserves a place. © 2014 SAGE Publications.

  2. The qualitative interview and challenges for clinicians undertaking research: a personal reflection.

    Science.gov (United States)

    Fisher, Karin

    2011-01-01

    Drawing on my doctoral experience the aim of this article is to present my transition from practitioner to novice researcher and the challenges I encountered when undertaking qualitative in-depth interviews. The contents of my research diary were coded for words, sentences and paragraphs and were then grouped into themes and subsequently organised into concepts and categories. The analysis identified one core category: 'changing states: learning to become a researcher'. The related categories included 'guessing responses', 'confusing boundaries' and 'revealing hidden concepts'. These concepts provide a description of how I learnt to become a researcher and became a changed state. The paper provides practitioners with practical examples of my transition from practitioner to novice researcher. I offer some tips for practitioners who wish to undertake research in their clinical role.

  3. Pediatric advance care planning from the perspective of health care professionals: a qualitative interview study.

    Science.gov (United States)

    Lotz, Julia D; Jox, Ralf J; Borasio, Gian Domenico; Führer, Monika

    2015-03-01

    Pediatric advance care planning differs from the adult setting in several aspects, including patients' diagnoses, minor age, and questionable capacity to consent. So far, research has largely neglected the professionals' perspective. We aimed to investigate the attitudes and needs of health care professionals with regard to pediatric advance care planning. This is a qualitative interview study with experts in pediatric end-of-life care. A qualitative content analysis was performed. We conducted 17 semi-structured interviews with health care professionals caring for severely ill children/adolescents, from different professions, care settings, and institutions. Perceived problems with pediatric advance care planning relate to professionals' discomfort and uncertainty regarding end-of-life decisions and advance directives. Conflicts may arise between physicians and non-medical care providers because both avoid taking responsibility for treatment limitations according to a minor's advance directive. Nevertheless, pediatric advance care planning is perceived as helpful by providing an action plan for everyone and ensuring that patient/parent wishes are respected. Important requirements for pediatric advance care planning were identified as follows: repeated discussions and shared decision-making with the family, a qualified facilitator who ensures continuity throughout the whole process, multi-professional conferences, as well as professional education on advance care planning. Despite a perceived need for pediatric advance care planning, several barriers to its implementation were identified. The results remain to be verified in a larger cohort of health care professionals. Future research should focus on developing and testing strategies for overcoming the existing barriers. © The Author(s) 2014.

  4. Family Caregivers' Reflections on Experiences of Assisted Suicide in Switzerland: A Qualitative Interview Study.

    Science.gov (United States)

    Gamondi, C; Pott, Murielle; Preston, Nancy; Payne, Sheila

    2018-04-01

    Thousands of family members worldwide are annually involved in assisted dying. Family participation in assisted dying has rarely been investigated and families' needs typically are not considered in assisted dying legislation and clinical guidelines. To explore family caregivers' reflections on experiences of assisted suicide in Switzerland. A cross-sectional qualitative interview study conducted in the Italian- and French-speaking regions of Switzerland. Interpretation and analysis were performed using qualitative content analysis. Twenty-eight close relatives and family carers of 18 patients who died by assisted suicide in Switzerland were interviewed. Family members perceived their involvement in assisted suicide as characterized by five phases; 1) contemplation, 2) gaining acceptance, 3) gaining permission, 4) organization, and 5) aftermath. Families can participate in these phases at diverse levels and with varying degrees of involvement. Important triggers for families and patients for transition between phases include patients' experiences of their life-threatening illnesses and related treatments, their increasing awareness of approaching death, and family member recognition of their loved one's unbearable suffering. Participating in assisted suicide created further demanding tasks for families in addition to their role of caregivers. Families appeared to be involved in the preparation of assisted suicide along with patients, irrespective of their personal values regarding assisted dying. Support for family members is essential if they are involved in tasks preparatory to assisted suicide. Clinical guidelines and policies concerning assisted dying should acknowledge and address family needs. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. GP views on strategies to cope with increasing workload: a qualitative interview study.

    Science.gov (United States)

    Fisher, Rebecca Fr; Croxson, Caroline Hd; Ashdown, Helen F; Hobbs, Fd Richard

    2017-02-01

    The existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative. To explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each. Semi-structured, qualitative interviews with GPs working within NHS England. All GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum-variation sample was selected and interviewed until data saturation was reached. Data were analysed thematically. Responses were received from 171 GPs, and, from these, 34 were included in the study. Four main themes emerged for workload management: patient-level, GP-level, practice-level, and systems-level strategies. A need for patients to take greater responsibility for self-management was clear, but many felt that GPs should not be responsible for this education. Increased delegation of tasks was felt to be key to managing workload, with innovative use of allied healthcare professionals and extended roles for non-clinical staff suggested. Telephone triage was a commonly used tool for managing workload, although not all participants found this helpful. This in-depth qualitative study demonstrates an encouraging resilience among GPs. They are proactively trying to manage workload, often using innovative local strategies. GPs do not feel that they can do this alone, however, and called repeatedly for increased recruitment and more investment in primary care. © British Journal of General Practice 2017.

  6. Unmarried women's decisions on pregnancy termination: Qualitative interviews in Colombo, Sri Lanka.

    Science.gov (United States)

    Olsson, Pia; Wijewardena, Kumudu

    2010-11-01

    In Sri Lanka pregnancy termination is very restricted by law and social norms. Premarital sex, and pregnancies are not generally accepted and unmarried pregnant women are vulnerable in their decision-making on pregnancy termination. The objective of this study was to describe the circumstances of becoming pregnant and factors considered in the decision-making for seeking pregnancy termination in a sample of unmarried women in Colombo, Sri Lanka. Individual qualitative interviews were conducted with 19 unmarried women seeking pregnancy terminations at a reproductive health centre in Colombo, Sri Lanka. The interviews were later analysed using qualitative content analysis. Becoming pregnant in a love relationship was predominant in this sample. Awareness of contraceptives varied and initial reaction to the pregnancy involved strong contradictory emotions. Multiple interrelated factors were considered in the decision-making for termination. Family pressure was the most prominent factor followed by the partner's qualities and attitude towards the pregnancy, economic factors and own feelings, values and future fertility. The women described that their own emotional, religious and economic reasons for continuing the pregnancy were often outweighed by their responsibility to the family, male partner and unborn child. These unmarried women's sexual and reproductive rights were limited and for many the pregnancy termination was socially unsafe. They found themselves at the interface of two value systems. Modern values allow for relationships with men prior to marriage; whereas, traditional values did not. The limited possibilities to prevent pregnancies and little hope for support if continuing the pregnancy; made women seek pregnancy termination despite own doubts. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Movie making as a cognitive distraction for paediatric patients receiving radiotherapy treatment: qualitative interview study.

    Science.gov (United States)

    Shrimpton, Bradley J M; Willis, David J; Tongs, Cáthal D; Rolfo, Aldo G

    2013-01-16

    To establish the outcomes achieved by using an innovative movie-making programme designed to reduce fear of radiotherapy among paediatric patients. Qualitative descriptive evaluation based on semistructured, qualitative interviews with purposeful sampling and thematic analysis. Tertiary Cancer Centre. 20 parents of paediatric patients who had produced a movie of their radiation therapy experience and were in a follow-up phase of cancer management. Participants attributed a broad range of outcomes to the movie-making program. These included that the programme had helped reduce anxiety and distress exhibited by paediatric patients and contributed to a willingness to receive treatment. Other outcomes were that the completed movies had been used in school reintegration and for maintaining social connections. Allowing children to create a video of their experience of radiotherapy provided a range of benefits to paediatric patients that varied according to their needs. For some patients, movie-making offered a valuable medium for overcoming fear of the unknown as well as increasing understanding of treatment processes. For others, the development of a personalised video offered an important cognitive/attentional distraction through engaging with an age-appropriate activity. Together these outcomes helped children maintain self-control and a positive outlook.

  8. Is counselling necessary? Making the decision to have an abortion. A qualitative interview study.

    Science.gov (United States)

    Brown, Sally

    2013-02-01

    To explore young women's decision-making about having an abortion, in particular, how they reached the decision and with whom they discussed it. Qualitative study comprising semi-structured one-to-one interviews with 24 women aged between 16 and 20 who were waiting for, or had recently had, a surgical abortion. Interviews were recorded with the consent of the interviewees, fully transcribed, and analysed using a grounded theory approach. All but one of the women had been offered counselling; one could not remember. Only two had accepted the offer of counselling, most feeling that it was unnecessary. The majority of these young women had decided that they wanted an abortion before accessing health services to request one. They had discussed their decision with someone close to them and did not feel the need to have further discussions with counsellors. Most young women have already made the decision to have an abortion before they approach their GP or a family planning clinic to request one. At present, counselling is voluntary in the UK. Requiring women to undergo couanselling would delay the process and for most women would be an unnecessary burden, whilst also diverting resources from those women who require counselling.

  9. Meta-analysis, complexity, and heterogeneity: a qualitative interview study of researchers’ methodological values and practices

    Directory of Open Access Journals (Sweden)

    Theo Lorenc

    2016-11-01

    Full Text Available Abstract Background Complex or heterogeneous data pose challenges for systematic review and meta-analysis. In recent years, a number of new methods have been developed to meet these challenges. This qualitative interview study aimed to understand researchers’ understanding of complexity and heterogeneity and the factors which may influence the choices researchers make in synthesising complex data. Methods We conducted interviews with a purposive sample of researchers (N = 19 working in systematic review or meta-analysis across a range of disciplines. We analysed data thematically using a framework approach. Results Participants reported using a broader range of methods and data types in complex reviews than in traditional reviews. A range of techniques are used to explore heterogeneity, but there is some debate about their validity, particularly when applied post hoc. Conclusions Technical considerations of how to synthesise complex evidence cannot be isolated from questions of the goals and contexts of research. However, decisions about how to analyse data appear to be made in a largely informal way, drawing on tacit expertise, and their relation to these broader questions remains unclear.

  10. [Recognition and communication of early preventive services in obstetrics : A qualitative interview study with parents].

    Science.gov (United States)

    Prüßmann, Christiane; Stindt, Daniela; Brunke, Jana; Klinkhammer, Ursula; Thyen, Ute

    2016-10-01

    The perception of patients' needs of support and sensitive communication about psychosocial stress all represent new, exacting tasks for nursing staff, midwives, social workers and physicians in obstetrics. As part of Good Start into the Family (GuStaF), a learning and teaching project in a university hospital, we were able to interview parents about their experiences with the intervention. Evaluation of the process of establishing contacts, the communication with professionals in obstetrics and the support offered from the perspective of parents. Qualitative guided interviews with seven families one year after the delivery. Problem areas reported by parents were predominately related to increased parental care and the feeling of being overwhelmed in addition to social stress. Core themes in communication addressed the entry into conversations, which was remembered negatively when advice was perceived as improper, patronizing or stigmatizing, and positively when professionals had listened sensitively and had provided tangible support. Some conversations increased stress. Relating to assistance and support, parents reported both positive and negative experiences. Justness and reliability emerged as particularly important topics. The attendance of families around the time of the delivery poses varying demands upon the hospital staff, not necessarily in keeping with traditional professional attitudes and competencies. Careful attention to the personal physical and emotional well-being of mothers and newborns, non-stigmatizing entry into the conversations, justness of the support and avoiding inconsistencies within the institution and the network all appear to be of great importance.

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

    Science.gov (United States)

    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.

  12. What does physicians' clinical expertise contribute to oncologic decision-making? A qualitative interview study.

    Science.gov (United States)

    Salloch, Sabine; Otte, Ina; Reinacher-Schick, Anke; Vollmann, Jochen

    2018-02-01

    Physicians' clinical expertise forms an exclusive body of competences, which helps them to find the appropriate diagnostics and treatment for each individual patient. Empirical evidence, however, suggests that there is an inverse relationship between the number of years in practice and the quality of care provided by a physician. Knowledge and adherence to professional standards (such as clinical guidelines) are often used as indicators in previous research. Semistructured interviews and the Q method were used for an explorative study on oncologists' views on the interplay between their own clinical expertise, intuition, and the external evidence incorporated in clinical guidelines. The interviews were audio recorded, transcribed ad verbatim, and analysed using qualitative content analysis. Data analysis shows the complex character of clinical expertise with respect to experience, professional development, and intuition. An irreplaceable role is attributed to personal and bodily experience during the providing of care for a patient. Professional experience becomes important, particularly in those situations that lie out of the focus of "guideline medicine." Intuition is regarded as having a strong emotional component and helps for deciding which therapeutic option the patient can deal with. Using measurable knowledge and adherence to standards as indicators does not account for the complexity of clinical expertise. Other factors, such as the importance of bodily experience and physicians' intuitive knowledge, must be considered, also with respect to the occurrence of treatment biases. © 2017 John Wiley & Sons, Ltd.

  13. Meta-analysis, complexity, and heterogeneity: a qualitative interview study of researchers' methodological values and practices.

    Science.gov (United States)

    Lorenc, Theo; Felix, Lambert; Petticrew, Mark; Melendez-Torres, G J; Thomas, James; Thomas, Sian; O'Mara-Eves, Alison; Richardson, Michelle

    2016-11-16

    Complex or heterogeneous data pose challenges for systematic review and meta-analysis. In recent years, a number of new methods have been developed to meet these challenges. This qualitative interview study aimed to understand researchers' understanding of complexity and heterogeneity and the factors which may influence the choices researchers make in synthesising complex data. We conducted interviews with a purposive sample of researchers (N = 19) working in systematic review or meta-analysis across a range of disciplines. We analysed data thematically using a framework approach. Participants reported using a broader range of methods and data types in complex reviews than in traditional reviews. A range of techniques are used to explore heterogeneity, but there is some debate about their validity, particularly when applied post hoc. Technical considerations of how to synthesise complex evidence cannot be isolated from questions of the goals and contexts of research. However, decisions about how to analyse data appear to be made in a largely informal way, drawing on tacit expertise, and their relation to these broader questions remains unclear.

  14. Audiology Students' Perspectives of Enacting and Learning Clinical Communication: A Qualitative Interview and Video Reflexivity Study.

    Science.gov (United States)

    Tai, Samantha; Woodward-Kron, Robyn; Barr, Caitlin

    2018-03-27

    Effective clinical communication is pivotal to the provision of quality hearing health care. To date, audiology students reportedly felt ill-prepared when counseling patients about their hearing impairment, yet there is a paucity of studies exploring how clinical communication is taught and learned in audiology programs. Thus, the aims of the study were (a) to explore final year audiology students' perspectives of their own clinical communication skills during an in-house university clinical placement and (b) to explore students' perceptions of their clinical communication education. Using a qualitative description approach, students were asked to coview their filmed clinical encounter using video reflexivity during a semistructured interview on clinical communication education. Fifteen final year graduate audiology students from The University of Melbourne, Australia, participated in the study. The interviews were audio-recorded and analyzed thematically. The overarching themes of striving to be patient-centered, assessment shapes behavior, and power relations emerged from students' reflection of their own clinical encounter. In addition, the theme what students want described the perceived teaching methods that assisted students' clinical communication practices. The findings of this study highlight the challenges that students perceived during their clinical placement as they strive to enact a patient-centered interaction. An assessment rubric that incorporates communication skills can provide greater opportunities for feedback and self-reflection. Additionally, clinical communication education that adopts experiential learning and is longitudinally integrated into the curriculum can further reinforce students' communication learning needs.

  15. Critical environmental factors for transportation cycling in children: a qualitative study using bike-along interviews.

    Science.gov (United States)

    Ghekiere, Ariane; Van Cauwenberg, Jelle; de Geus, Bas; Clarys, Peter; Cardon, Greet; Salmon, Jo; De Bourdeaudhuij, Ilse; Deforche, Benedicte

    2014-01-01

    Environmental factors are found to influence transport-related physical activity, but have rarely been studied in relation with cycling for transport to various destinations in 10-12 yr old children. The current qualitative study used 'bike-along interviews' with children and parents to allow discussion of detailed environmental factors that may influence children's cycling for transport, while cycling in the participant's neighborhood. Purposeful convenience sampling was used to recruit 35 children and one of their parents residing in (semi-) urban areas. Bike-along interviews were conducted to and from a randomly chosen destination (e.g. library) within a 15 minutes' cycle trip in the participant's neighborhood. Participants wore a GoPro camera to objectively assess environmental elements, which were subsequently discussed with participants. Content analysis and arising themes were derived using a grounded theory approach. The discussed environmental factors were categorized under traffic, urban design, cycling facilities, road design, facilities at destination, aesthetics, topography, weather, social control, stranger danger and familiar environment. Across these categories many environmental factors were (in)directly linked to road safety. This was illustrated by detailed discussions of the children's visibility, familiarity with specific traffic situations, and degree of separation, width and legibility of cycle facilities. Road safety is of major concern in this 10-12 yr old study population. Bike-along interviews were able to identify new, detailed and context-specific physical environmental factors which could inform policy makers to promote children's cycling for transport. However, future studies should investigate whether hypothetical changes to such micro environmental features influence perceptions of safety and if this in turn could lead to changes in children's cycling for transport.

  16. Significant others, situations and infant feeding behaviour change processes: a serial qualitative interview study.

    Science.gov (United States)

    McInnes, Rhona J; Hoddinott, Pat; Britten, Jane; Darwent, Kirsty; Craig, Leone C A

    2013-05-16

    Exclusive breastfeeding until six months followed by the introduction of solids and continued breastfeeding is recommended by the World Health Organisation. The dominant approach to achieving this has been to educate and support women to start and continue breastfeeding rather than understanding behaviour change processes from a broader perspective. Serial qualitative interviews examined the influences of significant others on women's feeding behaviour. Thirty-six women and 37 nominated significant others participated in 220 interviews, conducted approximately four weekly from late pregnancy to six months after birth. Responses to summative structured questions at the end of each interview asking about significant influences on feeding decisions were compared and contrasted with formative semi-structured data within and between cases. Analysis focused on pivotal points where behaviour changed from exclusive breastfeeding to introducing formula, stopping breastfeeding or introducing solids. This enabled us to identify processes that decelerate or accelerate behaviour change and understand resolution processes afterwards. The dominant goal motivating behaviour change was family wellbeing, rather than exclusive breastfeeding. Rather than one type of significant other emerging as the key influence, there was a complex interplay between the self-baby dyad, significant others, situations and personal or vicarious feeding history. Following behaviour change women turned to those most likely to confirm or resolve their decisions and maintain their confidence as mothers. Applying ecological models of behaviour would enable health service organisation, practice, policy and research to focus on enhancing family efficacy and wellbeing, improving family-centred communication and increasing opportunities for health professionals to be a constructive influence around pivotal points when feeding behaviour changes. A paradigm shift is recommended away from the dominant approach of

  17. Coping Well with Advanced Cancer: A Serial Qualitative Interview Study with Patients and Family Carers

    Science.gov (United States)

    Roberts, Diane; Appleton, Lynda; Calman, Lynn; Large, Paul; Lloyd-Williams, Mari; Grande, Gunn

    2017-01-01

    Objectives To understand successful strategies used by people to cope well when living with advanced cancer; to explore how professionals can support effective coping strategies; to understand how to support development of effective coping strategies for patients and family carers. Design Qualitative serial (4–12 week intervals) interview study with people with advanced cancer and their informal carers followed by focus groups. The iterative design had a novel focus on positive coping strategies. Interview analysis focused on patients and carers as individuals and pairs, exploring multiple dimensions of their coping experiences. Focus group analysis explored strategies for intervention development. Participants 26 people with advanced (stage 3–4) breast, prostate, lung or colorectal cancer, or in receipt of palliative care, and 24 paired nominated informal/family carers. Setting Participants recruited through outpatient clinics at two tertiary cancer centres in Merseyside and Manchester, UK, between June 2012 and July 2013. Results 45 patient and 41 carer interviews were conducted plus 4 focus groups (16 participants). People with advanced cancer and their informal/family carers develop coping strategies which enable effective management of psychological wellbeing. People draw from pre-diagnosis coping strategies, but these develop through responding to the experience of living with advanced cancer. Strategies include being realistic, indulgence, support, and learning from others, which enabled participants to regain a sense of wellbeing after emotional challenge. Learning from peers emerged as particularly important in promoting psychological wellbeing through the development of effective ‘everyday’, non-clinical coping strategies. Conclusions Our findings challenge current models of providing psychological support for those with advanced cancer which focus on professional intervention. It is important to recognise, enable and support peoples’ own

  18. Exploring Dutch surgeons' views on volume-based policies: a qualitative interview study.

    Science.gov (United States)

    Mesman, Roos; Faber, Marjan J; Westert, Gert P; Berden, Bart

    2018-01-01

    Objective In many countries, the evidence for volume-outcome associations in surgery has been transferred into policy. Despite the large body of research that exists on the topic, qualitative studies aimed at surgeons' views on, and experiences with, these volume-based policies are lacking. We interviewed Dutch surgeons to gain more insight into the implications of volume-outcome policies for daily clinical practice, as input for effective surgical quality improvement. Methods Semi-structured interviews were conducted with 20 purposively selected surgeons from a stratified sample for hospital type and speciality. The interviews were recorded, transcribed verbatim and underwent inductive content analysis. Results Two overarching themes were inductively derived from the data: (1) minimum volume standards and (2) implications of volume-based policies. Although surgeons acknowledged the premise 'more is better', they were critical about the validity and underlying evidence for minimum volume standards. Patients often inquire about caseload, which is met with both understanding and discomfort. Surgeons offered many examples of controversies surrounding the process of determining thresholds as well as the ways in which health insurers use volume as a purchasing criterion. Furthermore, being held accountable for caseload may trigger undesired strategic behaviour, such as unwarranted operations. Volume-based policies also have implications for the survival of low-volume providers and affect patient travel times, although the latter is not necessarily problematic in the Dutch context. Conclusions Surgeons in this study acknowledged that more volume leads to better quality. However, validity issues, undesired strategic behaviour and the ways in which minimum volume standards are established and applied have made surgeons critical of current policy practice. These findings suggest that volume remains a controversial quality measure and causes polarization that is not

  19. Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study.

    Science.gov (United States)

    Merriweather, Judith; Smith, Pam; Walsh, Timothy

    2014-03-01

    To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83). Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation. The study is a qualitative study based on patient interviews and observations of ward practice. Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay. Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness. The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway. Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake. © 2013 John Wiley & Sons Ltd.

  20. Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study.

    Directory of Open Access Journals (Sweden)

    Anne Christenson

    Full Text Available Obesity in Sweden has doubled to 14% over the last 20 years. New strategies for treatment and prevention are needed. Excessive gestational weight gain has been found to contribute substantially to obesity, and there is a consistent association between postpartum weight retention and obesity later in life. We aimed to explore what factors women perceive as reasons for having substantial postpartum weight retention, to identify areas for new and improved interventions.Qualitative interview study (semi-structured using an emergent design. Fifteen women, with a postpartum weight retention ≥ 10 kg, were interviewed by a trained cognitive therapist. Eight women had pre-pregnancy BMI below 30 kg/m2. Interviews were transcribed verbatim and data analysed using inductive manifest content analysis. Salient text passages were extracted, shortened, coded and clustered into categories.Participants reported no knowledge of current gestational weight gain recommendations or of risks for adverse pregnancy outcomes with excessive weight gain or postpartum weight retention. Excessive eating emerged as a common strategy to provide relief of psychological, emotional and physical discomfort, such as depression and morning sickness. Women perceived medical staff as being unconcerned about weight, and postpartum weight loss support was scarce or absent. Some women reported eating more due to a belief that breastfeeding would automatically lead to weight loss.There is a need to raise awareness about risks with unhealthy gestational weight development and postpartum weight retention in women of childbearing age. The common strategy to cope with psychological, emotional or physical discomfort by eating is an important factor to target with intervention. The postpartum year is a neglected period where additional follow-up on weight and weight loss support is strongly indicated.

  1. Critical environmental factors for transportation cycling in children: a qualitative study using bike-along interviews.

    Directory of Open Access Journals (Sweden)

    Ariane Ghekiere

    Full Text Available Environmental factors are found to influence transport-related physical activity, but have rarely been studied in relation with cycling for transport to various destinations in 10-12 yr old children. The current qualitative study used 'bike-along interviews' with children and parents to allow discussion of detailed environmental factors that may influence children's cycling for transport, while cycling in the participant's neighborhood.Purposeful convenience sampling was used to recruit 35 children and one of their parents residing in (semi- urban areas. Bike-along interviews were conducted to and from a randomly chosen destination (e.g. library within a 15 minutes' cycle trip in the participant's neighborhood. Participants wore a GoPro camera to objectively assess environmental elements, which were subsequently discussed with participants. Content analysis and arising themes were derived using a grounded theory approach.The discussed environmental factors were categorized under traffic, urban design, cycling facilities, road design, facilities at destination, aesthetics, topography, weather, social control, stranger danger and familiar environment. Across these categories many environmental factors were (indirectly linked to road safety. This was illustrated by detailed discussions of the children's visibility, familiarity with specific traffic situations, and degree of separation, width and legibility of cycle facilities.Road safety is of major concern in this 10-12 yr old study population. Bike-along interviews were able to identify new, detailed and context-specific physical environmental factors which could inform policy makers to promote children's cycling for transport. However, future studies should investigate whether hypothetical changes to such micro environmental features influence perceptions of safety and if this in turn could lead to changes in children's cycling for transport.

  2. Palliative care nurses' views on euthanasia.

    Science.gov (United States)

    Verpoort, Charlotte; Gastmans, Chris; Dierckx de Casterlé, Bernadette

    2004-09-01

    In debates on euthanasia legalization in Belgium, the voices of nurses were scarcely heard. Yet studies have shown that nurses are involved in the caring process surrounding euthanasia. Consequently, they are in a position to offer valuable ideas about this problem. For this reason, the views of these nurses are important because of their palliative expertise and their daily confrontation with dying patients. The aim of this paper is to report a study of the views of palliative care nurses about euthanasia. A grounded theory approach was chosen, and interviews were carried out with a convenience sample of 12 palliative care nurses in Flanders (Belgium). The data were collected between December 2001 and April 2002. The majority of the nurses were not a priori for or against euthanasia, and their views were largely dependent on the situation. What counted was the degree of suffering and available palliative options. Depending on the situation, we noted both resistance and acceptance towards euthanasia. The underlying arguments for resistance included respect for life and belief in the capabilities of palliative care; arguments underlying acceptance included the quality of life and respect for patient autonomy. The nurses commented that working in palliative care had a considerable influence on one's opinion about euthanasia. In light of the worldwide debate on euthanasia, it is essential to know how nurses, who are confronted with terminally ill patients every day, think about it. Knowledge of these views can also contribute to a realistic and qualified view on euthanasia itself. This can be enlightening to the personal views of caregivers working in a diverse range of care settings.

  3. Euthanasia and cryothanasia.

    Science.gov (United States)

    Minerva, Francesca; Sandberg, Anders

    2017-09-01

    In this article we discuss the moral and legal aspects of causing the death of a terminal patient in the hope of extending their life in the future. We call this theoretical procedure cryothanasia. We argue that administering cryothanasia is ethically different from administering euthanasia. Consequently, objections to euthanasia should not apply to cryothanasia, and cryothanasia could also be considered a legal option where euthanasia is illegal. © 2017 John Wiley & Sons Ltd.

  4. Attitudes of cancer patients, their family members and health professionals toward active euthanasia.

    Science.gov (United States)

    Kuuppelomäki, M

    2000-03-01

    This qualitative study describes the attitudes of four groups of people in cancer care toward active euthanasia. Patients (32) with incurable cancer, their family members (13), nurses (13) and physicians (13) participated in the study which was carried out in two central hospitals and in four health centres in Finland. The data was collected by means of focused interviews which were taped, transcribed and then analysed by content analysis. More than half of the participants said that they could ethically justify active euthanasia. Most of these were family members and nurses. The main reasons for their ethical justification were the terminal illness of the patient, the presence of suffering and pain and the patient's own request. Those who could not justify active euthanasia said that one human being has no right to decide death of another. Potential abuse, uncertainty about the finality of the situation, the possibility of effective alleviation of symptoms and the effects which the practice might have on medical staff were also mentioned by this group. The results of this study support the assumption given in the earlier literature that attitudes toward active euthanasia are most positive where terminally ill cancer patients are concerned.

  5. Managing uncertainty in advanced liver disease: a qualitative, multiperspective, serial interview study.

    Science.gov (United States)

    Kimbell, Barbara; Boyd, Kirsty; Kendall, Marilyn; Iredale, John; Murray, Scott A

    2015-11-19

    To understand the experiences and support needs of people with advanced liver disease and those of their lay and professional carers to inform improvements in the supportive and palliative care of this rapidly growing but currently neglected patient group. Multiperspective, serial interviews. We conducted up to three qualitative in-depth interviews with each patient and lay carer over 12 months and single interviews with case-linked healthcare professionals. Data were analysed using grounded theory techniques. Patients with advanced liver disease of diverse aetiologies recruited from an inpatient hepatology ward, and their lay carers and case-linked healthcare professionals nominated by the patients. Primary and secondary care in South-East Scotland. 37 participants (15 patients, 11 lay and 11 professional carers) completed 51 individual and 13 joint patient-carer interviews. Nine patients died during the study. Uncertainty dominated experiences throughout the course of the illness, across patients' considerable physical, psychological, social and existential needs and affected patients, lay carers and professionals. This related to the nature of the condition, the unpredictability of physical deterioration and prognosis, poor communication and information-sharing, and complexities of care. The pervasive uncertainty also shaped patients' and lay carers' strategies for coping and impeded care planning. While patients' acute medical care was usually well coordinated, their ongoing care lacked structure and focus. Living, dying and caring in advanced liver disease is dominated by pervasive, enduring and universally shared uncertainty. In the face of high levels of multidimensional patient distress, professionals must acknowledge this uncertainty in constructive ways that value its contribution to the person's coping approach. Pervasive uncertainty makes anticipatory care planning in advanced liver disease challenging, but planning 'just in case' is vital to ensure

  6. Fatigue in hospital nurses - 'Supernurse' culture is a barrier to addressing problems: A qualitative interview study.

    Science.gov (United States)

    Steege, Linsey M; Rainbow, Jessica G

    2017-02-01

    Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue. The purpose of this paper is to describe emergent themes that offer new insight describing the relationships among nurse perceptions of fatigue, nursing professional culture, and implications for the nursing workforce. A qualitative exploratory study was used to explore nurse identified sources, barriers to addressing, and consequences of fatigue. Twenty-two nurses working in intensive care and medical-surgical units within a large academic medical center in the United States participated in the interviews. Interviews with the participants followed a semi-structured interview guide that included questions eliciting participants' views on nurse fatigue levels, consequences of fatigue, and barriers to addressing fatigue. The interview transcripts were analyzed using directed content analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) model. Additional themes that did not directly align with the SEIPS model were also identified. All nurses in the current study experienced fatigue; yet they had varying perspectives on the importance of addressing fatigue in relation to other health systems challenges. A new construct related to nursing professional culture was identified and defined as "Supernurse". Identified subthemes of Supernurse include: extraordinary powers used for good; cloak of invulnerability; no sidekick; Kryptonite, and an alterego. These values, beliefs, and behaviors define the specific aspects of nursing professional culture that can act as barriers to fatigue risk management programs

  7. Physicians' opinions on palliative care and euthanasia in the Netherlands.

    Science.gov (United States)

    Georges, Jean-Jacques; Onwuteaka-Philipsen, Bregje D; van der Heide, Agnes; van der Wal, Gerrit; van der Maas, Paul J

    2006-10-01

    In recent decades significant developments in end-of-life care have taken place in The Netherlands. There has been more attention for palliative care and alongside the practice of euthanasia has been regulated. The aim of this paper is to describe the opinions of physicians with regard to the relationship between palliative care and euthanasia, and determinants of these opinions. Cross-sectional. Representative samples of physicians (n = 410), relatives of patients who died after euthanasia and physician-assisted suicide (EAS; n = 87), and members of the Euthanasia Review Committees (ERCs; n = 35). Structured interviews with physicians and relatives of patients, and a written questionnaire for the members of the ERCs. Approximately half of the physicians disagreed and one third agreed with statements describing the quality of palliative care in The Netherlands as suboptimal and describing the expertise of physicians with regard to palliative care as insufficient. Almost two thirds of the physicians disagreed with the suggestion that adequate treatment of pain and terminal care make euthanasia redundant. Having a religious belief, being a nursing home physician or a clinical specialist, never having performed euthanasia, and not wanting to perform euthanasia were related to the belief that adequate treatment of pain and terminal care could make euthanasia redundant. The study results indicate that most physicians in The Netherlands are not convinced that palliative care can always alleviate all suffering at the end of life and believe that euthanasia could be appropriate in some cases.

  8. Experiences of health care in women with Peripartum Cardiomyopathy in Sweden: a qualitative interview study.

    Science.gov (United States)

    Patel, Harshida; Schaufelberger, Maria; Begley, Cecily; Berg, Marie

    2016-12-08

    Peripartum cardiomyopathy is often associated with severe heart failure occurring towards the end of pregnancy or in the months following birth with debilitating, exhausting and frightening symptoms requiring person-centered care. The aim of this study was to explore women's experiences of health care while being diagnosed with peripartum cardiomyopathy. Qualitative interviews were conducted with 19 women with peripartum cardiomyopathy in Sweden, following consent. Data were analysed using qualitative content analysis. Confirmability was ensured by peer-debriefing, and an audit trail was kept to establish the credibility of the study. The main theme in the experience of health care was, 'Exacerbated Suffering', expressed in three subthemes; 'not being cared about', 'not being cared for' and 'not feeling secure.' The suffering was present in relation to the illness with failing health symptoms, but most of all in relation to not being taken seriously and adequately cared for by healthcare professionals. Women felt they were on an assembly line in midwives' routine work where knowledge about peripartum cardiomyopathy was lacking and they showed distrust and dissatisfaction with care related to negligence and indifference experienced from healthcare professionals. Feelings of being alone and lost were prominent and related to a sense of insecurity, distress and uneasiness. This study shows a knowledge gap of peripartum cardiomyopathy in maternity care personnel. This is alarming as the deprecation of symptoms and missed diagnosis of peripartum cardiomyopathy can lead to life-threatening consequences. To prompt timely diagnosis and avoid unnecessary suffering it is important to listen seriously to, and respect, women's narratives and act on expressions of symptoms of peripartum cardiomyopathy, even those overlapping normal pregnancy symptoms.

  9. Effect of Educational Debt on Emergency Medicine Residents: A Qualitative Study Using Individual Interviews.

    Science.gov (United States)

    Young, Timothy P; Brown, Madison M; Reibling, Ellen T; Ghassemzadeh, Sassan; Gordon, Dawn M; Phan, Tammy H; Thomas, Tamara L; Brown, Lance

    2016-10-01

    In 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt. Our emergency medicine residents anecdotally reported much larger debt loads. Surveys have reported that debt affects career and life choices. Qualitative approaches are well suited to explore how and why such complex phenomena occur. We aim to gain a better understanding of how our emergency medicine residents experience debt. We conducted individual semistructured interviews with emergency medicine residents. We collected self-reported data related to educational debt and asked open-ended questions about debt influence on career choices, personal life, future plans, and financial decisions. We undertook a structured thematic analysis using a qualitative approach based in the grounded theory method. Median educational debt was $212,000. Six themes emerged from our analysis: (1) debt influenced career and life decisions by altering priorities; (2) residents experienced debt as a persistent source of background stress and felt powerless to change it; (3) residents made use of various techniques to negotiate debt in order to focus on day-to-day work; (4) personal debt philosophy, based on individual values and obtained from family, shaped how debt affected each individual; (5) debt had a normative effect and was acculturated in residency; and (6) residents reported a wide range of financial knowledge, but recognized its importance to career success. Our emergency medicine residents' debt experience is complex and involves multiple dimensions. Given our current understanding, simple solutions are unlikely to be effective in adequately addressing this issue. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  10. Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study.

    Science.gov (United States)

    Barnicot, Kirsten; Couldrey, Laura; Sandhu, Sima; Priebe, Stefan

    2015-01-01

    Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients' experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants' reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research.

  11. Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study.

    Directory of Open Access Journals (Sweden)

    Kirsten Barnicot

    Full Text Available Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients' experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants' reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research.

  12. Experiences of living with dementia: qualitative content analysis of semi-structured interviews.

    Science.gov (United States)

    Mazaheri, Monir; Eriksson, Lars E; Heikkilä, Kristiina; Nasrabadi, Alireza Nikbakht; Ekman, Sirkka-Liisa; Sunvisson, Helena

    2013-11-01

    To describe people's experiences of living with dementia in Iran. A knowledge gap exists regarding the experiences of living with dementia in nonWestern contexts. This gap may be especially apparent within the Iranian context, where dementia research is relatively new. Deeper understanding about context-related experiences of dementia is a prerequisite for nurses' ability to provide adequate and meaningful care. Qualitative, cross-sectional design. Qualitative content analysis of semi-structured interviews with people living with dementia in urban Iran (six women and nine men; 60-87 years old). The participants experienced their condition as a state of forgetfulness that was accompanied by losses and dependency on others. They wanted to feel good about themselves and feel important, but they continually struggled with matters such as a loss of accountability, feelings of futility and the frustration of others. Economic dependency and a lack of economic resources were sources of feelings of futility. Experiences of living with dementia in Iran included a substantial struggle to stay connected to the social world and to deal with dramatic life changes, aspects of living with dementia that seem to be universal. However, the feelings of financial burden and the experience of being nagged for their shortfalls by family members have seldom been described in other studies and seem to represent a cultural aspect of their experience. The results of the study call for further nursing efforts in supporting people living with dementia in their struggle with their altered lives and in retaining their connections to everyday life. Furthermore, their family members might benefit from specific nursing interventions including information about dementia and advice on how to help the family members with dementia to interact with others while exercising their individual strengths. © 2013 John Wiley & Sons Ltd.

  13. Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study.

    Science.gov (United States)

    Klingler, Corinna; Marckmann, Georg

    2016-09-23

    With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts. A thorough understanding of challenges faced by this group, however, is needed to develop adequate support structures-as required by the WHO Global Code of Practice on the International Recruitment of Health Personnel. A qualitative study was conducted to give an overview of the multifaceted difficulties migrant physicians might face in German hospitals. Twenty semi-structured interviews with foreign-born and foreign-trained physicians were conducted in German. Participants were recruited via the State Chambers of Physicians and snowballing based on a maximum variation sampling strategy varying purposefully by source country and medical specialty. The interviews were recorded, transcribed verbatim, and analysed using qualitative content analysis. Participants described difficulties relating to healthcare institutions, own competencies, and interpersonal interactions. Participants experienced certain legal norms, the regulation of licensure and application for work, and the organization of the hospital environment as inadequate. Most struggled with their lack of setting-specific (language, cultural, clinical, and system) knowledge. Furthermore, behaviour of patients and co-workers was perceived as discriminating or inadequate for other reasons. This is the first study to describe the broad range of issues migrant physicians experience in Germany. Based on this information, institutional actors should devise support structures to ensure quality of care, physician wellbeing, and

  14. Elderly patients' and GPs' perspectives of patient-GP communication concerning polypharmacy: a qualitative interview study.

    Science.gov (United States)

    Schöpf, Andrea C; von Hirschhausen, Maike; Farin, Erik; Maun, Andy

    2017-12-26

    Aim The aim of this study was to explore elderly patients' and general practitioners' (GPs') perceptions of communication about polypharmacy, medication safety and approaches for empowerment. To manage polypharmacy, GPs need to know patients' real medication consumption. However, previous research has shown that patients do not always volunteer all information about their medication regimen, for example, such as the intake of over-the-counter medication or the alteration or discontinuation of prescribed medication. A qualitative interview study including patients of at least 65 years old with polypharmacy (⩾5 medications) and their GPs in a German Primary Healthcare Centre. The transcripts from the semi-structured interviews (n=6 with patients; n=3 with GPs) were analysed using a framework analytical approach. Findings We identified three themes: differing medication plans: causes?; dialogue concerning medication: whose responsibility?; supporting patients' engagement: how? While GPs stated that patients do not always report or might even conceal information, all patients reported that they could speak openly about everything with their GPs. In this context, trust might act as a double-edged sword, as it can promote open communication but also prevent patients from asking questions. Both GPs and patients could name very few ways in which patients could be supported to become more informed and active in communication concerning polypharmacy and medication safety. This study shows that patients' awareness of the significance of their active role in addressing polypharmacy needs to be increased. This includes understanding that trusting the doctor does not preclude asking questions or seeking more information. Thus, interventions which improve patients' communication skills and address specific issues of polypharmacy, particularly in elderly patients, should be designed. GPs might support patients by 'inviting' their contribution.

  15. Barriers and facilitators to cooking from 'scratch' using basic or raw ingredients: A qualitative interview study.

    Science.gov (United States)

    Lavelle, Fiona; McGowan, Laura; Spence, Michelle; Caraher, Martin; Raats, Monique M; Hollywood, Lynsey; McDowell, Dawn; McCloat, Amanda; Mooney, Elaine; Dean, Moira

    2016-12-01

    Previous research has highlighted an ambiguity in understanding cooking related terminology and a number of barriers and facilitators to home meal preparation. However, meals prepared in the home still include convenience products (typically high in sugars, fats and sodium) which can have negative effects on health. Therefore, this study aimed to qualitatively explore: (1) how individuals define cooking from 'scratch', and (2) their barriers and facilitators to cooking with basic ingredients. 27 semi-structured interviews were conducted with participants (aged 18-58 years) living on the island of Ireland, eliciting definitions of 'cooking from scratch' and exploring the reasons participants cook in a particular way. The interviews were professionally transcribed verbatim and Nvivo 10 was used for an inductive thematic analysis. Our results highlighted that although cooking from 'scratch' lacks a single definition, participants viewed it as optimal cooking. Barriers to cooking with raw ingredients included: 1) time pressures; (2) desire to save money; (3) desire for effortless meals; (4) family food preferences; and (5) effect of kitchen disasters. Facilitators included: 1) desire to eat for health and well-being; (2) creative inspiration; (3) ability to plan and prepare meals ahead of time; and (4) greater self-efficacy in one's cooking ability. Our findings contribute to understanding how individuals define cooking from 'scratch', and barriers and facilitators to cooking with raw ingredients. Interventions should focus on practical sessions to increase cooking self-efficacy; highlight the importance of planning ahead and teach methods such as batch cooking and freezing to facilitate cooking from scratch. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Mothers' perceptions of their health choices, related duties and responsibilities: A qualitative interview study.

    Science.gov (United States)

    Kangasniemi, Mari; Blomberg, Katja; Korhonen, Anne

    2015-11-01

    to describe mothers' perceptions of their health choices, related duties and responsibilities. descriptive exploratory study with qualitative research method. interviews conducted after the clients' regular health visits to one publicly provided maternity clinic in a southern city in Finland. 13 mothers aged between 21 and 40-years-old, who were pregnant or had given birth in the past four weeks. Six of participants were pregnant or had delivered for first time and it was the second to fourth pregnancy for the remainder. one-to-one semi-structured interviews using the inductive content analysis method. women reported increased responsibility for their health choices for themselves and their baby during pregnancy. However, their duties and responsibilities were seldom discussed at maternity clinics. The duty to reconsider their health choices was described as a predictor of commitment to their pregnancy and motherhood, but they recognised that it required sufficient knowledge to realise this. In addition, the mothers said their health choices changed from private to one of public interest during this period. health choices are connected to maternal duties and responsibilities, but they can sometimes lack clarity during this new phase of life. In future, more research should be conducted to study maternal duties and responsibilities in different contexts. findings highlight the skills of nurses and midwives at maternity clinics to discuss and support mothers' moral pondering during pregnancy. Although health choices in general are well recognised as a part of maternal counselling, these findings suggest a moral perspective should be incorporated into the advice that is provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Bereaved relatives' experiences during the incurable phase of cancer: a qualitative interview study.

    Science.gov (United States)

    Wijnhoven, Marleen N; Terpstra, Wim E; van Rossem, Ronald; Haazer, Carolien; Gunnink-Boonstra, Nicolette; Sonke, Gabe S; Buiting, Hilde M

    2015-11-25

    To examine bereaved relatives' experiences from time of diagnosis of incurable cancer until death with specific emphasis on their role in the (end-of-life) decision-making concerning chemotherapy. Qualitative interview study. Hospital-based. In-depth interviews with 15 close relatives of patients who died from non-small cell lung cancer or pancreatic cancer, using a thematic content analysis. All relatives reported that patients' main reason to request chemotherapy was the possibility to prolong life. Relatives reported that patients receiving chemotherapy had more difficulty to accept the incurable nature of their disease than patients who did not. They mostly followed the patients' treatment wish and only infrequently suggested ceasing chemotherapy (because of side effects) despite sometimes believing that this would be a better option. Relatives continuously tried to support the patient in either approaching the death or in attaining hope to continue life satisfactorily. Most relatives considered the chemotherapy period meaningful, since it sparked patients' hope and was what patients wanted. Cessation of chemotherapy caused a relief but coincided with physical deterioration and an increased caregivers' role; many relatives recalled this latter period as more burdensome. Relatives tend to follow patients' wish to continue or cease chemotherapy, without expressing their own feelings, although they were more inclined to opt cessation. They experience a greater caregiver role after cessation and their feelings of responsibility associated with the disease can be exhausting. More attention is needed to reduce relatives' distress at the end of life, also to fully profit from this crucial form of (informal) healthcare. 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/

  18. Young women describe the ideal first pelvic examination: Qualitative research using semistructured interviews.

    Science.gov (United States)

    Freyens, Anne; Dejeanne, Mélanie; Fabre, Elise; Rouge-Bugat, Marie-Eve; Oustric, Stéphane

    2017-08-01

    To explore representations of the first pelvic examination (PE) among adolescents who had not yet had this examination and to identify their criteria for a positive experience of it. Qualitative study using semistructured interviews. Midi-Pyrénées and Auvergne in France. Adolescents aged 15 to 19 years who had never had a PE. Participants were recruited through snowball sampling and targeted sampling until data saturation was reached. Maximum variation was sought in the profiles of the study participants. Open-ended questions dealt with the interviewee's sources of information, knowledge of the PE, criteria for a positive PE experience, and representations of the PE itself. Verbatim transcripts were immediately subjected to longitudinal analysis with the context (researchers' notes) and key themes of the interview. Cross-sectional analysis was then performed. Many adolescents lack knowledge about the PE and believe that it is mandatory. According to study participants, the ideal PE would take place when they felt ready. They would be given adequate information in advance and the option of being accompanied by a friend or family member. They described the ideal examining room as warm, comfortable, and reassuring. The quality of their relationship with the examining physician would also affect their acceptance of this examination. An information session before the consultation for the PE would make it possible to reduce the patient's apprehension, improve her level of knowledge, and set the right tone for the upcoming PE, both for her and for the physician. Copyright© the College of Family Physicians of Canada.

  19. What does confidence mean to people who have had a stroke? A qualitative interview study.

    Science.gov (United States)

    Horne, Jane; Lincoln, Nadina Berrice; Preston, Jenny; Logan, Pip

    2014-11-01

    To explore the meaning of confidence to stroke patients after stroke in order to inform the development of a measurement tool. Qualitative interview study using interpretative phenomenological analysis (IPA). Ten stroke survivors were purposively selected from those participating in a multi-centre randomised trial of outdoor mobility rehabilitation. Interviews about confidence were conducted in participants' homes, audio recorded and transcribed verbatim. Six themes emerged from the analysis. These were loss of identity, fear, social confidence, role confidence, mastering skill and attitudes and beliefs. Loss of identity was particularly evident in the early stages of stroke recovery. Fear was a barrier to regaining confidence and was associated with avoidance behaviours. Lack of social confidence was a common problem which appeared difficult to resolve. Life roles motivated participants to re-engage in daily life activities. Personal attitudes and beliefs, combined with the attitudes of significant others, contributed to personal feelings of competence. This study provides a coherent definition of the meaning of confidence through the experiences of stroke survivors. Being successful in gradually re-engaging in activities, including social activities and life roles helped to establish a positive self-belief. The influence of others, such as family and friends reinforce self-beliefs. Confidence and self-efficacy appear to be a similar construct. However, participants in this study also identified a relationship between confidence and self-esteem. The findings indicate that all six themes need to be included in a confidence measure to encompass the meaning of confidence as described by participants with stroke. © The Author(s) 2014.

  20. Bereaved parents' experience of stillbirth in UK hospitals: a qualitative interview study.

    Science.gov (United States)

    Downe, Soo; Schmidt, Ellie; Kingdon, Carol; Heazell, Alexander E P

    2013-01-01

    To obtain the views of bereaved parents about their interactions with healthcare staff when their baby died just before or during labour. Qualitative in-depth interview study, following an earlier national survey. All interviews took place during 2011, either face-to-face or on the telephone. Data analysis was informed by the constant comparative technique from grounded theory. Every National Health Service (NHS) region in the UK was represented. Bereaved parents who had completed an e-questionnaire, via the website of Sands (Stillbirth and Neonatal Death Society). Of the 304 survey respondents who gave provisional consent, 29 families were approached to take part, based on maximum variation sampling and data saturation. 22 families (n=25) participated. Births took place between 2002 and 2010. Specific practices were identified that were particularly helpful to the parents. Respondents talked about their interactions with hospital staff as having profound effects on their capacity to cope, both during labour and in the longer term. The data generated three key themes: 'enduring and multiple loss': 'making irretrievable moments precious'; and the 'best care possible to the worst imaginable'. The overall synthesis of findings is encapsulated in the meta-theme 'One chance to get it right.' This pertains to the parents and family themselves, clinical and support staff who care for them directly, and the NHS organisations that indirectly provide the resources and governance procedures that may (or may not) foster a caring ethos. Positive memories and outcomes following stillbirth depend as much on genuinely caring staff attitudes and behaviours as on high-quality clinical procedures. All staff who encounter parents in this situation need to see each meeting as their one chance to get it right.

  1. Patients' views and needs about systemic sclerosis and its management: a qualitative interview study.

    Science.gov (United States)

    Mouthon, Luc; Alami, Sophie; Boisard, Anne-Sophie; Chaigne, Benjamin; Hachulla, Eric; Poiraudeau, Serge

    2017-05-30

    Systemic sclerosis (SSc) is a chronic connective-tissue disease responsible for reduced life expectancy, disability and a decreased quality of life. In order to optimize patients-physicians relationship and care strategy we aimed to survey views of patients on SSc and its management to reveal potential hurdles and improve health care strategies. A qualitative study combined semi-structured interviews, focus groups, and a direct observation of an information session was performed between November 2008 and January 2009. Twenty-five patients with SSc were included. They encounter difficulties to have a clear representation of their disease. Physical, psychological, and social repercussions of SSc may lead to a psychological distress and different coping strategies, which widely differ among interviewed patients. Patients' views on their therapeutic journey and the management of their disease highlighted strong expectations about patient-physician relationship. These expectations were numerous, complex and sometimes ambivalent. Patients expected physicians to be human and attentive but also involved in research in the field and to provide psychological and affective support to help them to accept the uncertainty of disease evolution and lack of curative treatment. They also expected more individualized management, improvements in diagnosis and follow-up organization, more efforts in education and information, comprehensive behaviors and support from working colleagues and relatives, and increased funding from the health care system. Our results suggest that SSc management could be optimized, particularly with more attention to the patient-practitioner relationship. Patient profiles should be more precisely defined in terms of coping strategies and treatment preferences to propose more individualized options.

  2. A serial qualitative interview study of infant feeding experiences: idealism meets realism

    Science.gov (United States)

    Craig, Leone C A; Britten, Jane; McInnes, Rhona M

    2012-01-01

    Objective To investigate the infant feeding experiences of women and their significant others from pregnancy until 6 months after birth to establish what would make a difference. Design Qualitative serial interview study. Setting Two health boards in Scotland. Participants 72 of 541 invited pregnant women volunteered. 220 interviews approximately every 4 weeks with 36 women, 26 partners, eight maternal mothers, one sister and two health professionals took place. Results The overarching theme was a clash between overt or covert infant feeding idealism and the reality experienced. This is manifest as pivotal points where families perceive that the only solution that will restore family well-being is to stop breast feeding or introduce solids. Immediate family well-being is the overriding goal rather than theoretical longer term health benefits. Feeding education is perceived as unrealistic, overly technical and rules based which can undermine women's confidence. Unanimously families would prefer the balance to shift away from antenatal theory towards more help immediately after birth and at 3–4 months when solids are being considered. Family-orientated interactive discussions are valued above breastfeeding-centred checklist style encounters. Conclusions Adopting idealistic global policy goals like exclusive breast feeding until 6 months as individual goals for women is unhelpful. More achievable incremental goals are recommended. Using a proactive family-centred narrative approach to feeding care might enable pivotal points to be anticipated and resolved. More attention to the diverse values, meanings and emotions around infant feeding within families could help to reconcile health ideals with reality. PMID:22422915

  3. Extending Beyond Qualitative Interviewing to Illuminate the Tacit Nature of Everyday Occupation: Occupational Mapping and Participatory Occupation Methods.

    Science.gov (United States)

    Huot, Suzanne; Rudman, Debbie Laliberte

    2015-07-01

    The study of human occupation requires a variety of methods to fully elucidate its complex, multifaceted nature. Although qualitative approaches have commonly been used within occupational therapy and occupational science, we contend that such qualitative research must extend beyond the sole use of interviews. Drawing on qualitative methodological literature, we discuss the limits of interview methods and outline other methods, particularly visual methods, as productive means to enhance qualitative research. We then provide an overview of our critical ethnographic study that used narrative, visual, and observational methods to explore the occupational transitions experienced by immigrants to Canada. We describe our use of occupational mapping and participatory occupation methods and the contributions of these combined methods. We conclude that adopting a variety of methods can enable a deeper understanding of the tacit nature of everyday occupation, and is key to advancing knowledge regarding occupation and to informing occupational therapy practice.

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

    Science.gov (United States)

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

    2015-02-21

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

  5. Relation between a career and family life for English hospital consultants: qualitative, semistructured interview study.

    Science.gov (United States)

    Dumelow, C; Littlejohns, P; Griffiths, S

    2000-05-27

    To explore the relation between work and family life among hospital consultants and their attitude towards the choices and constraints that influence this relation. Qualitative study of consultants' experiences and views based on tape recorded semistructured interviews. Former South Thames health region in southeast England. 202 male and female NHS hospital consultants aged between 40 to 50 years representing all hospital medical specialties. Three types of relation between work and family life (career dominant, segregated, and accommodating) were identified among hospital consultants. Most consultants had a segregated relation, although female consultants were more likely than male consultants to have a career dominant or an accommodating relation. Many male consultants and some female consultants expressed considerable dissatisfaction with the balance between their career and family life. A factor influencing this dissatisfaction was the perceived lack of choice to spend time on their personal or family life, because of the working practices and attitudes within hospital culture, if they wanted a successful career. Consultants are currently fitting in with the profession rather than the profession adapting to enable doctors to have fulfilling professional and personal lives. Current government policies to increase the medical workforce and promote family friendly policies in the NHS ought to take account of the need for a fundamental change in hospital culture to enable doctors to be more involved in their personal or family life without detriment to their career progress.

  6. Supervisor descriptions of veterinary student performance in the clinical workplace: a qualitative interview study.

    Science.gov (United States)

    Norman, E J

    2017-06-10

    This qualitative study investigated the qualities of veterinary student performance that inform a supervisor's impression of their competency. Semi-structured interviews were conducted with a purposive sample of 15 supervisors from different veterinary subdisciplines, to elicit descriptions of excellent, weak and marginal students. Thematic analysis of transcriptions revealed 12 themes, of which engagement was frequently discussed and of stated importance, and trustworthiness was a differentiator of weak and marginal students from excellent students. Other themes were knowledge, application of knowledge, technical and animal handling skills, communication, social interaction, personal functioning, caring for animals, impact, prospects and the difficulty in judging competency. Patterns of association of themes were found, however themes were also used independently in unique combinations for most students described. The findings show the range of abilities, behaviours, attitudes and personal characteristics of students that are considered by supervisors and how these are weighted and balanced. The key contribution of engagement and trustworthiness to the overall impression aligns with research indicating their importance for success in clinical practice, as both contributors to competency and indicators of it. The findings may inform future design and investigation of workplace-based learning and in-training evaluation, as well as conceptions of veterinary competency. British Veterinary Association.

  7. Doctors' perspectives of informed consent for non-emergency surgical procedures: a qualitative interview study.

    Science.gov (United States)

    Wood, Fiona; Martin, Sean Michael; Carson-Stevens, Andrew; Elwyn, Glyn; Precious, Elizabeth; Kinnersley, Paul

    2016-06-01

    The need to involve patients more in decisions about their care, the ethical imperative and concerns about ligation and complaints has highlighted the issue of informed consent and how it is obtained. In order for a patient to make an informed decision about their treatment, they need appropriate discussion of the risks and benefits of the treatment. To explore doctors' perspectives of gaining informed consent for routine surgical procedures. Qualitative study using semi-structured interviews selected by purposive sampling. Data were analysed thematically. Twenty doctors in two teaching hospitals in the UK. Doctors described that while consent could be taken over a series of consultations, it was common for consent to be taken immediately prior to surgery. Juniors were often taking consent when they were unfamiliar with the procedure. Doctors used a range of communication techniques to inform patients about the procedure and its risks including quantifying risks, personalizing risk, simplification of language and use of drawings. Barriers to effective consent taking were reported to be shortage of time, clinician inexperience and patients' reluctance to be involved. Current consent processes do not appear to be ideal for many doctors. In particular, junior doctors are often not confident taking consent for surgical procedures and require more support to undertake this task. This might include written information for junior staff, observation by senior colleagues when undertaking the task and ward-based communication skills teaching on consent taking. © 2014 John Wiley & Sons Ltd.

  8. Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

    Science.gov (United States)

    McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

    2004-09-01

    Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

  9. Birth environment facilitation by midwives assisting in non-hospital births: a qualitative interview study.

    Science.gov (United States)

    Igarashi, Toshiko; Wakita, Mariko; Miyazaki, Kikuko; Nakayama, Takeo

    2014-07-01

    midwifery homes (similar to birth centres) are rich in midwifery wisdom and skills that differ from those in hospital obstetrical departments, and a certain percentage of pregnant women prefer birth in these settings. This study aimed to understand the organisation of the perinatal environment considered important by independent midwives in non-hospital settings and to clarify the processes involved. semi-structured qualitative interview study and constant comparative analysis. 14 independent midwives assisting at births in midwifery homes in Japan, and six independent midwives assisting at home births. Osaka, Kyoto, Nara, and Shiga, Japan. midwives assisting at non-hospital births organised the birth environment based on the following four categories: 'an environment where the mother and family are autonomous'; 'a physical environment that facilitates birth'; 'an environment that facilitates the movement of the mother for birth'; and 'scrupulous safety preparation'. These, along with their sub-categories, are presented in this paper. independent midwives considered it important to create a candid relationship between the midwife and the woman/family from the period of pregnancy to facilitate birth in which the woman and her family were autonomous. They also organised a distinctive environment for non-hospital birth, with preparations to guarantee safety. Experiential knowledge and skills played a major part in creating an environment to facilitate birth, and the effectiveness of this needs to be investigated objectively in future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Midwives' experiences of labour care in midwifery units. A qualitative interview study in a Norwegian setting.

    Science.gov (United States)

    Skogheim, Gry; Hanssen, Tove A

    2015-12-01

    In some economically developed countries, women's choice of birth care and birth place is encouraged. The aim of this study was to explore and describe the experiences of midwives who started working in alongside/free-standing midwifery units (AMU/FMU) and their experiences with labour care in this setting. A qualitative explorative design using a phenomenographic approach was used. Semi-structured interviews were conducted with ten strategically sampled midwives working in midwifery units. The analysis revealed the following five categories of experiences noted by the midwives: mixed emotions and de-learning obstetric unit habits, revitalising midwifery philosophy, alertness and preparedness, presence and patience, and coping with time. Starting to work in an AMU/FMU can be a distressing period for a midwife. First, it may require de-learning the medical approach to birth, and, second, it may entail a revitalisation (and re-learning) of birth care that promotes physiological birth. Midwifery, particularly in FMUs, requires an especially careful assessment of the labouring process, the ability to be foresighted, and capability in emergencies. The autonomy of midwives may be constrained also in AMUs/FMUs. However, working in these settings is also viewed as experiencing "the art of midwifery" and enables revitalisation of the midwifery philosophy. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Learning to manage vasoactive drugs-A qualitative interview study with critical care nurses.

    Science.gov (United States)

    Häggström, Marie; Bergsman, Ann-Christin; Månsson, Ulrika; Holmström, Malin Rising

    2017-04-01

    Being a nurse in an intensive care unit entails caring for seriously ill patients. Vasoactive drugs are one of the tools that are used to restore adequate circulation. Critical care nurses often manage and administer these potent drugs after medical advice from physicians. To describe the experiences of critical care nurses learning to manage vasoactive drugs, and to highlight the competence required to manage vasoactive drugs. Twelve critical care nurses from three hospitals in Sweden were interviewed. Qualitative content analysis was applied. The theme "becoming proficient requires accuracy, practice and precaution" illustrated how critical care nurses learn to manage vasoactive drugs. Learning included developing cognitive, psychomotor, and effective skills. Sources for knowledge refers to specialist education combined with practical exercises, collegial support, and accessible routine documents. The competence required to manage vasoactive drugs encompassed well-developed safety thinking that included being careful, in control, and communicating failures. Specific skills were required such as titrating doses, being able to analyse and evaluate the technological assessments, adapting to the situation, and staying calm. Learning to manage vasoactive drugs requires a supportive introduction for novices, collegial support, lifelong learning, and a culture of safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Emotions surrounding friendships of adolescents with autism spectrum disorder in Japan: A qualitative interview study.

    Science.gov (United States)

    Sumiya, Motofumi; Igarashi, Kazue; Miyahara, Motohide

    2018-01-01

    Emotions are embedded in culture and play a pivotal role in making friends and interacting with peers. To support the social participation of students with autism spectrum disorders (ASD) it is essential to understand their emotional life in the context of ethnic and school cultures. We are particularly interested in how anxiety and loneliness are experienced in developing and maintaining friendships in the daily encounters of adolescents with ASD in the specific context of Japanese schools, because these emotions could serve either as facilitators or barriers to social interaction, depending on how individuals manage them. The present qualitative study investigated perceptions of emotions related to friendship in the everyday school life of 11 adolescents with ASD in Japan. Data were collected by means of semi-structured individual interviews, which revealed a wide range of motivations for socialization, limited future prospects to deepen friendships, robust self-awareness of one's own social challenges, and conscious efforts to cope with these challenges. An inductive approach to data analysis resulted in four themes: social motivation, loneliness, anxiety, and distress. To our knowledge this is the first study to uncover the rich emotional life of adolescents with ASD in the context of their friendships in an Asian culture.

  13. What Do Children with Chronic Diseases and Their Parents Think About Pediatricians? A Qualitative Interview Study.

    Science.gov (United States)

    Konstantynowicz, Jerzy; Marcinowicz, Ludmiła; Abramowicz, Paweł; Abramowicz, Magdalena

    2016-08-01

    Objectives The aim of this study was to determine how pediatric patients and their parents perceive health care during hospital stays, what are their expectations of doctor behaviors, and which components of care do they consider to be the most important. Methods A qualitative descriptive study was carried out using the open interview technique. Twenty-six parents and 22 children undergoing hospital treatment participated. Results Our analysis identified two major themes: (1) doctor verbal and non-verbal behaviors, which included informing and explaining, conversations on topics other than the illness, tone of voice and other behaviors; and (2) perceived strategies used by doctors. This category included claims of doctors' intentional use of medical jargon to avoid addressing parental questions directly. Parents admitted that they did not understand medical vocabulary, but they also thought they might understand more of the medical issues if the doctor spoke using terms comprehensible to them. Conlcusions Our study shows the importance of interpersonal relationship affecting patient perception of quality of pediatric care. Parents of pediatric patients perceive that doctors behave in ways that deflect parents' questions and avoid providing them with medical information. Such behaviors include doctors excusing themselves by saying they are busy and using medical jargon. Medical students and doctors should be trained to communicate effectively with patients and their parents and develop skills to convey information in a simple and comprehensible way.

  14. Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study.

    Science.gov (United States)

    Togher, Fiona J; O'Cathain, Alicia; Phung, Viet-Hai; Turner, Janette; Siriwardena, Aloysius Niroshan

    2015-12-01

    There is an increasing need to assess the performance of emergency ambulance services using measures other than the time taken for an ambulance to arrive on scene. In line with government policy, patients and carers can help to shape new measures of ambulance service performance. To investigate the aspects of emergency ambulance service care valued by users. Qualitative interview study. One of 11 ambulance services in England. Twenty-two users and eight of their spouses (n = 30). Users of the emergency ambulance service, experiencing different types of ambulance service response, valued similar aspects of their pre-hospital care. Users were often extremely anxious about their health, and the outcome they valued was reassurance provided by ambulance service staff that they were receiving appropriate advice, treatment and care. This sense of being reassured was enhanced by the professional behaviour of staff, which instilled confidence in their care; communication; a short wait for help; and continuity during transfers. A timely response was valued in terms of allaying anxiety quickly. The ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service. Measures developed to assess and monitor the performance of emergency ambulance services should include the proportion of users reporting feeling reassured by the response they obtained. © 2014 John Wiley & Sons Ltd.

  15. Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data.

    Science.gov (United States)

    Engler, J; Güthlin, C; Dahlhaus, A; Kojima, E; Müller-Nordhorn, J; Weißbach, L; Holmberg, C

    2017-11-01

    The importance of outpatient cancer care services is increasing due to the growing number of patients having or having had cancer. However, little is known about cooperation among physicians in outpatient settings. To understand what inter- and multidisciplinary care means in community settings, we conducted an amplified secondary analysis that combined qualitative interview data with 42 general practitioners (GPs), 21 oncologists and 21 urologists that mainly worked in medical practices in Germany. We compared their perspectives on cooperation relationships in cancer care. Our results indicate that all participants regarded cooperation as a prerequisite for good cancer care. Oncologists and urologists mainly reported cooperating for tumour-specific treatment tasks, while GPs' reasoning for cooperation was more patient-centred. While oncologists and urologists reported experiencing reciprocal communication with other physicians, GPs had to gather the information they needed. GPs seldom reported engaging in formal cooperation structures, while for specialists, participation in formal spaces of cooperation, such as tumour boards, facilitated a more frequent and informal discussion of patients, for instance on the phone. Further research should focus on ways to foster GPs' integration in cancer care and evaluate if this can be reached by incorporating GPs in formal cooperation structures such as tumour boards. © 2017 John Wiley & Sons Ltd.

  16. How do healthcare consumers process and evaluate comparative healthcare information? A qualitative study using cognitive interviews

    Directory of Open Access Journals (Sweden)

    Delnoij Diana MJ

    2009-11-01

    Full Text Available Abstract Background To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods Using semi-structured cognitive interviews, interviewees (n = 20 were asked to think aloud and answer questions, as they were prompted with three Dutch web pages providing comparative healthcare information. Results We identified twelve themes from consumers' thoughts and evaluations. These themes were categorized under four important areas of interest: (1 a response to the design; (2 a response to the information content; (3 the use of the information, and (4 the purpose of the information. Conclusion Several barriers to an effective use of comparative healthcare information were identified, such as too much information and the ambiguity of terms presented on websites. Particularly important for future research is the question of how comparative healthcare information can be integrated with alternative information, such as patient reviews on the Internet. Furthermore, the readability of quality of care concepts is an issue that needs further attention, both from websites and communication experts.

  17. [Living and dying with frailty : Qualitative interviews with elderly people in the domestic environment].

    Science.gov (United States)

    Klindtworth, Katharina; Geiger, Karin; Pleschberger, Sabine; Bleidorn, Jutta; Schneider, Nils; Müller-Mundt, Gabriele

    2017-02-01

    Frail older people are becoming an increasingly more important target group in healthcare provision. Little is known about patients' views on frailty and its various impacts, especially towards the end of life. This study was carried out to analyze the needs of frail elderly people at the end of life. A qualitative, longitudinal case study design was applied and included 31 frail older patients (≥ 70 year) with a Canadian study of health and aging (CSHA) clinical frailty scale (CFS) grade 6/7 from urban and rural areas within the region of Lower Saxony. The analysis was based on guided interviews and followed the principles of grounded theory. From the patients' perspective frailty is perceived as a process of increasing complexity of health problems, increased vulnerability and reduced ability to perform tasks. Frailty is experienced as various deficits including the physical, psychological, social and existential dimensions. Living and dying in a familiar environment and maintaining autonomy was identified as a core category. Key determinants were access to and quality of healthcare services as well as various individual and social resources. A palliative biopsychosocial care approach should be established early in the process of frailty, including advance care planning in order to meet the patients' needs of staying in a familiar environment. General practitioners as well as home care nursing personnel have to collaborate in order to balance issues of autonomy with increased care needs and the support of informal carers as key partners towards the end of life.

  18. Emotions surrounding friendships of adolescents with autism spectrum disorder in Japan: A qualitative interview study

    Science.gov (United States)

    Igarashi, Kazue; Miyahara, Motohide

    2018-01-01

    Emotions are embedded in culture and play a pivotal role in making friends and interacting with peers. To support the social participation of students with autism spectrum disorders (ASD) it is essential to understand their emotional life in the context of ethnic and school cultures. We are particularly interested in how anxiety and loneliness are experienced in developing and maintaining friendships in the daily encounters of adolescents with ASD in the specific context of Japanese schools, because these emotions could serve either as facilitators or barriers to social interaction, depending on how individuals manage them. The present qualitative study investigated perceptions of emotions related to friendship in the everyday school life of 11 adolescents with ASD in Japan. Data were collected by means of semi-structured individual interviews, which revealed a wide range of motivations for socialization, limited future prospects to deepen friendships, robust self-awareness of one’s own social challenges, and conscious efforts to cope with these challenges. An inductive approach to data analysis resulted in four themes: social motivation, loneliness, anxiety, and distress. To our knowledge this is the first study to uncover the rich emotional life of adolescents with ASD in the context of their friendships in an Asian culture. PMID:29408894

  19. Constructions of ‘the Polish’ in Northern England: Findings From a Qualitative Interview Study

    Directory of Open Access Journals (Sweden)

    Stephen Gibson

    2015-10-01

    Full Text Available The enlargement of the European Union in 2004 gave rise to moral panics concerning the likelihood of mass migration from the new eastern European member states to established member states in the west. A great deal of social and political science research has examined the ongoing impact of the enlargement, but there remains a gap in the literature regarding the ways in which members of ‘receiving’ populations reacted to these changes. The present paper reports findings from a qualitative interview study of 14-16 year-olds conducted in northern England. It focuses on how migrants from one particular country – Poland – were constructed by participants. Drawing on previous analyses of immigration and racist discourse, the study points to some ways in which Polish migrants and migration were constructed, and how complaints against ‘the Polish’ were formulated. The analysis focusses on four key issues: employment and the economy; language and culture; threat and intimidation; and physical stereotyping. It is suggested that constructions of ‘the Polish’ draw on the tropes of both ‘old’ and ‘new’ racism, and that attention to the use of deixical ingroup referents (‘us’, ‘we’, ‘our’ in contrast to the explicit labelling of the outgroup (‘the Polish’ can be understood in terms of the requirement to present complaints concerning migrant groups via appeals to assumed universal standards of behaviour and civility.

  20. The cardiac patients' perceptions of their responsibilities in adherence to care: a qualitative interview study.

    Science.gov (United States)

    Kangasniemi, Mari; Hirjaba, Marina; Kohonen, Katja; Vellone, Ercole; Moilanen, Tanja; Pietilä, Anna-Maija

    2017-09-01

    To describe cardiac patients' perceptions of their responsibilities in adherence to care. The responsibilities of cardiac patients' adherence to care is a topical issue because of the increasing prevalence of noncommunicable diseases in Western countries, including cardiovascular disease (CVD). Responsibilities for cardiac patients' care have been studied, but little is described about patients' perspectives in this study. A qualitative, hermeneutic inquiry. We used face-to-face individual semistructured interviews with 21 cardiac patients (76% male) aged 58-86 in an urban area of Finland in winter 2013. The data were analysed hermeneutically with inductive content analysis. Based on our results, patients with cardiac disease understood that autonomy provided a basis for their responsibility in adherence to care. It included being able to make independent decisions, in collaboration with health professionals, or even to entrust that responsibility to healthcare professionals. Responsibilities were understood to be an expression of adherence, perceived to benefit the patient and included the duty to adopt a healthy lifestyle and care for their own medical condition. The main factors that influenced patients' responsibilities around adherence to care were their individual resources and motivation, relationships with healthcare professionals and the resources of the healthcare system. Autonomy is an inherent part of cardiac patients' adherence to care, but there has been little focus on their responsibilities in the literature. More attention needs to be paid to the healthcare providers' abilities to support patients' duties and responsibilities in clinical practice and to future research. © 2016 John Wiley & Sons Ltd.

  1. Emotions surrounding friendships of adolescents with autism spectrum disorder in Japan: A qualitative interview study.

    Directory of Open Access Journals (Sweden)

    Motofumi Sumiya

    Full Text Available Emotions are embedded in culture and play a pivotal role in making friends and interacting with peers. To support the social participation of students with autism spectrum disorders (ASD it is essential to understand their emotional life in the context of ethnic and school cultures. We are particularly interested in how anxiety and loneliness are experienced in developing and maintaining friendships in the daily encounters of adolescents with ASD in the specific context of Japanese schools, because these emotions could serve either as facilitators or barriers to social interaction, depending on how individuals manage them. The present qualitative study investigated perceptions of emotions related to friendship in the everyday school life of 11 adolescents with ASD in Japan. Data were collected by means of semi-structured individual interviews, which revealed a wide range of motivations for socialization, limited future prospects to deepen friendships, robust self-awareness of one's own social challenges, and conscious efforts to cope with these challenges. An inductive approach to data analysis resulted in four themes: social motivation, loneliness, anxiety, and distress. To our knowledge this is the first study to uncover the rich emotional life of adolescents with ASD in the context of their friendships in an Asian culture.

  2. Autism and Bilingualism: A Qualitative Interview Study of Parents' Perspectives and Experiences.

    Science.gov (United States)

    Hampton, Sarah; Rabagliati, Hugh; Sorace, Antonella; Fletcher-Watson, Sue

    2017-02-01

    Research into how bilingual parents of children with autism spectrum disorder (ASD) make choices about their children's language environment is scarce. This study aimed to explore this issue, focusing on understanding how bilingual parents of children with ASD may make different language exposure choices compared with bilingual parents of children without ASD. Semistructured qualitative interviews were conducted with 17 bilingual parents with a child with ASD and 18 bilingual parents with a typically developing (TD) child. Thematic analysis revealed that, in contrast to parents of TD children, parents with a child with ASD expressed concerns that a bilingual environment would cause confusion for their child and exacerbate language delays. This was particularly common for parents of children with lower verbal ability. Parents also identified potential benefits of bilingualism, particularly in terms of maintaining a close and affectionate bond with their child. Parents of children with ASD have concerns about bilingualism not present for parents of TD children, and these concerns are greater for parents of children with lower verbal ability. Future research in this area should take into account factors such as parent-child bonds as well as communication and language development.

  3. Euthanasia: Some Legal Considerations

    Science.gov (United States)

    Koza, Pamela

    1976-01-01

    Several sections of the Criminal Code of Canada which are relevant to the issue of euthanasia are discussed. In addition, the value placed on the sanctity of life by the law, the failure to recognize motive in cases of euthanasia, and disparate legal and medical definitions of death are also considered. (Author)

  4. Questions and answers on the Belgian model of integral end-of-life care: experiment? Prototype? : "Eu-euthanasia": the close historical, and evidently synergistic, relationship between palliative care and euthanasia in Belgium: an interview with a doctor involved in the early development of both and two of his successors.

    Science.gov (United States)

    Bernheim, Jan L; Distelmans, Wim; Mullie, Arsène; Ashby, Michael A

    2014-12-01

    This article analyses domestic and foreign reactions to a 2008 report in the British Medical Journal on the complementary and, as argued, synergistic relationship between palliative care and euthanasia in Belgium. The earliest initiators of palliative care in Belgium in the late 1970s held the view that access to proper palliative care was a precondition for euthanasia to be acceptable and that euthanasia and palliative care could, and should, develop together. Advocates of euthanasia including author Jan Bernheim, independent from but together with British expatriates, were among the founders of what was probably the first palliative care service in Europe outside of the United Kingdom. In what has become known as the Belgian model of integral end-of-life care, euthanasia is an available option, also at the end of a palliative care pathway. This approach became the majority view among the wider Belgian public, palliative care workers, other health professionals, and legislators. The legal regulation of euthanasia in 2002 was preceded and followed by a considerable expansion of palliative care services. It is argued that this synergistic development was made possible by public confidence in the health care system and widespread progressive social attitudes that gave rise to a high level of community support for both palliative care and euthanasia. The Belgian model of so-called integral end-of-life care is continuing to evolve, with constant scrutiny of practice and improvements to procedures. It still exhibits several imperfections, for which some solutions are being developed. This article analyses this model by way of answers to a series of questions posed by Journal of Bioethical Inquiry consulting editor Michael Ashby to the Belgian authors.

  5. General Practitioners' Perspective on eHealth and Lifestyle Change: Qualitative Interview Study.

    Science.gov (United States)

    Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane; Sndergaard, Jens; Nielsen, Jesper Bo

    2018-04-17

    Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to

  6. The Voice Transcription Technique: Use of Voice Recognition Software to Transcribe Digital Interview Data in Qualitative Research

    Science.gov (United States)

    Matheson, Jennifer L.

    2007-01-01

    Transcribing interview data is a time-consuming task that most qualitative researchers dislike. Transcribing is even more difficult for people with physical limitations because traditional transcribing requires manual dexterity and the ability to sit at a computer for long stretches of time. Researchers have begun to explore using an automated…

  7. Breaking Up Is Hard to Do: A Qualitative Interview Study of How and Why Youth Mentoring Relationships End

    Science.gov (United States)

    Spencer, Renée; Basualdo-Delmonico, Antoinette; Walsh, Jill; Drew, Alison L.

    2017-01-01

    Endings in youth mentoring relationships have received little empirical attention despite the fact that many relationships do end. The present study utilized qualitative interview data collected from participants in a longitudinal study of community-based mentoring relationships to examine how and why the relationships ended and how participants…

  8. Family members' expectations regarding nurses' competence in care homes: a qualitative interview study.

    Science.gov (United States)

    Kiljunen, Outi; Kankkunen, Päivi; Partanen, Pirjo; Välimäki, Tarja

    2017-11-22

    Structural and cultural changes in the care of older people have influenced nursing practice, creating a need to identify current competency requirements for nurses working in care homes. Family members have an important role in ensuring the well-being of older people living in care homes, and family members' can provide valuable information about competence requirements. To explore the expectations of the care home residents' family members regarding the competence of nurses in care homes for older people. A qualitative descriptive design was used. Semi-structured interviews were conducted with 18 care home residents' family members between March and September 2016. Participants were recruited with help from regional associations and member associations of The Central Association of Carers in Finland and from regional associations of The Alzheimer's Society of Finland. The snowball technique was also used. The data were analysed using inductive content analysis. Ethics committee approval was obtained from the university committee on research ethics, and written informed consent was obtained from participants. The care home residents' family members expected that nurses would be able to interact with and treat people respectfully. Reflective collaboration between the nurse and a family member was also emphasised. Family members expected nurses to provide high-quality basic care and nursing and support residents' well-being individually and holistically. Family members' expectations reflect the need for ethical and interactional competence in the care home. In addition, evidence-based practice competencies are required to provide high-quality care. Nurses' ability to provide person-centred, individual and holistic care is vital to ensure care home residents' well-being. © 2017 Nordic College of Caring Science.

  9. Impossible meals? The food and meal situation of flight attendants in Scandinavia - A qualitative interview study.

    Science.gov (United States)

    Nyberg, Maria; Lennernäs Wiklund, Maria

    2017-06-01

    The working conditions of flight attendants (FAs) often involve extended and irregular working hours, short rest periods, difficulties in planning for breaks and high demands of service provision. Moreover, work schedules including early check-in, shifts during circadian low and time-zone transitions imply constant exposure to alterations in circadian systems and related health risks. The aim of this explorative study was to investigate how the organisation of work, time and place influence the food and meal situation of FAs when at work, focusing on patterns, form and social context of meals. The research questions posed were how food and meals at work were characterised and perceived among the FAs, and what strategies were adopted to manage the food and meal situation. Qualitative, semi-structured interviews were conducted with fourteen FAs working in Scandinavia. The results indicated that the organisation of work, time and place have a major influence on the meal situation at work, and how food and meals are perceived and managed by FAs. The work was defined as fragmented and inconsistent regarding time and place resulting in scattered meals and a more snack-based form of eating. The meal situation was characterised by irregularity as well as unpredictability. Eating took place when food was available and when there was enough time to eat, rather than being guided by hunger or social context. Various strategies such as eating in prevention, using emergency food, avoiding certain food and drinks or eating little or nothing at all were used to manage the unpredictability of the meal situation as well as the gap between organisational and individual times. The findings demonstrated the individual responsibility to solve the meal at work, e.g. to solve organisational times. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Managing barriers to empathy in the clinical encounter: a qualitative interview study with GPs.

    Science.gov (United States)

    Derksen, Frans Awm; Olde Hartman, Tim C; Bensing, Jozien M; Lagro-Janssen, Antoine Lm

    2016-12-01

    Current daily general practice has become increasingly technical and somatically oriented (where attention to patients' feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP-patient communication have shifted from a focus on listening and empathy to task-oriented communication. To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed. Thirty Dutch GPs with sufficient heterogeneity in sex, age, type of practice, and rural or urban setting were interviewed. The consolidated criteria for reporting qualitative research (COREQ) were applied. The verbatim transcripts were then analysed. According to participating GPs, the current emphasis on protocol-driven care can be a significant barrier to genuineness in communication. Other potential barriers mentioned were time pressures and constraints, and dealing with patients displaying 'unruly behaviour' or those with personality disorders. GPs indicated that it can be difficult to balance emotional involvement and professional distance. Longer consulting times, smaller practice populations, and efficient practice organisation were described as practical solutions. In order to focus on a patient-as-person approach, GPs strongly suggested that deviating from guidelines should be possible when necessary as an element of good-quality care. Joining intercollegiate counselling groups was also discussed. In addition to practical solutions for barriers to behaving empathically, GPs indicated that they needed more freedom to balance working with protocols and guidelines, as well as a patient-as-person and patient-as-partner approach. This balance is necessary to remain connected with patients and to deliver care that is truly personal. © British Journal of General Practice 2016.

  11. Discovering untapped relationship potential with patients in telehealth: a qualitative interview study.

    Science.gov (United States)

    Heckemann, Birgit; Wolf, Axel; Ali, Lilas; Sonntag, Steffen Mark; Ekman, Inger

    2016-03-02

    To explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective. 4 focus group interviews were conducted in June 2014. Digital recordings were transcribed verbatim and qualitative content analysis was performed using an iterative process of 3 coding rounds. 20 telehealth professionals. A telehealth service centre in the south of Germany that provided care for 12,000 patients with chronic heart failure across Germany. Non-video telehealth technology creates an atmosphere that fosters sharing of personal information and a non-judgemental attitude. This facilitates the delivery of fair and equal healthcare. A combination of a protocol-driven service structure along with shared team and organisational values provide a basis for establishing long-term healthcare relationships. However, each contact between a telehealth professional and a patient has an uncertain outcome and requires skillful negotiation of the relationship. Although care provision was personalised, there was scope to include the patients as 'experts on their own illness' to a greater extent as advocated by person-centred care. Currently, provision of person-centred care is not sufficiently addressed in telehealth professional training. Telehealth offers a viable environment for the delivery of person-centred care for patients with long-standing disease. Current telehealth training programmes may be enhanced by teaching person-centred care skills. 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/

  12. Women's interpretation of and responses to potential gynaecological cancer symptoms: a qualitative interview study.

    Science.gov (United States)

    Low, E L; Whitaker, K L; Simon, A E; Sekhon, M; Waller, J

    2015-07-06

    To explore women's experiences of symptoms potentially indicative of gynaecological cancer in a community-based sample without imposing a cancer perspective. A qualitative interview study with thematic analysis of transcripts. 26 women aged ≥30 years, who had experienced a symptom that might indicate gynaecological cancer in the past 3 months, were recruited using a screening questionnaire distributed online and in community settings. London, UK. Women attributed gynaecological symptoms to existing illnesses/conditions or considered themselves to be predisposed to them, either through their 'genes' or previous personal experience. Normalising symptoms by attributing them to demographic characteristics (eg, age, sex) was common, as was considering them a side effect of hormonal contraception. When women raised cancer as a possible cause, they often dismissed it as unlikely. Responses to symptoms included self-management (eg, self-medicating, making lifestyle changes), adopting a 'lay system of care', or consulting a healthcare professional. Triggers to help-seeking included persistent, painful or debilitating symptoms, concern about symptom seriousness, and feeling that help-seeking was legitimised. Barriers to help-seeking included lack of concern, vague symptoms, unusual symptom location, competing time demands, previous negative experiences with the healthcare system, and not wanting to be perceived as a time-waster. Attributions of symptoms potentially indicative of a gynaecological cancer were varied, but most often involved women fitting symptoms into their expectations of what was 'normal'. Normalising acted as a barrier to seeking help from a healthcare professional, alongside competing time demands and negative attitudes towards help-seeking. These barriers may lead to later diagnosis and poorer cancer survival. Our findings could be used to inform the development of interventions to encourage appropriate help-seeking. Published by the BMJ Publishing

  13. Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study.

    Science.gov (United States)

    Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

    2018-01-01

    Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Semi-structured in-depth qualitative interviews analysed using thematic analysis. In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer ( n = 21), non-cancer ( n = 16) and both a cancer and a non-cancer conditions ( n = 3). In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals' preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.

  14. Influences on hospital admission for asthma in south Asian and white adults: qualitative interview study.

    Science.gov (United States)

    Griffiths, C; Kaur, G; Gantley, M; Feder, G; Hillier, S; Goddard, J; Packe, G

    2001-10-27

    To explore reasons for increased risk of hospital admission among south Asian patients with asthma. Qualitative interview study using modified critical incident technique and framework analysis. Newham, east London, a deprived area with a large mixed south Asian population. 58 south Asian and white adults with asthma (49 admitted to hospital with asthma, 9 not admitted); 17 general practitioners; 5 accident and emergency doctors; 2 out of hours general practitioners; 1 asthma specialist nurse. Patients' and health professionals' views on influences on admission, events leading to admission, general practices' organisation and asthma strategies, doctor-patient relationship, and cultural attitudes to asthma. South Asian and white patients admitted to hospital coped differently with asthma. South Asians described less confidence in controlling their asthma, were unfamiliar with the concept of preventive medication, and often expressed less confidence in their general practitioner. South Asians managed asthma exacerbations with family advocacy, without systematic changes in prophylaxis, and without systemic corticosteroids. Patients describing difficulty accessing primary care during asthma exacerbations were registered with practices with weak strategies for asthma care and were often south Asian. Patients with easy access described care suggesting partnerships with their general practitioner, had better confidence to control asthma, and were registered with practices with well developed asthma strategies that included policies for avoiding hospital admission. The different ways of coping with asthma exacerbations and accessing care may partly explain the increased risk of hospital admission in south Asian patients. Interventions that increase confidence to control asthma, confidence in the general practitioner, understanding of preventive treatment, and use of systemic corticosteroids in exacerbations may reduce hospital admissions. Development of more sophisticated

  15. The impact of a father's presence during newborn resuscitation: a qualitative interview study with healthcare professionals.

    Science.gov (United States)

    Harvey, Merryl E; Pattison, Helen M

    2013-03-27

    To explore healthcare professionals' experiences around the time of newborn resuscitation in the delivery room, when the baby's father was present. A qualitative descriptive, retrospective design using the critical incident approach. Tape-recorded semistructured interviews were undertaken with healthcare professionals involved in newborn resuscitation. Participants recalled resuscitation events when the baby's father was present. They described what happened and how those present, including the father, responded. They also reflected upon the impact of the resuscitation and the father's presence on themselves. Participant responses were analysed using thematic analysis. A large teaching hospital in the UK. Purposive sampling was utilised. It was anticipated that 35-40 participants would be recruited. Forty-nine potential participants were invited to take part. The final sample consisted of 37 participants including midwives, obstetricians, anaesthetists, neonatal nurse practitioners, neonatal nurses and paediatricians. Four themes were identified: 'whose role?' 'saying and doing' 'teamwork' and 'impact on me'. While no-one was delegated to support the father during the resuscitation, midwives and anaesthetists most commonly took on this role. Participants felt the midwife was the most appropriate person to support fathers. All healthcare professional groups said they often did not know what to say to fathers during prolonged resuscitation. Teamwork was felt to be of benefit to all concerned, including the father. Some paediatricians described their discomfort when fathers came to the resuscitaire. None of the participants had received education and training specifically on supporting fathers during newborn resuscitation. This is the first known study to specifically explore the experiences of healthcare professionals of the father's presence during newborn resuscitation. The findings suggest the need for more focused training about supporting fathers. There is also

  16. Qualitative interviews with mentor mothers living with HIV: potential impacts of role and coping strategies.

    Science.gov (United States)

    Dhlamini, Lebohang; Knight, Lucia; van Rooyen, Heidi; van Heerden, Alastair; Jane Rotheram-Borus, Mary

    2012-07-11

    In South Africa where HIV prevalence is high, mentor mother programmes have been used to promote the health and wellbeing of women enrolled in government programmes preventing vertical transmission. The Masihambisane Project trained mentors to be educators and facilitators as "expert patients" in self-help groups. While this and other similar interventions demonstrate positive outcomes for mothers and their children, the long-term repercussions for mentors delivering the intervention are seldom considered. This article explores the personal impact of being a mentor, the potentially traumatizing effects of repeatedly sharing their experiences of living with HIV and the coping strategies they adopt. Towards the end of the Masihambisane intervention, 10 semi-structured qualitative interviews were conducted with locally recruited mentors living with HIV and were thematically analysed. Mentors found the repeated telling of their stories a painful reminder of adverse personal experiences. In some cases, retelling caused a physical reaction. Mentors relied on coping strategies like taking breaks, writing their experiences down and debriefing sessions. Despite the difficulties associated with their role, some mentors found being advisors and the group sessions therapeutic and empowering. These findings indicate that the inclusion of peer mentors comes with certain responsibilities. While the mentors were resilient and some found the experience therapeutic and empowering found creative ways to cope with secondary trauma, the negative implications cannot be ignored. To effectively deliver a mentor-driven intervention to mothers enrolled in a programme to prevent vertical transmission, the possibilities of secondary trauma should be considered and mentors provided with ongoing counselling, training on coping skills and regular debriefing sessions.

  17. Lived experience of women with gestational diabetes mellitus living in China: a qualitative interview study.

    Science.gov (United States)

    Ge, Li; Wikby, Kerstin; Rask, Mikael

    2017-11-28

    To explore the lived experience of women with gestational diabetes mellitus (GDM) living in China in order to add knowledge about how the Chinese women suffer from GDM. A qualitative interpretive interview study. Data were collected with a snowball sampling technique. Phenomenological hermeneutics was used as the analysis method based on Ricoeur's phenomenological hermeneutical interpretation theory. The study was performed at the participants' work places, or at the obstetric clinics or wards at two provincial hospitals and one municipal hospital in the southeast of China. Inclusion criteria were age ≥18 years, diagnosis of GDM without other pregnancy complications, in 34th gestational weeks-postpartum 4th weeks and speaking Mandarin Chinese without speech impediment. 62 women, who met the inclusion criteria, took part in the study. The lived experience of the women with GDM living in China was formulated into a main theme: 'longing for caring care'. The main theme was derived from four themes: being stricken by GDM, wishing to receive caring GDM care, being left alone to struggle with GDM and trying to adjust and adapt to life with GDM. The eagerness for caring care in China was highlighted. The lack of caring care could be one of the possible reasons why the professional-patient relations were deteriorating in China. It could be useful for health providers and health policymakers to receive education and training about caring care. Using the health metaphor of balance and 'patient participation' and 'patient-centred' approaches may benefit women with GDM and thus improve the quality of care in China. © 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.

  18. Palliative care for Parkinson's disease: Patient and carer's perspectives explored through qualitative interview.

    Science.gov (United States)

    Fox, Siobhan; Cashell, Alison; Kernohan, W George; Lynch, Marie; McGlade, Ciara; O'Brien, Tony; O'Sullivan, Sean S; Foley, Mary J; Timmons, Suzanne

    2017-07-01

    Palliative care is recommended for non-malignant illnesses, including Parkinson's disease. However, past research with healthcare workers highlights unmet palliative needs in this population and referral rates to Specialist Palliative Care are low. Some healthcare workers perceive a 'fear' in their patients about introducing palliative care. However, less is known about the views of people with Parkinson's disease and their carers about palliative care. (1) To explore the palliative care and related issues most affecting people with Parkinson's disease and their families and (2) to examine perceptions about/understanding of palliative care. This was a qualitative study; semi-structured interviews were conducted, transcribed and analysed using thematic analysis. A total of 31 people participated, both people with Parkinson's disease ( n = 19) and carers ( n = 12), across three Movement Disorder Clinics in the Republic of Ireland. People with Parkinson's disease and their carers were unfamiliar with the term palliative care. When informed of the role of palliative care, most felt that they would benefit from this input. People with Parkinson's disease and carers experienced a high illness burden and wanted extra support. Crises requiring Specialist Palliative Care involvement may occur at diagnosis and later, with advancing illness. Participants wanted more information about palliative care and especially further supports to address their psychosocial needs. A holistic palliative care approach could address the complex physical and psychosocial symptoms experienced by people with Parkinson's disease and their carers, and people with Parkinson's disease and their carers are open to palliative care. Further research needs to explore how palliative care can be introduced into the routine care for people with Parkinson's disease.

  19. Bangladeshi school-age children's experiences and perceptions on child maltreatment: A qualitative interview study.

    Science.gov (United States)

    Atiqul Haque, M; Janson, S; Moniruzzaman, S; Rahman, A K M F; Mashreky, S R; Eriksson, U-B

    2017-11-01

    Child maltreatment (CM) is a public health problem and is recognized as a huge barrier for child development. Most of the research and definitions on CM are from the perspective of high-income western countries. Because no major studies have been conducted on CM in Bangladesh, the aim of the current study was to explore the experiences of and perceptions on CM in school-age children in rural and urban Bangladesh in order to understand maltreatment in a local context and from a child perspective. Semistructured individual interviews with 24 children (13 boys and 11 girls), between the ages of 9 and 13 years of which 11 were schoolgoing and 13 non-schoolgoing, were conducted during July 2013 and analysed according to qualitative content analysis. CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society. Vulnerable groups were especially young children, girls, and poor children. The children's voices were not heard due to their low status and low position in their families, schools, and working places. The main theme that emerged in the analysis was children's subordination, which permeated the five categories: (a) perception of children's situation in society, (b) understanding children's development and needs, (c) CM associated to school achievement, (d) negative impact of CM, and (e) emotional responses. Different kinds of abuse are obviously common in Bangladesh, and the schools do not follow the law from 2011 prohibiting corporal punishment at school. The society has to take further steps to live up to the UN Convention on the Rights of the Child, which was ratified already in 1990, to protect the Bangladeshi children from CM. © 2017 John Wiley & Sons Ltd.

  20. Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study.

    Directory of Open Access Journals (Sweden)

    Mariska G Oosterveld-Vlug

    Full Text Available BACKGROUND: Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. AIM: To investigate if and how nursing home residents' personal dignity changes over the course of time, and what contributes to this. DESIGN: A longitudinal qualitative study. METHODS: Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. RESULTS: From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1 finding a way to cope with one's situation; 2 getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3 physical improvement (with or without an electric wheelchair; 4 being socially involved with nursing home staff, other residents and relatives; and 5 being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. CONCLUSION: Although the direction in which a resident's personal dignity develops is also dependent on one's character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person.

  1. Changes in the personal dignity of nursing home residents: a longitudinal qualitative interview study.

    Science.gov (United States)

    Oosterveld-Vlug, Mariska G; Pasman, H Roeline W; van Gennip, Isis E; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

    2013-01-01

    Most nursing home residents spend the remainder of their life, until death, within a nursing home. As preserving dignity is an important aim of the care given here, insight into the way residents experience their dignity throughout their entire admission period is valuable. To investigate if and how nursing home residents' personal dignity changes over the course of time, and what contributes to this. A longitudinal qualitative study. Multiple in-depth interviews, with an interval of six months, were carried out with 22 purposively sampled nursing home residents of the general medical wards of four nursing homes in The Netherlands. Transcripts were analyzed following the principles of thematic analysis. From admission onwards, some residents experienced an improved sense of dignity, while others experienced a downward trend, a fluctuating one or no change at all. Two mechanisms were especially important for a nursing home resident to maintain or regain personal dignity: the feeling that one is in control of his life and the feeling that one is regarded as a worthwhile person. The acquirement of both feelings could be supported by 1) finding a way to cope with one's situation; 2) getting acquainted with the new living structures in the nursing home and therefore feeling more at ease; 3) physical improvement (with or without an electric wheelchair); 4) being socially involved with nursing home staff, other residents and relatives; and 5) being amongst disabled others and therefore less prone to exposures of disrespect from the outer world. Although the direction in which a resident's personal dignity develops is also dependent on one's character and coping capacities, nursing home staff can contribute to dignity by creating optimal conditions to help a nursing home resident recover feelings of control and of being regarded as a worthwhile person.

  2. Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study

    Science.gov (United States)

    Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

    2017-01-01

    Background: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. Aim: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Design: Semi-structured in-depth qualitative interviews analysed using thematic analysis. Setting/participants: In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer (n = 21), non-cancer (n = 16) and both a cancer and a non-cancer conditions (n = 3). Results: In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals’ preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Conclusion: Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access

  3. Water security at local government level in South Africa: a qualitative interview-based analysis

    Directory of Open Access Journals (Sweden)

    Richard Meissner, DPhil

    2018-05-01

    Full Text Available Background: As one of the 40 driest countries in the world with an annual average rainfall of 497 mm, South Africa is a water-scarce country. Additionally, South Africa's rate of economic development is closely linked to its water security. Thus, increasing water stress, supply variability, flooding, and water pollution levels and inadequate access to safe drinking water and sanitation are slowing economic growth. Despite the high premium placed on South Africa's water resources, no commonly shared understanding of water security exists. The aim of this study was to research, using qualitative social scientific methods, how people in two South African localities understand water security. Methods: We used interviews and qualitative analyses to establish and compare how people from different lifestyles perceive water security in the Greater Sekhukhune District and the eThekwini Metropolitan Municipalities of South Africa. The inland Sekhukhune has a drier climate and more rural socioeconomic profile than the coastal, urbanised eThekwini with its complex economy and diverse socioeconomic structure. We did face-to-face structured interviews with a diverse stakeholder group consisting of community members, traditional leaders, municipal officials, researchers, business people, and farmers in each municipality and focus groups in two communities of each municipality: Leeuwfontein and Motetema (Sekhukhune and Inanda and Ntshongweni (eThekwini. Each interview lasted 40–60 min, and focus group discussions lasted 90–120 min. We asked the respondents about their understanding of the concept of water security and whether they believe that, at the local and national level, the authorities had achieved water security for all. Findings: Following a qualitative analysis, we found that water security is a state of mind based on context-specific (ie, localised and individualised perceptions held by an individual of water-related threats and how it influences

  4. [Application of qualitative interviews in inheritance research of famous old traditional Chinese medicine doctors: ideas and experience].

    Science.gov (United States)

    Luo, Jing; Fu, Chang-geng; Xu, Hao

    2015-04-01

    The inheritance of famous old traditional Chinese medicine (TCM) doctors plays an essential role in the fields of TCM research. Qualitative interviews allow for subjectivity and individuality within clinical experience as well as academic ideas of doctors, making it a potential appropriate research method for inheritance of famous old TCM doctors. We summarized current situations of inheritance research on famous old TCM doctors, and then discussed the feasibility of applying qualitative interviews in inheritance of famous old TCM doctors. By combining our experience in research on inheritance of famous old TCM doctors, we gave some advice on study design, interview implementation, data transcription and analyses , and report writing, providing a reference for further relevant research.

  5. Qualitative and Quantitative Analyses on "Greetings" Exchanged by Japanese Doctors and Patients in Metical Interviews

    OpenAIRE

    植田, 栄子

    2007-01-01

    The study aims to analyze the interactional verbal and non-verbal behaviors between doctors and patients in medical interviews, focusing on the exchange of "greetings" at the opening of each interview. The conversational data of medical interviews were recorded in Tokyo and Osaka, consisting of 91 interviews by male doctors and 3 interviews by female doctors. There were 36 male patients (14 in Tokyo and 22 in Osaka) and 58 female patients (31 in Tokyo and 27 in Osaka). The average age of the ...

  6. Rethinking voluntary euthanasia.

    Science.gov (United States)

    Stoyles, Byron J; Costreie, Sorin

    2013-12-01

    Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient's care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails to reflect what is important from the patient's perspective and (2) fails to reflect the significance of health care providers' interests, including their autonomy and integrity.

  7. 'We are (not) the master of our body': elderly Jewish women's attitudes towards euthanasia and assisted suicide.

    Science.gov (United States)

    Baeke, Goedele; Wils, Jean-Pierre; Broeckaert, Bert

    2011-06-01

    In Belgium, dominant ideological traditions--Christianity and non-religious humanism--have the floor in debates on euthanasia and hardly any attention is paid to the practices and attitudes of ethnic and religious minorities, for instance, Jews. This article aims to meet this lacuna. Qualitative empirical research was performed in the Orthodox Jewish community of Antwerp (Belgium) with a purposive sample of elderly Jewish (non-)Hasidic and secularised Orthodox women. In-depth interviews were conducted to elicit their attitudes towards (non-)voluntary euthanasia and assisted suicide. The research reveals diverse views among women in the community on intentionally terminating a patient's life. Absolute rejection of every act which deliberately terminates life is found among the overwhelming majority of (religiously observant) Orthodox (Hasidic and non-Hasidic) women, as they have an unconditional faith and trust in God's sovereign power over the domain of life and death. On the other hand, the views of secularised Orthodox women--mostly irreligious women, who do not consider themselves Orthodox, thus not following Jewish law, yet say they belong to the Orthodox Jewish community--show an acceptance of voluntary euthanasia and assisted suicide but non-voluntary euthanasia is approached more negatively. As they perceive illness and death as merely profane facts, they stress a patient's absolute right towards self-determination, in particular with regard to one's end of life. Among non-Hasidic Orthodox respondents, more openness is found for cultivating a personal opinion which deviates from Jewish law and for the right of self-determination with regard to questions concerning life and death. In this study, these participants occupy an intermediate position. Our study reveals an interplay between ethical attitudes on euthanasia and religious convictions. The image one has of a transcendental reality, or of God, has a stronger effect on one's (dis)approval of euthanasia

  8. Mental health nursing students' experiences of stress during training: a thematic analysis of qualitative interviews.

    Science.gov (United States)

    Galvin, J; Suominen, E; Morgan, C; O'Connell, E-J; Smith, A P

    2015-12-01

    What is known on the subject? Stress can impact students on mental health nurse training. This can have implications at the individual level (e.g. their own mental health) and at the level of the organization (e.g. sickness absence and attrition). What this paper adds to existing knowledge? We interviewed 12 mental health nursing students regarding the stress they experienced during training. Participants described how the academic demands can at times be unbearable during clinical placements. There were also issues with 'being a student' on some placements, with participants describing negative attitudes towards them from staff. The younger participants reported feeling overwhelmed on their initial placements and described some of the main challenges of mental health work for them. Raising concerns about the quality of care on wards was also described as particularly challenging for the students. What are the implications for practice? This paper can be useful to help training providers support mental health nursing students. Recommendations include reducing academic demands during clinical placements and extending and promoting existing support services beyond normal 9 am-5 pm working hours, even if these services are limited. Younger students could be better supported by being allocated to the more well-resourced placements in the early stages of their training. Raising awareness among staff of the tasks students can and cannot perform can help improve staff/student relations. Finally, students should be educated about the issues around raising concerns on placements to help the government's drive for a more open and transparent National Health Service (NHS). Previous studies investigating stress in nursing students focus on general nursing students or adopt quantitative measures. A qualitative study focusing specifically on mental health nursing students is required. One-to-one interviews were carried out with mental health nursing students (n = 12). Data were

  9. Preferences for Web-Based Information Material for Low Back Pain: Qualitative Interview Study on People Consulting a General Practitioner

    DEFF Research Database (Denmark)

    Riis, Allan; Hjelmager, Meulengracht Ditte; Vinther, Dausel Line

    2018-01-01

    in Denmark. Methods: This is a phenomenological qualitative study. Adults who had consulted their general practitioner because of LBP within the past 14 days were included. Each participated in a semistructured interview, which was audiotaped and transcribed for text condensation. Interviews were conducted...... at the participant?s home by 2 interviewers. Participants also completed a questionnaire that requested information on age, gender, internet usage, interest in searching new knowledge, LBP-related function, and pain. Results: Fifteen 45-min interviews were conducted. Participants had a median age of 40 years (range......-based information confusing, often difficult to comprehend, and not relevant for them, and they questioned the motives driving most hosting companies or organizations. The Patient Handbook, a Danish government-funded website that provides information to Danes about health, was mentioned as a trustworthy...

  10. Difficult Decisions: Euthanasia.

    Science.gov (United States)

    Parakh, Jal S.; Slesnick, Irwin L.

    1992-01-01

    Focuses on the moral arguments for and against the controversial topic of voluntary active euthanasia. Discusses the question of legalization and decriminalization of the practice. Provides a student worksheet with questions to stimulate discussion on the issue. (MDH)

  11. Bioethics and euthanasia

    OpenAIRE

    Pérez Pérez, Jorge Arturo

    2008-01-01

    Discourses on death and dying are multiple, heterogeneous and not always coincide and never fully complement. Each aims to define, meet and own death phenomenon. Each discipline created with its own resources. One of the first problems that euthanasia since its inception is the lot of concepts, types and subtitles in the world. The origin of this situation is that euthanasia only etymologically means "good death", which is sufficiently ambiguous and neutral that generates all kinds of interpr...

  12. Traveler information services in rural tourism areas : appendix B, qualitative interviews and focus groups

    Science.gov (United States)

    2000-06-30

    This report documents results from surveys which were conducted for qualitatively assessing the use of traveler information services in rural areas. The focus of the surveys was to identify those factors which influence travel planning and thus impro...

  13. Water security at local government level in South Africa: a qualitative interview-based analysis

    CSIR Research Space (South Africa)

    Meissner, Richard

    2018-05-01

    Full Text Available understanding of water security exists. The aim of this study was to research, using qualitative social scientific methods, how people in two South African localities understand water security....

  14. The role of primary care in adult weight management: qualitative interviews with key stakeholders in weight management services

    OpenAIRE

    Blane, David N.; Macdonald, Sara; Morrison, David; O’Donnell, Catherine A.

    2017-01-01

    Background Primary care has a key role to play in the prevention and management of obesity, but there remain barriers to engagement in weight management by primary care practitioners. The aim of this study was to explore the views of key stakeholders in adult weight management services on the role of primary care in adult weight management. Methods Qualitative study involving semi-structured interviews with nine senior dietitians involved in NHS weight management from seven Scottish health bo...

  15. Methodological developments in qualitative longitudinal research: the advantages and challenges of regular telephone contact with participants in a qualitative longitudinal interview study.

    Science.gov (United States)

    Carduff, Emma; Murray, Scott A; Kendall, Marilyn

    2015-04-11

    Qualitative longitudinal research is an evolving methodology, particularly within health care research. It facilitates a nuanced understanding of how phenomena change over time and is ripe for innovative approaches. However, methodological reflections which are tailored to health care research are scarce. This article provides a synthesised and practical account of the advantages and challenges of maintaining regular telephone contact between interviews with participants in a qualitative longitudinal study. Participants with metastatic colorectal cancer were interviewed at 3 time points over the course of a year. Half the group also received monthly telephone calls to explore the added value and the feasibility of capturing change as close to when it was occurring as possible. The data gathered from the telephone calls added context to the participants' overall narrative and informed subsequent interviews. The telephone calls meant we were able to capture change close to when it happened and there was a more evolved, and involved, relationship between the researcher and the participants who were called on a monthly basis. However, ethical challenges were amplified, boundaries of the participant/researcher relationship questioned, and there was the added analytical burden. The telephone calls facilitated a more nuanced understanding of the illness experience to emerge, when compared with the interview only group. The findings suggest that intensive telephone contact may be justified if retention is an issue, when the phenomena being studied is unpredictable and when participants feel disempowered or lack control. These are potential issues for research involving participants with long-term illness.

  16. Using qualitative repertory grid interviews to gather shared perspectives in a sequential mixed methods research design

    OpenAIRE

    Rojon, C; Saunders, M.N.K.; McDowall, Almuth

    2016-01-01

    In this chapter, we consider a specific example of applying mixed methods designs combining both qualitative and quantitative data collection and analysis approaches, giving particular attention to issues including reliability and validity. Human resource management (HRM) researchers, like others setting out to examine a novel or insufficiently defined research topic, frequently favour qualitative approaches to gather data during initial stages, to facilitate an in-depth exploration of indivi...

  17. “Do the next thing”: an interview with Elizabeth Adams St. Pierre on post-qualitative methodology

    Directory of Open Access Journals (Sweden)

    Hanna Guttorm

    2015-06-01

    Full Text Available Professor Elizabeth Adams St. Pierre’s work focuses on critical and poststructural theories of language and the subject and what she has called post qualitative inquiry or post inquiry. She asks what might come after conventional humanist qualitative research methodology. She’s especially interested in the new empiricisms/new materialisms as well as new research practices enabled by the ontological turn. During St. Pierre's visit to the Finnish Educational Research Association (FERA Conference in Oulu in November 2014, we had the opportunity to talk with her about post qualitative research around some questions we had sent her beforehand. We then transcribed, edited, and translated the interview, and published it in the Finnish journal Kasvatus (Education in spring 2015. In this interview St. Pierre talks in the US context, where qualitative methodology is turning—or being pushed to turn—back to positivism with normalized and formalized practices, St. Pierre encourages researchers to constantly question the prevailing truths and the traditions they have learnt too well.

  18. Euthanasia: another face of murder.

    Science.gov (United States)

    Bamgbose, Oluyemisi

    2004-02-01

    Debate over euthanasia is not a recent phenomenon. Over the years, public opinion, decisions of courts, and legal and medical approaches to the issue of euthanasia has been conflicting. The connection between murder and euthanasia has been attempted in a few debates. Although it is widely accepted that murder is a crime, a clearly defined stand has not been taken on euthanasia. This article considers euthanasia from the medical, legal, and global perspectives and discusses the crime of murder in relation to euthanasia, taking into consideration the issue of consent in the law of crime. This article concludes that in the midst of this debate on euthanasia and murder, the important thing is that different countries need to find their own solution to the issue of euthanasia rather than trying to import solutions from other countries.

  19. Online stroke forum as source of data for qualitative research: insights from a comparison with patients' interviews.

    Science.gov (United States)

    Jamison, James; Sutton, Stephen; Mant, Jonathan; De Simoni, Anna

    2018-03-30

    To determine the appropriateness of an online forum compared with face-to-face interviews as a source of data for qualitative research on adherence to secondary prevention medications after stroke. A comparison of attributes of two data sources, interviews and a forum, using realistic evaluation; a comparison of themes around adherence according to the Perceptions and Practicalities Approach (PAPA) framework. Interviews were conducted in UK GP practices in 2013 and 2014; online posts were written by UK stroke survivors and family members taking part in the online forum of the Stroke Association between 2004 and 2011. 42 interview participants: 28 stroke survivors (age range 61-92 years) and 14 caregivers (85% spouses). 84 online forum participants: 49 stroke survivors (age range 32-72 years) and 33 caregivers (60% sons/daughters). 10 attributes were identified within the two data sources and categorised under three domains (context, mechanisms and outcomes). Participants' characteristics of forum users were often missing. Most forum participants had experienced a stroke within the previous 12 months, while interviewees had done so 1-5 years previously.All interview themes could be matched with corresponding themes from the forum. The forum yielded three additional themes: influence of bad press on taking statins, criticisms of clinicians' prescribing practices and caregiver burden in assisting with medications and being advocates for survivors with healthcare professionals. An online forum is an appropriate source of data for qualitative research on patients' and caregivers' issues with adherence to secondary prevention stroke medications and may offer additional insights compared with interviews, which can be attributed to differences in the approach to data collection. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Online stroke forum as source of data for qualitative research: insights from a comparison with patients’ interviews

    Science.gov (United States)

    Jamison, James; Sutton, Stephen; Mant, Jonathan; De Simoni, Anna

    2018-01-01

    Objective To determine the appropriateness of an online forum compared with face-to-face interviews as a source of data for qualitative research on adherence to secondary prevention medications after stroke. Design A comparison of attributes of two data sources, interviews and a forum, using realistic evaluation; a comparison of themes around adherence according to the Perceptions and Practicalities Approach (PAPA) framework. Setting Interviews were conducted in UK GP practices in 2013 and 2014; online posts were written by UK stroke survivors and family members taking part in the online forum of the Stroke Association between 2004 and 2011. Participants 42 interview participants: 28 stroke survivors (age range 61–92 years) and 14 caregivers (85% spouses). 84 online forum participants: 49 stroke survivors (age range 32–72 years) and 33 caregivers (60% sons/daughters). Results 10 attributes were identified within the two data sources and categorised under three domains (context, mechanisms and outcomes). Participants’ characteristics of forum users were often missing. Most forum participants had experienced a stroke within the previous 12 months, while interviewees had done so 1–5 years previously. All interview themes could be matched with corresponding themes from the forum. The forum yielded three additional themes: influence of bad press on taking statins, criticisms of clinicians’ prescribing practices and caregiver burden in assisting with medications and being advocates for survivors with healthcare professionals. Conclusions An online forum is an appropriate source of data for qualitative research on patients’ and caregivers’ issues with adherence to secondary prevention stroke medications and may offer additional insights compared with interviews, which can be attributed to differences in the approach to data collection. PMID:29602848

  1. [Euthanasia outside Europe].

    Science.gov (United States)

    Julesz, Máté

    2014-08-10

    The passive form of euthanasia is legalized almost in every civilized country. Its active form is not a generally accepted legal institution. In Europe, active euthanasia is legalized only in The Netherlands, Belgium, Luxembourg and Switzerland. In Australia, the Act on the Rights of the Terminally Ill of 1995 legalized the institution of assisted suicide, which is not identical to active euthanasia. The difference lies in the fact that legalized active euthanasia means that the author of a murder is not punishable (under certain circumstances), whilst assisted suicide is not about murder, rather about suicide. In the first case, the patient is killed on his or her request by someone else. In the second case, the patient himself or herself executes the act of self-killing (by the assistance of a healthcare worker). In Australia, the institution of assisted suicide was repealed in 1997. Assisted suicide is legal in four USA member states: in Vermont, Washington, Montana and Oregon. In Uruguay, the active form of euthanasia has been legal since 1932.

  2. Euthanasia: a problem for psychiatrists

    African Journals Online (AJOL)

    Adele

    2004-02-17

    Feb 17, 2004 ... ally permissible to seek a person's death intending that death to be for their sake. Kinds of euthanasia can be distinguished in a number of im- portant ways. There is, first, the distinction between active and passive euthanasia. Active euthanasia is the intentional killing of a person (for their sake). Passive ...

  3. Non-voluntary and involuntary euthanasia in The Netherlands: Dutch perspectives.

    Science.gov (United States)

    Cohen-Almagor, Raphael

    2003-01-01

    During the summer of 1999, twenty-eight interviews with some of the leading authorities on euthanasia policy were conducted in the Netherlands. They were asked about cases of non-voluntary (when patients are incompetent) and involuntary euthanasia (when patients are competent and made no request to die). This study reports the main findings, showing that most respondents are quite complacent with regard to breaches of the guideline that require the patient's consent as a prerequisite to performance of euthanasia.

  4. Qualitative analysis of cognitive interviews with school children: A web-based food intake questionnaire

    Science.gov (United States)

    The use of computers to administer dietary assessment questionnaires has shown potential, particularly due to the variety of interactive features that can attract and sustain children's attention. Cognitive interviews can help researchers to gain insights into how children understand and elaborate t...

  5. How Do Patients with Chronic Neck Pain Experience the Effects of Qigong and Exercise Therapy? A Qualitative Interview Study.

    Science.gov (United States)

    Holmberg, Christine; Farahani, Zubin; Witt, Claudia M

    2016-01-01

    Background. The high prevalence of chronic neck pain in high income countries impacts quality of life and the social and work-related activities of those afflicted. We aimed to understand how mind-body therapies and exercise therapy may influence the experience of pain among patients with chronic neck pain. Methods. This qualitative interview study investigated how patients with chronic neck pain experienced the effects of exercise or qigong therapy at two time points: during an intervention at three months and after the intervention at six months. Interviews were analysed thematically across interviews and within person-cases. Based on other qualitative studies, a sample size of 20 participants was deemed appropriate. Results. The sample (n = 20) consisted of 16 women and four men (age range: 29 to 59). Patients' experiences differed according to the therapies' philosophies. Exercise therapy group interviewees described a focus on correct posture and muscle tension release. Qigong group interviewees discussed calming and relaxing effects. Maintaining regular exercise was easier to achieve with exercise therapy. Conclusions. The findings of this study may help health care providers when counselling chronic pain patients on self-help interventions by informing them of different bodily and emotional experiences of mind-body interventions compared to exercise therapy.

  6. Child and family experiences with inborn errors of metabolism: a qualitative interview study with representatives of patient groups.

    Science.gov (United States)

    Khangura, Sara D; Tingley, Kylie; Chakraborty, Pranesh; Coyle, Doug; Kronick, Jonathan B; Laberge, Anne-Marie; Little, Julian; Miller, Fiona A; Mitchell, John J; Prasad, Chitra; Siddiq, Shabnaz; Siriwardena, Komudi; Sparkes, Rebecca; Speechley, Kathy N; Stockler, Sylvia; Trakadis, Yannis; Wilson, Brenda J; Wilson, Kumanan; Potter, Beth K

    2016-01-01

    Patient-centered health care for children with inborn errors of metabolism (IEM) and their families is important and requires an understanding of patient experiences, needs, and priorities. IEM-specific patient groups have emerged as important voices within these rare disease communities and are uniquely positioned to contribute to this understanding. We conducted qualitative interviews with IEM patient group representatives to increase understanding of patient and family experiences, needs, and priorities and inform patient-centered research and care. We developed a sampling frame of patient groups representing IEM disease communities from Canada, the United States, and United Kingdom. With consent, we interviewed participants to explore their views on experiences, needs, and outcomes that are most important to children with IEM and their families. We analyzed the data using a qualitative descriptive approach to identify key themes and sub-themes. We interviewed 18 organizational representatives between February 28 and September 17, 2014, representing 16 IEMs and/or disease categories. Twelve participants voluntarily self-identified as parents and/or were themselves patients. Three key themes emerged from the coded data: managing the uncertainty associated with raising and caring for a child with a rare disease; challenges associated with the affected child's life transitions, and; the collective struggle for improved outcomes and interventions that rare disease communities navigate. Health care providers can support children with IEM and their families by acknowledging and reducing uncertainty, supporting families through children's life transitions, and contributing to rare disease communities' progress toward improved interventions, experiences, and outcomes.

  7. Barriers to medication adherence for the secondary prevention of stroke: a qualitative interview study in primary care.

    Science.gov (United States)

    Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

    2016-08-01

    Medications are highly effective at reducing risk of recurrent stroke, but success is influenced by adherence to treatment. Among survivors of stroke and transient ischaemic attack (TIA), adherence to medication is known to be suboptimal. To identify and report barriers to medication adherence for the secondary prevention of stroke/TIA. A qualitative interview study was conducted within general practice surgeries in the East of England, UK. Patients were approached by letter and invited to take part in a qualitative research study. Semi-structured interviews were undertaken with survivors of stroke, caregivers, and GPs to explore their perspectives and views around secondary prevention and perceived barriers to medication adherence. Key themes were identified using a grounded theory approach. Verbatim quotes describing the themes are presented here. In total, 28 survivors of stroke, including 14 accompanying caregivers and five GPs, were interviewed. Two key themes were identified. Patient level barriers included ability to self-care, the importance people attach to a stroke event, and knowledge of stroke and medication. Medication level barriers included beliefs about medication and beliefs about how pills work, medication routines, changing medications, and regimen complexity and burden of treatment. Patients who have had a stroke are faced with multiple barriers to taking secondary prevention medications in UK general practice. This research suggests that a collaborative approach between caregivers, survivors, and healthcare professionals is needed to address these barriers and facilitate medication-taking behaviour. © British Journal of General Practice 2016.

  8. Experiences and attitudes about physical activity and exercise in patients with chronic pain: a qualitative interview study.

    Science.gov (United States)

    Karlsson, Linn; Gerdle, Björn; Takala, Esa-Pekka; Andersson, Gerhard; Larsson, Britt

    2018-01-01

    The purpose of this study was to describe how patients with chronic pain experience physical activity and exercise (PA&E). This qualitative interview study included 16 women and two men suffering from chronic pain and referred to a multimodal pain rehabilitation program. Semi-structured interviews were conducted and qualitative content analysis was used to analyze the interviews. One main theme emerged: "To overcome obstacles and to seize opportunities to be physically active despite chronic pain." This main theme was abstracted from five themes: "Valuing a life with physical activity," "Physical activity and exercise - before and after pain," "A struggle - difficulties and challenges," "The enabling of physical activity," and "In need of continuous and active support." Although these participants valued PA&E, they seldom achieved desirable levels, and performance of PA&E was undermined by difficulties and failure. The discrepancy between the intention to perform physical activity and the physical activity accomplished could be related to motivation, self-efficacy, and action control. The participants desired high-quality interaction with healthcare providers. The findings can be applied to chronic pain rehabilitation that uses PA&E as treatment.

  9. [Euthanasia and medical act].

    Science.gov (United States)

    2011-05-01

    Right to life -as the prohibition of intentionally and arbitrarily taking life, even with authorization of the concerned one- is an internationally recognized right. In many countries, debate regarding euthanasia is more centered in its convenience, social acceptability and how it is regulated, than in its substantial legitimacy. Some argue that euthanasia should be included as part of clinical practice of health professionals, grounded on individual's autonomy claims-everyone having the liberty to choose how to live and how to die. Against this, others sustain that life has a higher value than autonomy, exercising autonomy without respecting the right to life would become a serious moral and social problem. Likewise, euthanasia supporters some-times claim a 'right to live with dignity', which must be understood as a personal obligation, referred more to the ethical than to the strictly legal sphere. In countries where it is already legalized, euthanasia practice has extended to cases where it is not the patient who requests this but the family or some healthcare professional, or even the legal system-when they think that the patient is living in a condition which is not worthy to live. Generalization of euthanasia possibly will end in affecting those who need more care, such as elder, chronically ill or dying people, damaging severely personal basic rights. Nature, purpose and tradition of medicine rule out the practice of euthanasia, which ought not be considered a medical act or legitimately compulsory for physicians. Today's medicine counts with effective treatments for pain and suffering, such as palliative care, including sedative therapy, which best preserves persons dignity and keeps safe the ethos of the medical profession.

  10. EUTHANASIA DALAM PERSPEKTIF HUKUM ISLAM

    Directory of Open Access Journals (Sweden)

    Arifin Rada

    2013-05-01

    Full Text Available Euthanasia is an attempt to end someone life when he/she has an uncurable illness, euthanasia will be done in order to release his/her from suffering his/her illness. In Indonesia, euthanasia can not be done and it is classified as an illegal act. Both in the positive law and the ethics code regulate that performing an euthanasia is not allowed. Regarded to the perspective of Islamic law, also regulated that an active euthanasia is an act that is forbidden and punishable by God with a punishment of hell for those who did.

  11. Knowledge and Attitudes of Cervical Cancer Screening Among Caribbean Women: A Qualitative Interview Study From Barbados.

    Science.gov (United States)

    Christian, Trudy; Guell, Cornelia

    2015-01-01

    The purpose of this study was to explore Barbadian women's attitudes toward and knowledge of routine cervical cancer screening (Pap tests). We conducted semi-structured individual interviews with fourteen female patients between the ages of 20 and 60 years who attended a selected public clinic in Barbados in May and June 2013. Interviews were audio-recorded with participants' consent. The interviews were then transcribed verbatim and, using thematic content analysis, indexed and coded inductively for emerging similar themes. We identified four themes: (1) women had poor knowledge of the purpose of Pap tests. The most frequently occurring misconception was that the test was for the detection of sexually transmitted infections. (2) The women displayed limited cervical cancer awareness. (3) Health professionals were identified by the women as the main driving force behind women taking up screening. (4) The screening procedure was perceived as painful, but women's overriding attitude was that screening was necessary. These findings suggest that Barbadian women would benefit from focused health education efforts surrounding cervical cancer screening to eradicate the misconception that the purpose of the Pap test is the detection of sexually transmitted diseases.

  12. Why don't teenagers use contraception? A qualitative interview study.

    Science.gov (United States)

    Brown, Sally; Guthrie, Kate

    2010-06-01

    To investigate the causes of unintended pregnancies and, in particular, reasons for non-use of contraception among young women attending a day unit for surgical abortion. Women between the ages of 16 and 20 attending a day unit at a hospital in the north of England who were due to have, or had recently had, a surgical abortion were interviewed about their knowledge of and views on contraception, sex education, and sexual health services. Twenty-four young women were interviewed, 22 on the day unit, one in her home and one over the phone, after the abortion. Interviews were recorded with the consent of the interviewees and fully transcribed. Transcripts were analysed using a grounded theory approach. The most common reasons for non-use of contraception related to forgetting or 'not thinking', being 'in the moment' (i.e., being 'in the mood', not wishing to 'break a spell'), the influence of alcohol, and pressure from young men not to use condoms. Lack of knowledge was rarely cited as a reason. Young people are aware of the need to use contraception, and knowledgeable about its availability; however, they often do not think about using it, especially where sex is unplanned. Alcohol and being 'in the moment' are key factors which diminish the likelihood of contraceptive use.

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

    Science.gov (United States)

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

    2015-12-01

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

  14. Experiences and attitudes about physical activity and exercise in patients with chronic pain: a qualitative interview study

    Directory of Open Access Journals (Sweden)

    Karlsson L

    2018-01-01

    Full Text Available Linn Karlsson,1 Björn Gerdle,1 Esa-Pekka Takala,2 Gerhard Andersson,3,4 Britt Larsson1 1Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; 2Work-related Diseases, Finnish Institute of Occupational Health, Helsinki, Finland; 3Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; 4Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institute, Stockholm, Sweden Purpose: The purpose of this study was to describe how patients with chronic pain experience physical activity and exercise (PA&E.Method: This qualitative interview study included 16 women and two men suffering from chronic pain and referred to a multimodal pain rehabilitation program. Semi-structured interviews were conducted and qualitative content analysis was used to analyze the interviews.Results: One main theme emerged: “To overcome obstacles and to seize opportunities to be physically active despite chronic pain.” This main theme was abstracted from five themes: “Valuing a life with physical activity,” “Physical activity and exercise – before and after pain,” “A struggle – difficulties and challenges,” “The enabling of physical activity,” and “In need of continuous and active support.” Conclusion: Although these participants valued PA&E, they seldom achieved desirable levels, and performance of PA&E was undermined by difficulties and failure. The discrepancy between the intention to perform physical activity and the physical activity accomplished could be related to motivation, self-efficacy, and action control. The participants desired high-quality interaction with healthcare providers. The findings can be applied to chronic pain rehabilitation that uses PA&E as treatment. Keywords: chronic pain, experiences, physical activity, rehabilitation, qualitative content analysis

  15. Experience of guilt and strategies for coping with guilt in patients with severe COPD: a qualitative interview study.

    Science.gov (United States)

    Strang, Susann; Farrell, Mary; Larsson, Lars-Olof; Sjöstrand, Charlotte; Gunnarsson, Anna; Ekberg-Jansson, Ann; Strang, Peter

    2014-01-01

    Guilt is associated with an increased level of mood disturbance and a poorer quality of life. The aim of this study was to explore how patients with severe COPD view and experience guilt and the ways in which they cope with this guilt. A total of 31 COPD patients were interviewed about their perceptions and experiences of guilt. Qualitative content analysis was used to examine the interviews. In the descriptive (manifest) analysis, the categories "not feeling personal guilt" and "experiencing guilt" emerged; in the interpretative (latent) analysis, various strategies for dealing with guilt were identified--for example, acceptance or blaming others. Relatively few patients reported that they felt guilt on a conscious level, but those who did expressed anguish, and remorse before God; some felt blamed by others. It is important that healthcare providers acknowledge the guilt that their patients express, since guilt may have adverse effects on the patients' overall health.

  16. A qualitative interview study exploring pregnant women's and health professionals' attitudes to external cephalic version.

    Science.gov (United States)

    Say, Rebecca; Thomson, Richard; Robson, Stephen; Exley, Catherine

    2013-01-16

    Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women's attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals' attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence-based information about ECV and lay beliefs

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

    Science.gov (United States)

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

    2016-11-01

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

  18. Immer nur die zweitbeste Lösung? Protokolle als Dokumentationsmethode für qualitative Interviews

    Directory of Open Access Journals (Sweden)

    Dita Vogel

    2017-12-01

    Full Text Available In der methodischen Literatur zu qualitativen Interviews wird als Standardverfahren oft die Aufzeichnung mit einem Aufnahmegerät und anschließende wortgetreue Verschriftlichung (Transkription empfohlen. Protokolle werden als Mittel der Interviewdokumentation zumeist als zweitbeste Lösung für den Fall dargestellt, dass Mitschnitte nicht möglich sind. Diese Position stellen wir in diesem Beitrag aufgrund theoretischer Überlegungen und empirischer Erfahrungen infrage. Vor- und Nachteile der Dokumentationsformen "Audiomitschnitt + Transkription" und "Notizen + Protokollierung" werden systematisch gegenübergestellt. Anschließend wird anhand von zwei Studien exemplarisch verdeutlicht, dass die Protokollierung die beste Lösung zur Dokumentation der Interviewdaten sein kann. In beiden Studien wurden in Interviews sensible Themen behandelt und die Erhebung grundlegender Informationen über Prozesse und Routinen bezweckt. Grundsätzlich kann Protokollierung angezeigt sein, wenn weniger die Interpretation des Gesagten als vielmehr dessen Intention im Fokus der Forschung ist. Außerdem sollte eine Protokollierung erwogen werden, wenn eine Aufnahme besonders interessante InterviewpartnerInnen von der Teilnahme abhalten oder ein offenes Gespräch verhindern könnte. Mit diesem Beitrag wollen wir zu einer Auseinandersetzung darüber anregen, wann Protokollieren angemessen ist und wie es methodisch angelegt sein sollte.

  19. On interviewing people with pets: reflections from qualitative research on people with long-term conditions.

    Science.gov (United States)

    Ryan, Sara; Ziebland, Sue

    2015-01-01

    There is mounting evidence that pets are associated with physiological, psychological and social benefits for humans. Much of this research has come from western countries, where there have been consistent calls for greater engagement with pet ownership and health. Drawing on a secondary analysis of 61 in-depth interviews with people, or carers of people, with long-term conditions, we explore how pets feature in people's narrative accounts of their experiences. Our findings demonstrate the multifaceted nature of people's relationships with pets, and the embedded and embodied ways in which human-nonhuman interactions are played out in narratives of chronic illness. Our study differs from other work on pets and health in that, by returning to the interview video recordings, we were able to explore the sometimes three-way interactions, the co(a)gency, between participants, pets and researchers. Pets were often presented as important family members, yet the researchers' responses to the presence or talk about pets was often markedly different from their reactions to other household members. We conclude with cautioning against the downgrading of pets in narrative health research. Narrative approaches may invite participants to talk about what is important to them, yet they clearly have limitations in practice. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  20. Students' perspectives on promoting healthful food choices from campus vending machines: a qualitative interview study.

    Science.gov (United States)

    Ali, Habiba I; Jarrar, Amjad H; Abo-El-Enen, Mostafa; Al Shamsi, Mariam; Al Ashqar, Huda

    2015-05-28

    Increasing the healthfulness of campus food environments is an important step in promoting healthful food choices among college students. This study explored university students' suggestions on promoting healthful food choices from campus vending machines. It also examined factors influencing students' food choices from vending machines. Peer-led semi-structured individual interviews were conducted with 43 undergraduate students (33 females and 10 males) recruited from students enrolled in an introductory nutrition course in a large national university in the United Arab Emirates. Interviews were audiotaped, transcribed, and coded to generate themes using N-Vivo software. Accessibility, peer influence, and busy schedules were the main factors influencing students' food choices from campus vending machines. Participants expressed the need to improve the nutritional quality of the food items sold in the campus vending machines. Recommendations for students' nutrition educational activities included placing nutrition tips on or beside the vending machines and using active learning methods, such as competitions on nutrition knowledge. The results of this study have useful applications in improving the campus food environment and nutrition education opportunities at the university to assist students in making healthful food choices.

  1. Dutch euthanasia revisited.

    Science.gov (United States)

    Fenigsen, R

    1997-01-01

    The results of a follow-up study of euthanasia by the Dutch government, five years after the first study, were published on November 26, 1996. This article provides a detailed review of the two reports comparing and contrasting the statistics cited therein. The author notes that the "rules of careful conduct" proposed by the courts and by the Royal Dutch Society of Medicine were frequently disregarded. Special topics included for the first time in the second study were the notification and non-prosecution procedure, euthanasia of newborns and infants, and assisted suicide in psychiatric practice. The authors of the follow-up report state that it would be desirable to reduce the number of "terminations of life without patients' request," but this must be the common responsibility of the doctor and the patient. They suggest that the person who does not wish to have his life terminated should declare this clearly, in advance, verbally and in writing, preferably in the form of a living will. Involuntary euthanasia was rampant in 1990 and equally rampant in 1995. The author concludes that Dutch doctors who practice euthanasia are not on the slippery slope. From the very beginning, they have been at the bottom.

  2. Euthanasia in Albania

    Directory of Open Access Journals (Sweden)

    Beslinda Rrugia

    2016-03-01

    Full Text Available The right to live is a right guaranteed by the constitution as well as international legal acts in force in a country, and is based on the moral of a society. But does the right to live imply a parallel individual right to die? Or should the state protect the right to life of a person who does not want to live anymore, going like this against the will of that person? Albanian anthropology, as a post-communist society lacks the tradition of freedom, as in this case of the freedom that belongs to a man affected by an incurable disease. For this reason, in Albania not only we do not have a law on euthanasia, but the issue of euthanasia is not raised as an issue nor by the legislator nor by civil society. The purpose of this paper is to give an overview of euthanasia in Albania, as well as on some specific problems facing the Albanian reality. The methodology used in the paper consists with the combination of comparing legal provisions of euthanasia (or the lack of them in a vertical historical continuity.

  3. [Notes on euthanasia].

    Science.gov (United States)

    Goic, Alejandro

    2005-03-01

    In the Judeo-Christian tradition, human life is held to be sacred, a semblance of the divine and a gift from God which the individual cannot dispose of at his or her own will. Hence, these monotheistic religions have made of the crime of murder a transgression of God's own commandment not to kill and have extended the applicability of this commandment to the practice of euthanasia and suicide. On the other hand, some non-religious traditions offer plausible reasons favoring euthanasia. This is a delicate matter for physicians, since the Hippocratic tradition forbids euthanasia and because as care-givers they must also bear the psychological, moral and emotional burden of carrying it out. Physicians are trained to preserve life but not to bring it to an end. As human beings, they must always respect the principle of nonmaleficence, and as physicians they must always respect as well the principle of beneficence. It is difficult to accept the fact that ending a human life can be an act of beneficence. In order to differentiate between passive and active euthanasia, the concept of proportionality of medical acts must be brought into consideration. For instance, using high doses of opiates to alleviate pain or withholding the use of an extraordinary method of treatment are not passive acts aimed at ending the life of a terminally ill patient, but medical acts that are reasonable, judicious and proportionate to the condition and irreversibility of a patient's illness. Therefore, so-called passive euthanasia cannot be considered the same as euthanasia. On the other hand, medically assisted suicide is a deceitful form of active euthanasia. The aim of this act is to cause death and the physician is morally responsible for such a death, since he is providing the means for bringing a human life to an end. Many times the desire to die expressed by terminally ill elderly and helpless patients is a request for help and an expression of reproach against a society that allows for

  4. Evaluating recovery following hip fracture: a qualitative interview study of what is important to patients.

    Science.gov (United States)

    Griffiths, Frances; Mason, Victoria; Boardman, Felicity; Dennick, Katherine; Haywood, Kirstie; Achten, Juul; Parsons, Nicholas; Griffin, Xavier; Costa, Matthew

    2015-01-06

    To explore what patients consider important when evaluating their recovery from hip fracture and to consider how these priorities could be used in the evaluation of the quality of hip fracture services. Semistructured interviews exploring the experience of recovery from hip fracture at two time points-4 weeks and 4 months postoperative hip fixation. Two approaches to analysis: thematic analysis of data specifically related to recovery from hip fracture; summarising the participant's experience overall. 31 participants were recruited, of whom 20 were women and 12 were cognitively impaired. Mean age was 81.5 years. Interviews were provided by 19 patients, 14 carers and 8 patient/carer dyad; 10 participants were interviewed twice. Single major trauma centre in the West Midlands of the UK. Stable mobility (without falls or fear of falls) for valued activities was considered most important by participants who had some prefracture mobility and were able to articulate what they valued during recovery. Mobility was important for managing personal care, for day-to-day activities such as shopping and gardening, and for maintenance of mental well-being. Some participants used assistive mobility devices or adapted to their limitations. Others maintained their previous limited function through increased care provision. Many participants were unable to articulate what they valued as hip fracture was perceived as part of their decline with age. The fracture and problems from other health conditions were an inseparable part of one health experience. Prefracture mobility, adaptations to reduced mobility before or after fracture, and whether or not patients perceive themselves to be declining with age influence what patients consider important during recovery from hip fracture. No single patient-reported outcome measure could evaluate quality of care for all patients following hip fracture. General health-related quality of life tools may provide useful information within

  5. Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation

    Science.gov (United States)

    White, Martin; Wrieden, Wendy; Brown, Heather; Stead, Martine; Adams, Jean

    2017-01-01

    Food-related choices have an important impact on health. Food preparation methods may be linked to diet and health benefits. However, the factors influencing people’s food choices, and how they are shaped by food preparation experiences, are still not fully understood. We aimed to study home food preparation practices, experiences and perceptions amongst adults in North East England. A matrix was used to purposively sample participants with diverse socio-demographic characteristics. Participants developed photographic food diaries that were used as prompts during semi-structured interviews. Data were analysed using the Framework Method. Interviews were conducted with 18 adults (five men and 13 women), aged approximately 20 to 80 years, to reach data saturation. Participants’ practices varied widely, from reliance on pre-prepared foods, to preparing complex meals entirely from basic ingredients. Key themes emerged regarding the cook (identity), the task (process of cooking), and the context (situational drivers). Resources, in terms of time, money and facilities, were also underpinning influences on food preparation. Participants’ practices were determined by both personal motivations to cook, and the influence of others, and generally reflected compromises between varied competing demands and challenges in life. Most people appeared to be overall content with their food preparation behaviour, though ideally aspired to cook more frequently, using basic ingredients. This often seemed to be driven by social desirability. Home food preparation is complex, with heterogeneous practices, experiences and perceptions both between individuals and within the same individual over time, according to shifting priorities and circumstances. Generalisability of these findings may be limited by the regional participant sample; however the results support and build upon previous research. Focussing interventions on life transition points at which priorities and circumstances

  6. Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation.

    Science.gov (United States)

    Mills, Susanna; White, Martin; Wrieden, Wendy; Brown, Heather; Stead, Martine; Adams, Jean

    2017-01-01

    Food-related choices have an important impact on health. Food preparation methods may be linked to diet and health benefits. However, the factors influencing people's food choices, and how they are shaped by food preparation experiences, are still not fully understood. We aimed to study home food preparation practices, experiences and perceptions amongst adults in North East England. A matrix was used to purposively sample participants with diverse socio-demographic characteristics. Participants developed photographic food diaries that were used as prompts during semi-structured interviews. Data were analysed using the Framework Method. Interviews were conducted with 18 adults (five men and 13 women), aged approximately 20 to 80 years, to reach data saturation. Participants' practices varied widely, from reliance on pre-prepared foods, to preparing complex meals entirely from basic ingredients. Key themes emerged regarding the cook (identity), the task (process of cooking), and the context (situational drivers). Resources, in terms of time, money and facilities, were also underpinning influences on food preparation. Participants' practices were determined by both personal motivations to cook, and the influence of others, and generally reflected compromises between varied competing demands and challenges in life. Most people appeared to be overall content with their food preparation behaviour, though ideally aspired to cook more frequently, using basic ingredients. This often seemed to be driven by social desirability. Home food preparation is complex, with heterogeneous practices, experiences and perceptions both between individuals and within the same individual over time, according to shifting priorities and circumstances. Generalisability of these findings may be limited by the regional participant sample; however the results support and build upon previous research. Focussing interventions on life transition points at which priorities and circumstances change

  7. Sexual relationships among men who have sex with men in Hanoi, Vietnam: a qualitative interview study.

    Science.gov (United States)

    Bengtsson, Linus; Thorson, Anna; Thanh, Vu Pham Nguyen; Allebeck, Peter; Popenoe, Rebecca

    2013-02-05

    The prevalence of HIV among men who have sex with men (MSM) in Vietnam's two largest cities, Hanoi and Ho Chi Minh City, may be above 10%. The aim of this study was to explore sexual relationship patterns and experiences among MSM in Hanoi, to inform HIV preventive efforts. Using purposive sampling we recruited 17 MSM in Hanoi, Vietnam, for in-depth interviews. Participants were aged between 19 and 48 years and came from diverse socio-economic backgrounds. Interviews were tape-recorded, transcribed verbatim, and translated into English. Content analysis was used. Almost all men in the study saw their same-sex attraction as part of their "nature". Many informants had secret but rich social lives within the MSM social circles in Hanoi. However, poor men had difficulties connecting to these networks. Lifetime sexual partner numbers ranged from one to 200. Seven participants had at some point in their lives been in relationships lasting from one to four years. For several men, relationships were not primarily centered on romantic feelings but instead intimately connected to economic and practical dependence. Sexual relationships varied greatly in terms of emotional attachment, commitment, trust, relationship ideals, sexual satisfaction and exchange of money or gifts. Faithfulness was highly valued but largely seen as unobtainable. Several informants felt strong family pressure to marry a woman and have children. This study contextualizes sexual relationships among MSM in Hanoi and highlights the extent to which HIV prevention activities need to not only consider HIV prevention in the context of casual sexual encounters but also how to adequately target preventive efforts that can reach MSM in relationships.

  8. Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation.

    Directory of Open Access Journals (Sweden)

    Susanna Mills

    Full Text Available Food-related choices have an important impact on health. Food preparation methods may be linked to diet and health benefits. However, the factors influencing people's food choices, and how they are shaped by food preparation experiences, are still not fully understood. We aimed to study home food preparation practices, experiences and perceptions amongst adults in North East England. A matrix was used to purposively sample participants with diverse socio-demographic characteristics. Participants developed photographic food diaries that were used as prompts during semi-structured interviews. Data were analysed using the Framework Method. Interviews were conducted with 18 adults (five men and 13 women, aged approximately 20 to 80 years, to reach data saturation. Participants' practices varied widely, from reliance on pre-prepared foods, to preparing complex meals entirely from basic ingredients. Key themes emerged regarding the cook (identity, the task (process of cooking, and the context (situational drivers. Resources, in terms of time, money and facilities, were also underpinning influences on food preparation. Participants' practices were determined by both personal motivations to cook, and the influence of others, and generally reflected compromises between varied competing demands and challenges in life. Most people appeared to be overall content with their food preparation behaviour, though ideally aspired to cook more frequently, using basic ingredients. This often seemed to be driven by social desirability. Home food preparation is complex, with heterogeneous practices, experiences and perceptions both between individuals and within the same individual over time, according to shifting priorities and circumstances. Generalisability of these findings may be limited by the regional participant sample; however the results support and build upon previous research. Focussing interventions on life transition points at which priorities and

  9. Risk Taking and Decision Making in Kidney Paired Donation: A Qualitative Study by Semistructured Interviews.

    Science.gov (United States)

    Baines, L S; Dulku, H; Jindal, R M; Papalois, V

    2018-06-01

    Despite excellent outcomes of kidney paired donation (KPD), little is known about how a patient's frame (apply cognitive bias) or weight (attribute value) and concerns relating to risk, justice, and equity affect his or her decision-making process. A pilot study consisting of 3 KPD transplant recipients and 3 KPD kidney donors in the last year was conducted to identify and explore themes in decision making and risk taking. The pilot study was followed by the main study comprised of 20 recipients who had already undergone KPD transplantation and 20 donors who had undergone donor nephrectomy. We conducted semistructured interviews in this cohort and analyzed the data thematically. Each donor-recipient pair was interviewed together to facilitate dyadic conversation and provide deeper insight into the decision-making process leading to transplant and donation. Common themes to both recipient and donor decision making included quality of life; characteristics of the unknown donor and post-transplant expectations. Recipient-specific themes included failure to reach life span milestones, experiences of fellow patients, and altruistic desire to expand the donor pool. Donor-specific themes included balancing existing life commitments with the recipient's need for a kidney, equity and mental accounting in kidney exchange (comparable quality of the kidney received versus the kidney donated), and logistical justice for the recipient. Donors and recipients frame and weight the concepts of risk, justice, and equity differently. This may have direct implications to facilitating patient-centered communication and engagement in KPD pairs. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Challenges in shared decision making in advanced cancer care: a qualitative longitudinal observational and interview study.

    Science.gov (United States)

    Brom, Linda; De Snoo-Trimp, Janine C; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Stiggelbout, Anne M; Pasman, H Roeline W

    2017-02-01

    Patients' preferences and expectations should be taken into account in treatment decision making in the last phase of life. Shared decision making (SDM) is regarded as a way to give the patient a central role in decision making. Little is known about how SDM is used in clinical practice in advanced cancer care. To examine whether and how the steps of SDM can be recognized in decision making about second- and third-line chemotherapy. Fourteen advanced cancer patients were followed over time using face-to-face in-depth interviews and observations of the patients' out-clinic visits. Interviews and outpatient clinic visits in which treatment options were discussed or decisions made were transcribed verbatim and analysed using open coding. Patients were satisfied with the decision-making process, but the steps of SDM were barely seen in daily practice. The creation of awareness about available treatment options by physicians was limited and not discussed in an equal way. Patients' wishes and concerns were not explicitly assessed, which led to different expectations about improved survival from subsequent lines of chemotherapy. To reach SDM in daily practice, physicians should create awareness of all treatment options, including forgoing treatment, and communicate the risk of benefit and harm. Open and honest communication is needed in which patients' expectations and concerns are discussed. Through this, the difficult process of decision making in the last phase of life can be facilitated and the focus on the best care for the specific patient is strengthened. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  11. [Euthanasia--a moral choice?].

    Science.gov (United States)

    Sveinsson, Olafur Arni

    2007-01-01

    Euthanasia has been heatedly discussed in Western countries over the last years. Only a few nations have legalized euthanasia or physician assisted suicide with the Dutch at the forefront of that field. Proponents of euthanasia mostly argue for euthanasia on two grounds. Firstly, that the patient has a right to die and secondly, that there is no substantial difference between euthanasia and palliative care. In this paper I will argue against both of the above. I discuss the arguments against euthanasia which are in principle four. Firstly, it is held by many that taking a human life is wrong under all circumstances. Secondly, that it is an unjustifiable demand to ask a person to take another person's life. In relation to that argument, euthanasia is not in accordance with the basic principles of medicine and nursing as they have evolved over the years and could therefore easily disrupt the therapeutic relationship. Thirdly, as shown from Holland there is empirical evidence that euthanasia is not under good enough surveillance and therefore invites misuse. Fourthly, even though euthanasia might possibly be justifiable under certain circumstances, legalisation might well invite abuse because of the message and pressure that the option places on both patients and professionals in terminal care. My answer to the euthanasia demand is palliative care, where dialogue between the patient and doctor is central. But the dialogue cannot be effective, unless both partners are willing and able to engage in sincere and frank conversations.

  12. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians' and nurses' practice in three European countries

    NARCIS (Netherlands)

    J. Seymour (Jane); J.A.C. Rietjens (Judith); S.M. Bruinsma (Sophie); L. Deliens (Luc); S. Sterckx (Sigrid); F. Mortier (Freddy); J. Brown (Jayne); N. Mathers (Nigel); A. van der Heide (Agnes)

    2015-01-01

    textabstractBackground: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. Methods: Qualitative case studies using interviews.

  13. Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

    Directory of Open Access Journals (Sweden)

    Moczko TR

    2016-01-01

    Full Text Available Tobias R Moczko,1,2,* Till J Bugaj,1,* Wolfgang Herzog,1 Christoph Nikendei1 1Department for General Internal and Psychosomatic Medicine, University Hospital of Heidelberg, Heidelberg, 2School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany *These authors contributed equally to this work Objectives: This study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace. Methods: In this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed. Results: Students’ statements regarding burdens and dealing with stress were classified into four main categories: A perceived stressors and provoking factors, B stress-induced consequences, C personal and external resources for preventing and dealing with stress, and D final-year students’ suggestions for workplace improvement. Conclusion: Final-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically. Keywords: undergraduate medical education, stress prevention, final-year medical education, workplace learning, qualitative research

  14. A meta-ethnography of interview-based qualitative research studies on medical students' views and experiences of empathy.

    Science.gov (United States)

    Jeffrey, David

    2016-12-01

    Quantitative research suggests that medical students' empathy declines during their training. This meta-ethnography asks: What new understanding may be gained by a synthesis of interview-based qualitative research on medical students' views and experiences of empathy? How can such a synthesis be undertaken? A meta-ethnography synthesizes individual qualitative studies to generate knowledge increasing understanding and informing debate. A literature search yielded eight qualitative studies which met the inclusion criteria. These were analyzed from a phenomenological and interpretative perspective. The meta-ethnography revealed a conceptual confusion around empathy and a tension in medical education between distancing and connecting with patients. Barriers to empathy included a lack of patient contact and a strong emphasis on the biomedical over the psycho-social aspects of the curriculum. A number of influences discussed in the paper lead students to adopt less overt ways of showing their empathy. These insights deepen our understanding of the apparent decline in empathy in medical students. The lessons from these studies suggest that future curriculum development should include earlier patient contact, more emphasis on psycho-social aspects of care and address the barriers to empathy to ensure that tomorrow's doctors are empathetic as well as competent.

  15. Understanding barriers to the introduction of precision medicines in non-small cell lung cancer: A qualitative interview protocol.

    Science.gov (United States)

    Wright, Stuart; Daker-White, Gavin; Newman, William; Payne, Katherine

    2018-01-01

    Background: While precision medicines targeting genetic mutations and alterations in non-small cell lung cancer (NSCLC) have been available since 2010, their adoption into clinical practice has been slow. Evidence suggests that a number of barriers, such as insufficient clinician knowledge, a need for training of test providers, or a lack of specific clinical guidelines, may slow the implementation of precision in general. However, little attention has been given to the barriers to providing precision medicines in NSCLC. The purpose of this protocol is to outline the design for a qualitative interview study to identify the barriers and facilitators to the provision of precision medicines for NSCLC. Methods: This study will use semi-structured interviews with clinicians (n=10), test providers (n=10), and service commissioners (n=10) to identify the perceived barriers and facilitators to providing historical, current, and future precision medicines in NSCLC. Participants will be identified through mailing list advertisements and snowball sampling. Recruitment will continue until data saturation, indicated by no new themes arising from the data. Interviews will be conducted by telephone to facilitate geographical diversity. The qualitative data will be analysed using a framework analysis with themes anticipated to relate to; relevant barriers to providing precision medicines, the impact of different barriers on medicine provision, changes in the ability to provide precision medicines over time, and strategies to facilitate the provision of precision medicines. Ethics: This study has been approved by the University of Manchester Proportionate Review Research Ethics Committee (Reference number: 2017-1885-3619). Written consent will be obtained from all participants. Conclusion: This study is the first to explore the barriers and facilitators to providing precision medicines for NSCLC in the English NHS. The findings will inform strategies to improve the implementation

  16. The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study.

    Science.gov (United States)

    Heckemann, Birgit; Breimaier, Helga Elisabeth; Halfens, Ruud J G; Schols, Jos M G A; Hahn, Sabine

    2016-09-01

    Aggression management training for nurses is an important part of a comprehensive strategy to reduce patient and visitor aggression in healthcare. Although training is commonplace, few scientific studies examine its benefits. To explore and describe, from a nurse's perspective, the learning gained from attending aggression management training. This was a descriptive qualitative interview study. We conducted semi-structured individual interviews with seven nurses before (September/October 2012) and after they attended aggression management training (January/February 2013). Interview transcripts were content-analysed qualitatively. The study plan was reviewed by the responsible ethics committees. Participants gave written informed consent. Aggression management training did not change nurses' attitude. Coping emotionally with the management of patient and visitor aggression remained a challenge. Nurses' theoretical knowledge increased, but they did not necessarily acquire new strategies for managing patient/visitor aggression. Instead, the course refreshed or activated existing knowledge of prevention, intervention and de-escalation strategies. The training increased nurses' environmental and situational awareness for early signs of patient and visitor. They also acquired some strategies for emotional self-management. Nurses became more confident in dealing with (potentially) aggressive situations. While the training influenced nurses' individual clinical practice, learning was rarely shared within teams. Aggression management training increases skills, knowledge and confidence in dealing with patient or visitor aggression, but the emotional management remains a challenge. Future research should investigate how aggression management training courses can strengthen nurses' ability to emotionally cope with patient and visitor aggression. More knowledge is needed on how the theoretical and practical knowledge gained from the training may be disseminated more effectively

  17. Staff perceptions of a Productive Community Services implementation: A qualitative interview study.

    Science.gov (United States)

    Bradley, Dominique Kim Frances; Griffin, Murray

    2015-06-01

    The Productive Series is a collection of change programmes designed by the English National Health Service (NHS) Institute for Innovation and Improvement to help frontline healthcare staff improve quality and reduce wasted time, so that this time can be reinvested into time spent with patients. The programmes have been implemented in at least 14 countries around the world. This study examines an implementation of the Productive Community Services programme that took place in a Community healthcare organisation in England from July 2010 to March 2012. To explore staff members' perceptions of a Productive Community Services implementation. Cross-sectional interview. Community Healthcare Organisation in East Anglia, England. 45 participants were recruited using purposive, snowballing and opportunistic sampling methods to represent five main types of staff group in the organisation; clinical team members, administrative team members, service managers/team leaders, senior managers and software support staff. Team members were recruited on the basis that they had submitted data for at least one Productive Community Services module. Semi-structured individual and group interviews were carried out after the programme concluded and analysed using thematic analysis. This report focuses on six of the themes identified. The analysis found that communication was not always effective, and there was a lack of awareness, knowledge and understanding of the programme. Many staff did not find the Productive Community Services work relevant, and although certain improvements were sustained, suboptimal practices crept back. Although negative outcomes were reported, such as the programme taking time away from patients initially, many benefits were described including improved stock control and work environments, and better use of the Electronic Patient Record system. One of the themes identified highlighted the positive perceptions of the programme, however a focus on five other themes

  18. "One-night stands" - risky trips between lust and trust: qualitative interviews with Chlamydia trachomatis infected youth in North Sweden.

    Science.gov (United States)

    Christianson, Monica; Johansson, Eva; Emmelin, Maria; Westman, Göran

    2003-01-01

    The aim of the study was to get a deeper understanding of sexual risk-taking, by interviewing young people diagnosed with Chlamydia trachomatis. This qualitative study was conducted at a youth clinic in Umeå, Sweden. Five young women and four men, aged 18-22, participated. In-depth interviews were performed. Open questions around certain themes were posed, such as thoughts about getting CT, sexual encounters, and attitudes towards condoms. Interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. Norms, events, and emotions were explored. The goal was to develop credible and applicable concepts concerning sexual relationships, risk-taking, and experiences of CT. Informants revealed that behind their sexual risk-taking was a drive to "go steady". Lust and trust were the guidelines if sex was going to take place. When discussing "one-night stands" gender stereotypes occurred. Females were expected to be less forward compared with males. We found an uneven distribution of responsibility concerning condoms. Males expected females to be "condom promoters". By catching CT, females experienced guilt, while males felt content through knowing "the source of contamination". An important public health issue is to implement how males should play an equal part in reproductive health. General CT screening of males is one suggestion.

  19. Alcohol brief interventions practice following training for multidisciplinary health and social care teams: a qualitative interview study.

    Science.gov (United States)

    Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

    2015-03-01

    Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

  20. Reflections on the Swiss Consensus Statement in the context of qualitative interviews with heterosexuals living with HIV.

    Science.gov (United States)

    Persson, A

    2010-12-01

    In 2008, the Swiss Federal AIDS Commission released a statement concluding that people with HIV who are on treatment and have an undetectable viral load are non-infectious and can safely practice unprotected sex with their HIV-negative partner under certain conditions. Contradicting over 25 years of HIV prevention messages, the so called Swiss Consensus Statement sparked a polarised international debate. One key concern is that the Statement will be misinterpreted to imply that everybody on treatment can have unprotected sex. Therefore, critics warn against any departure from the emphasis on condoms as the most effective prevention method. Given this concern, it is useful to reflect on what relevance the Swiss Statement may have for those concerned. This paper draws on qualitative interviews with HIV-positive heterosexuals and HIV-negative partners in Australia. Conducted both before and after the release of the Statement, these interviews revealed that sexual decision-making was not based solely on calculations of risk, but shaped by complex emotions and relationship priorities. The interviews also revealed that participants were sceptical towards the Statement's prevention message. These findings call into question the central concerns that drive this debate.

  1. How to Design Tobacco Prevention and Control Games for Youth and Adolescents: A Qualitative Analysis of Expert Interviews.

    Science.gov (United States)

    Hall, Amanda K; Mercado, Rebeccah; Anderson-Lewis, Charkarra; Darville, Gabrielle; Bernhardt, Jay M

    2015-12-01

    Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents.

  2. Interhospital transfer of children in respiratory failure: a clinician interview qualitative study.

    Science.gov (United States)

    Odetola, Folafoluwa O; Anspach, Renee R; Han, Yong Y; Clark, Sarah J

    2017-02-01

    To investigate the decision making underlying transfer of children with respiratory failure from level II to level I pediatric intensive care unit care. Interviews with 19 eligible level II pediatric intensive care unit physicians about a hypothetical scenario of a 2-year-old girl in respiratory failure: RESULTS: At baseline, indices critical to management were as follows: OI (53%), partial pressure of oxygen in arterial blood (Pao 2 )/Fio 2 (32%), and inflation pressure (16%). Poor clinical response was signified by high OI, inflation pressure, and Fio 2 , and low Pao 2 /Fio 2 . At EP 1, 18 of 19 respondents would initiate high-frequency oscillatory ventilation, and 1 would transfer. At EP 2, 15 of 18 respondents would maintain high-frequency oscillatory ventilation, 9 of them calling to discuss transfer. All respondents would transfer if escalated therapies failed to reverse the patient's clinical deterioration. Interhospital transfer of children in respiratory failure is triggered by poor response to escalation of locally available care modalities. This finding provides new insight into decision making underlying interhospital transfer of children with respiratory failure. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Patient and family member perspectives on searching for cancer clinical trials: A qualitative interview study.

    Science.gov (United States)

    Ridgeway, Jennifer L; Asiedu, Gladys B; Carroll, Katherine; Tenney, Meaghan; Jatoi, Aminah; Radecki Breitkopf, Carmen

    2017-02-01

    Clinical trials are vital in the context of ovarian cancer and may offer further treatment options during disease recurrence, yet enrollment remains low. Understanding patient and family member experiences with identifying trials can inform engagement and education efforts. Interviews were conducted with 33 patients who had experience with clinical trial conversations and 39 nominated family members. Thematic analysis examined experiences and generated findings for clinical practice. Trial conversations with providers at diagnosis were uncommon and often overwhelming. Most participants delayed engagement until later in the disease course. With hindsight, though, some wished they considered trials earlier. Difficulty identifying appropriate trials led some to defer searching to providers, but then they worried about missed opportunities. Most family members felt unqualified to search. Trial conversations during clinical encounters should start early and include specifying search responsibilities of providers, patients, and family. Patients and family members can be engaged in searches but need guidance. Trials should be discussed throughout the disease course, even if patients are not ready to participate or are not making a treatment decision. Education should focus on identifying trials that meet search criteria. Transparency regarding each individual's role in identifying trials is critical. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Perceived benefits and proposed solutions for teen pregnancy: qualitative interviews with youth care workers.

    Science.gov (United States)

    Boustani, Maya Mroué; Frazier, Stacy L; Hartley, Chelsey; Meinzer, Michael; Hedemann, Erin

    2015-01-01

    The purpose of this article is to examine youth care workers' perceptions of the specific and unique sexual health needs of youth at risk for foster care. Semistructured interviews were conducted with youth care workers (N = 10) at a shelter for youth in or at risk for foster care. Youth care workers perceive that youth have unique experiences and needs related to sexual health programming and pregnancy prevention. Reflecting a great deal of family dysfunction, 3 themes emerged that revealed perceived benefits of teen pregnancy: youths' effort to prove themselves as adults, opportunity to secure their relationship with a partner, and desire to create an emotional connection with a baby. Lack of knowledge and accumulation of risk factors were viewed as most problematic. Current pregnancy prevention programs assume teen pregnancies are unwanted and emphasize the costs of sexual risk taking. Current findings suggest that sexual health programming for youth in or at risk for foster care should account for 3 perceived benefits of teen pregnancy. New opportunities for improving the reach and effectiveness of intervention for youth in or at risk for foster care are discussed.

  5. Changing organizational structure and organizational memory in primary care practices: a qualitative interview study.

    Science.gov (United States)

    Alyahya, Mohammad

    2012-02-01

    Organizational structure is built through dynamic processes which blend historical force and management decisions, as a part of a broader process of constructing organizational memory (OM). OM is considered to be one of the main competences leading to the organization's success. This study focuses on the impact of the Quality and Outcome Framework (QOF), which is a Pay-for-Performance scheme, on general practitioner (GP) practices in the UK. The study is based on semistructured interviews with four GP practices in the north of England involving 39 informants. The findings show that the way practices assigned different functions into specialized units, divisions or departments shows the degree of specialization in their organizational structures. More specialized unit arrangements, such as an IT division, particular chronic disease clinics or competence-based job distributions enhanced procedural memory development through enabling regular use of knowledge in specific context, which led to competence building. In turn, such competence at particular functions or jobs made it possible for the practices to achieve their goals more efficiently. This study concludes that organizational structure contributed strongly to the enhancement of OM, which in turn led to better organizational competence.

  6. Qualitative interviews of pharmacy interns: determining curricular preparedness for work life

    Directory of Open Access Journals (Sweden)

    Stupans I

    2012-03-01

    Full Text Available One of the key features affecting the transition from university to paid employment is the graduate’s perception of their capability to satisfactorily perform the work of a graduate. In some professions such as in nursing, the concept of “transition shock” is referred to. There is a need to understand how pharmacy students perceive the transition to their first job as intern pharmacists and identify potential curriculum gaps in their pharmacy studies. To date, little evidence around whether university programs are effective in equipping pharmacy graduates in transitioning to the world of work has been published.Objectives: To explore from the perspective of new pharmacy professionals, graduated from one Australian university areas that need to be addressed in pharmacy programs to prepare graduates for the transition to full-time work as interns in pharmacy. Methods: Thematic analysis of interviews with interns.Results: Subthemes were identified within the responses- relationships within the workplace and graduates needing to interest themselves in other people, adjusting to work hours and the differences between university assessments and performing in a workplace. Suggestions were made by graduates that the placement period within the pharmacy program be increased.Conclusions: Pharmacy graduates appear prepared for the world of pharmacy work. The concept of “transition shock” or “transition stress” described for graduates of other health professions commencing work was not apparent.

  7. ANALISIS TERHADAP PELAKSANAAN EUTHANASIA PASIF

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    Umi Enggarsasi

    1997-07-01

    Full Text Available Dalam KUHP tidak satu pasal pun yang menjelaskan batasan atau pengertian euthanasia. Namun demikian, pengenaan terhadap euthanasia dianalogikan dengan delik-delik yang tercantum dalam pasal 338, 340, 344 KUHP. Dengan dasar itulah maka pelaksanaan euthanasia dilarang. Larangan euthanasia pasif tidak pernah efektif karena kematian sebagai akibat ketidakmampuan ilmu dan teknologi kedokteran, dipandang sebagai kematian alamiah, sedangkan terhadap kematian alamiah tentu saja tidak ditahan-tahan atau dilarang hukum pidana maupun kode etik kedokteran. Hukum pidana dan kode etik kedokteran, tidak mewajibkan dokter untuk mengobati pasien di Iuar batas kemampuan ilmu dan teknologi kedokteran. berdasarkan penerapan karakteristik delik omisionis terbukti bahwa, larangan euthanasia pasif tidak memenuhi kriteria untuk diterapkan sebagai perbuatan pidana. Dalam hal terjadinya euthanasia pasif, walaupun dokter melakukan perbuatan positif, secara logika, kematian pasien tidak dapat dihindari. Dengan demikian sulit untuk dibuktikan adanya hubungan kausal antara akibat yang dilarang timbulnya dengan kelakuan negatif dokter.

  8. Should Euthanasia Be Considered Iatrogenic?

    Science.gov (United States)

    Barone, Silvana; Unguru, Yoram

    2017-08-01

    As more countries adopt laws and regulations concerning euthanasia, pediatric euthanasia has become an important topic of discussion. Conceptions of what constitutes harm to patients are fluid and highly dependent on a myriad of factors including, but not limited to, health care ethics, family values, and cultural context. Euthanasia could be viewed as iatrogenic insofar as it results in an outcome (death) that some might consider inherently negative. However, this perspective fails to acknowledge that death, the outcome of euthanasia, is not an inadvertent or preventable complication but rather the goal of the medical intervention. Conversely, the refusal to engage in the practice of euthanasia might be conceived as iatrogenic insofar as it might inadvertently prolong patient suffering. This article will explore cultural and social factors informing families', health care professionals', and society's views on pediatric euthanasia in selected countries. © 2017 American Medical Association. All Rights Reserved.

  9. Euthanasia is not medical treatment.

    Science.gov (United States)

    Boudreau, J Donald; Somerville, Margaret A

    2013-01-01

    The public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians. In furthering critical analysis, we supplement the discourse in the ethics and palliative care literature with that from medical education and evolving jurisprudence. Both proponents and opponents agree that the values of respect for human life and for individuals' autonomy are relevant to the debate. Advocates of euthanasia and assisted suicide give priority to the right to personal autonomy and avoid discussions of harmful impacts of these practices on medicine, law and society. Opponents give priority to respect for life and identify such harmful effects. These both require euthanasia to remain legally prohibited. Proposals are emerging that if society legalizes euthanasia it should not be mandated to physicians. The impact of characterizing euthanasia as 'medical treatment' on physicians' professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.

  10. Assessment of nurses’ views about euthanasia according to their departments

    Directory of Open Access Journals (Sweden)

    Bekir Karaarslan

    2014-12-01

    Full Text Available Objective: This study includes evaluation of views of the nurses working in two different university hospitals on euthanasia. Methods: This research was planned in form of a cross-sectional definitive questionnaire to analyze views of the nurses on euthanasia according to their departments. A face to face interview was performed with the nurses working in Medical Faculties of Dicle and Gaziantep Universities in 2013. One hundred and fifty two volunteers were examined according to the gender, age, marital status, number of children, family type that they live in, the department that they work, their frequency to meet death, professional experience, presence of any relative confined to bed, their ideas on whether the euthanasia law should be enacted, whether they would request euthanasia for themselves and their relatives. Result: Participants included 125 (82.2% women and 27 (17.8% men; average age was 26.68 ± 12.76 (20-56 years and 21 (13.8% cases did not report their ages. Eighty-nine (58.6% participants were married, 50 (32.9% participants were single and 105 (69.1% participants lived in an elementary family environment. Fifty eight (38.2% participants expressed an opinion on requirement of a legal regulation to make euthanasia possible and 40 (26.3% reported that they were uncertain about this subject. No statistically significant difference was detected between willingness and unwillingness of euthanasia according to their departments (p>0.05. Conclusion: As a result of this study, we find that some of the nurses consider application of the passive euthanasia occurs in our country although euthanasia is forbidden.

  11. Nursing students' approaches toward euthanasia.

    Science.gov (United States)

    Ozcelik, Hanife; Tekir, Ozlem; Samancioglu, Sevgin; Fadiloglu, Cicek; Ozkara, Erdem

    2014-01-01

    In Turkey, which is a secular, democratic nation with a majority Muslim population, euthanasia is illegal and regarded as murder. Nurses and students can be faced with ethical dilemmas and a lack of a legal basis, with a conflict of religious beliefs and social and cultural values concerning euthanasia. The aim of this study was to investigate undergraduate nursing students' attitudes towards euthanasia. The study, which had a descriptive design, was conducted with 600 students. The 1st, 2nd, 3rd, and 4th year nursing students at a school of nursing were contacted in May 2009, and 383 students (63.8% of the study population of a total of 600 students) gave informed consent. Two tools were used in accordance with questionnaire preparation rules. The majority of students were female and single (96.9%), and their mean age was 21.3 ± 1.5 years. A majority (78.9%) stated they had received no training course/education on the concept of euthanasia. Nearly one-third (32.4%) of the students were against euthanasia; 14.3% of the students in the study agreed that if their relatives had an irreversible, lethal condition, passive euthanasia could be performed. In addition, 24.8% of the students agreed that if they themselves had an irreversible, lethal condition, passive euthanasia could be performed. Less than half (42.5%) of the students thought that discussions about euthanasia could be useful. There was a significant relation between the study year and being against euthanasia (p euthanasia could be abused (p euthanasia was unethical (p euthanasia.

  12. Mechanisms of action of an implementation intervention in stroke rehabilitation: a qualitative interview study.

    Science.gov (United States)

    Connell, Louise A; McMahon, Naoimh E; Tyson, Sarah F; Watkins, Caroline L; Eng, Janice J

    2016-09-30

    Despite best evidence demonstrating the effectiveness of increased intensity of exercise after stroke, current levels of therapy continue to be below those required to optimise motor recovery. We developed and tested an implementation intervention that aims to increase arm exercise in stroke rehabilitation. The aim of this study was to illustrate the use of a behaviour change framework, the Behaviour Change Wheel, to identify the mechanisms of action that explain how the intervention produced change. We implemented the intervention at three stroke rehabilitation units in the United Kingdom. A purposive sample of therapy team members were recruited to participate in semi-structured interviews to explore their perceptions of how the intervention produced change at their work place. Audio recordings were transcribed and imported into NVivo 10 for content analysis. Two coders separately analysed the transcripts and coded emergent mechanisms. Mechanisms were categorised using the Theoretical Domains Framework (TDF) (an extension of the Capability, Opportunity, Motivation and Behaviour model (COM-B) at the hub of the Behaviour Change Wheel). We identified five main mechanisms of action: 'social/professional role and identity', 'intentions', 'reinforcement', 'behavioural regulation' and 'beliefs about consequences'. At the outset, participants viewed the research team as an external influence for whom they endeavoured to complete the study activities. The study design, with a focus on implementation in real world settings, influenced participants' intentions to implement the intervention components. Monthly meetings between the research and therapy teams were central to the intervention and acted as prompt or reminder to sustain implementation. The phased approach to introducing and implementing intervention components influenced participants' beliefs about the feasibility of implementation. The Behaviour Change Wheel, and in particular the Theoretical Domains Framework

  13. Euthanasia in The Netherlands.

    Science.gov (United States)

    van der Wal, G; Dillmann, R J

    1994-05-21

    The practice of euthanasia in the Netherlands is often used as an argument in debates outside the Netherlands--hence a clear description of the Dutch situation is important. This article summarises recent data and discusses conceptual issues and relevant characteristics of the system of health care. Special emphasis is put on regulation, including relevant data on notification and prosecution. Besides the practice of euthanasia the Dutch are confronted with the gaps in reporting of cases to the public prosecutor and the existence of cases of ending a life without an explicit request. Nevertheless, the "Dutch experiment" need not inevitably lead down the slippery slope because of the visibility and openness of this part of medical practice. This will lead to increased awareness, more safeguards, and improvement of medical decisions concerning the end of life.

  14. Should Pediatric Euthanasia be Legalized?

    Science.gov (United States)

    Brouwer, Marije; Kaczor, Christopher; Battin, Margaret P; Maeckelberghe, Els; Lantos, John D; Verhagen, Eduard

    2018-02-01

    Voluntary active euthanasia for adults at their explicit request has been legal in Belgium and the Netherlands since 2002. In those countries, acceptance of the practice for adults has been followed by acceptance of the practice for children. Opponents of euthanasia see this as a dangerous slippery slope. Proponents argue that euthanasia is sometimes ethically appropriate for minors and that, with proper safeguards, it should be legally available in appropriate circumstances for patients at any age. In this Ethics Rounds, we asked philosophers from the United States and the Netherlands, and a Dutch pediatrician, to discuss the ethics of legalizing euthanasia for children. Copyright © 2018 by the American Academy of Pediatrics.

  15. [EUTHANASIA AND ASSISTED SUICIDE].

    Science.gov (United States)

    Lantero, Caroline

    2015-07-01

    Euthanasia and assisted suicide are not part of French laws of bioethics and lack, for the time being, definition and normative framework other than their criminal prosecution. To transform them into a right, these concepts certainly call for an ethical and legal debate. This paper aims to question the ideas to be considered, the conceptual bases and normative tools that may be useful to the discussion.

  16. Living with uncertainty: a Swedish qualitative interview study of women at home on sick leave due to premature labour.

    Science.gov (United States)

    Höglund, Eva; Dykes, Anna-Karin

    2013-05-01

    to highlight the experiences of pregnant women, experiencing preterm labour, being on sick leave at home and how they handled their daily life. qualitative, descriptive using open interviews. 10 antenatal clinics in the south of Sweden. 15 pregnant women who were on sick leave for premature labour. four categories were identified: how to interpret unpredictable contractions in the uterus? Having concern regarding premature labour of their child, handling the new situation and finding a balance, and from work to sick leave. to be on sick leave for premature contractions can be compared with enduring a situation of inactivity. The woman finds herself in a stressful situation which she must learn to handle this and find a balance. it appears that supportive information offers the women in premature labour the opportunity of increased participation and responsibility which thereby positively affects her well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Pain experiences and non-pharmacological strategies for pain management after tonsillectomy: a qualitative interview study of children and parents.

    Science.gov (United States)

    Idvall, Ewa; Holm, Charlotta; Runeson, Ingrid

    2005-09-01

    Tonsillectomy is one of the most common paediatric surgical procedures. This study aimed to investigate children's experience of pain and the nonpharmacological strategies that they used to manage pain after tonsillectomy. A further aim was to investigate parental views on these same phenomena. Six children (aged seven to 18 years) and their parents (four mothers and two fathers) were interviewed separately on the day after tonsillectomy. The data were analysed using a qualitative approach. Pain experiences were divided into the categories of physiological pain and psychological pain. Children rated their 'worst pain' during the past 24 hours between 6 and 10 (visual analogue scale, 0-10). The non-pharmacological strategies used most frequently to manage pain were thermal regulation (physical method) and distraction (cognitive-behavioural method) according to the framework used. Specific non-pharmacological strategies for pain management relative to different surgical procedures need to be considered.

  18. How do health service professionals consider human factors when purchasing interactive medical devices? A qualitative interview study.

    Science.gov (United States)

    Vincent, Christopher James; Blandford, Ann

    2017-03-01

    We present findings of a UK study into how those involved in purchasing interactive medical devices go about evaluating usability, the challenges that arise, and opportunities for improvement. The study focused on procurement of infusion devices because these are used by various professionals across healthcare. A semi-structured interview study was carried out involving a range of stakeholders (20 in total) involved in or impacted by medical device procurement. Data was analysed using thematic analysis, a qualitative method designed to support the identification, analysis and reporting of patterns. In principle, health service purchasing was found to accommodate consideration of equipment usability. In practice, the evaluation process was driven primarily by engineering standards; assessment of local needs did not accommodate substantive assessment of usability; and choice was limited by the availability of equipment on the marketplace. We discuss ways in which purchasing could be improved through techniques that account for social circumstances. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Contact to the out-of-hours service among Danish parents of small children - a qualitative interview study

    DEFF Research Database (Denmark)

    Lass, Marie; Tatari, Camilla Rahr; Merrild, Camilla Hoffmann

    2018-01-01

    OBJECTIVE: In Denmark, parents with small children have the highest contact frequency to out-of-hours (OOH) service, but reasons for OOH care use are sparsely investigated. The aim was to explore parental contact pattern to OOH services and to explore parents' experiences with managing their chil......OBJECTIVE: In Denmark, parents with small children have the highest contact frequency to out-of-hours (OOH) service, but reasons for OOH care use are sparsely investigated. The aim was to explore parental contact pattern to OOH services and to explore parents' experiences with managing...... their children's acute health problems. DESIGN: A qualitative study was undertaken drawing on a phenomenological approach. We used semi-structured interviews, followed by an inductive content analysis. Nine parents with children below four years of age were recruited from a child day care centre in Aarhus...

  20. [Limits to euthanasia].

    Science.gov (United States)

    de Kort, Susanne J

    2015-01-01

    A recent survey showed that less than half of Dutch physicians would find it conceivable to grant a request for euthanasia from a patient suffering from psychiatric disease or dementia, or who is tired of life. Because of a broader interpretation by the Regional Review Committees of the official criteria for due care, all recent cases of euthanasia in these specific groups of patients had been accepted. In this commentary it is argued that, following recent social developments in the Netherlands (including cuts in provision of care for the elderly and of mental health care, and a narrowed view about end-of-life issues), the official euthanasia criteria for due care are no longer suitable if we are to avoid a 'slippery slope' effect in cases such as those mentioned above. The criteria of a) a voluntary and well-considered request and b) absence of reasonable treatment alternatives are particularly under pressure. A plea is hold for a return to stricter interpretation of the criteria.

  1. Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.

    Science.gov (United States)

    Pawa, Jasmine; Robson, John; Hull, Sally

    2017-11-01

    Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives. A qualitative study of network implementation in the London borough of Tower Hamlets, which serves a socially disadvantaged and ethnically diverse population. Nineteen semi-structured interviews were carried out with doctors, nurses, and managers, and were informed by existing literature on integrated care and GP networks. Interviews were recorded and transcribed, and thematic analysis used to analyse emerging themes. Interviewees agreed that networks improved clinical care and reduced variation in practice performance. Network implementation was facilitated by the balance struck between 'a given structure' and network autonomy to adopt local solutions. Improved use of data, including patient recall and peer performance indicators, were viewed as critical key factors. Targeted investment provided the necessary resources to achieve this. Barriers to implementing networks included differences in practice culture, a reluctance to share data, and increased workload. Commissioners and providers were positive about the implementation of GP networks as a way to improve the quality of clinical care in Tower Hamlets. The issues that arose may be of relevance to other areas implementing similar quality improvement programmes at scale. © British Journal of General Practice 2017.

  2. The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study

    Directory of Open Access Journals (Sweden)

    Kristin Wisell

    2015-12-01

    Full Text Available Community pharmacies are balancing between business (selling medicines and other products and healthcare (using the pharmacists’ knowledge in order to improve drug utilization. This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector.

  3. Perceptions of a cognitive rehabilitation group by older people living with cognitive impairment and their caregivers: A qualitative interview study.

    Science.gov (United States)

    Moebs, Isabelle; Gee, Susan; Miyahara, Motohide; Paton, Helen; Croucher, Matthew

    2017-05-01

    Cognitive rehabilitation has been developed to improve quality of life, activities of daily living and mood for people with cognitive impairment, but the voice of people with cognitive impairment has been underrepresented. This study aimed to understand the experience of people living with cognitive impairment, as well as their caregivers who took part in a cognitive rehabilitation intervention programme. Twelve individuals with cognitive impairment and 15 caregivers participated in individual qualitative interviews. The interview data were analysed in three steps: 1) familiarisation of the transcripts; 2) identification of themes; 3) re-interpretation, refinement and integration of themes with methodological auditors. Both participants living with cognitive impairment and caregivers valued the comfortable environment with friendly, caring and supportive group leaders who taught practical tips and strategies. The participants living with cognitive impairment enjoyed socialising with like others. Caregivers benefited from learning about memory problems and sharing their challenges with other caregivers. The participants living with cognitive impairment emphasised the benefits of relational and practical aspects, whereas the caregivers valued the informational and emotional support. In conclusion, both participants living with cognitive impairment and caregivers found the cognitive rehabilitation group useful.

  4. The role of gendered constructions of eating disorders in delayed help-seeking in men: a qualitative interview study.

    Science.gov (United States)

    Räisänen, Ulla; Hunt, Kate

    2014-04-08

    To understand how young men recognise eating disorder (ED) symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care. A qualitative interview study. Men from across the UK were interviewed as part of a study of 39 young men's and women's experiences of having an ED. 10 men aged 16-25 years with various EDs including anorexia nervosa and bulimia nervosa. The widespread perception of EDs as uniquely or predominantly a female problem led to an initial failure by young men to recognise their behaviours as symptoms of an ED. Many presented late in their illness trajectory when ED behaviours and symptoms were entrenched, and some felt that opportunities to recognise their illness had been missed because of others' lack of awareness of EDs in men. In addition, the men discussed the lack of gender-appropriate information and resources for men with EDs as an additional impediment to making sense of their experiences, and some felt that health and other professionals had been slow to recognise their symptoms because they were men. Although increasingly common in young men, widespread cultural constructions of EDs as a 'women's illness' mean that men may fail to recognise ED symptoms until disordered behaviours become entrenched and less tractable to intervention. Men also report that such perceptions can affect the reactions of their families and friends, as well as health and educational professionals. Primary care professionals are well placed to challenge inappropriate perceptions of EDs.

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

    Science.gov (United States)

    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

  6. The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study

    Science.gov (United States)

    Wisell, Kristin; Sporrong, Sofia Kälvemark

    2015-01-01

    Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector. PMID:28970376

  7. The facilitating role of chemotherapy in the palliative phase of cancer: qualitative interviews with advanced cancer patients.

    Directory of Open Access Journals (Sweden)

    Hilde M Buiting

    Full Text Available OBJECTIVE: To explore the extent to which patients have a directing role in decisions about chemotherapy in the palliative phase of cancer and (want to anticipate on the last stage of life. DESIGN: Qualitative interview study. METHODS: In depth-interviews with 15 patients with advanced colorectal or breast cancer at the medical oncology department in a Dutch teaching hospital; interviews were analysed following the principles of thematic content-analysis. RESULTS: All patients reported to know that the chemotherapy they received was with palliative intent. Most of them did not express the wish for information about (other treatment options and put great trust in their physicians' treatment advice. The more patients were aware of the severity of their disease, the more they seemed to 'live their life' in the present and enjoy things besides having cancer. Such living in the present seemed to be facilitated by the use of chemotherapy. Patients often considered the 'chemotherapy-free period' more stressful than periods when receiving chemotherapy despite their generally improved physical condition. Chemotherapy (regardless of side-effects seemed to shift patients' attention away from the approaching last stage of life. Interestingly, although patients often discussed advance care planning, they were reluctant to bring on end-of-life issues that bothered them at that specific moment. Expressing real interest in people 'as a person' was considered an important element of appropriate care. CONCLUSIONS: Fearing their approaching death, patients deliberately focus on living in the present. Active (chemotherapy treatment facilitates this focus, regardless of the perceived side-effects. However, if anxiety for what lies ahead is the underlying reason for treatment, efforts should be made in assisting patients to find other ways to cope with this fear. Simultaneously, such an approach may reduce the use of burdensome and sometimes costly treatment in the

  8. Competencies necessary for becoming a leader in the field of community medicine: a Japanese qualitative interview study.

    Science.gov (United States)

    Kainuma, Mosaburo; Kikukawa, Makoto; Nagata, Masaharu; Yoshida, Motofumi

    2018-04-17

    To clarify competencies for inclusion in our curriculum that focuses on developing leaders in community medicine. Qualitative interview study. All six regions of Japan, including urban and rural areas. Nineteen doctors (male: 18, female: 1) who play an important leadership role in their communities participated in semistructured interviews (mean age 48.3 years, range 34-59; mean years of clinical experience 23.1 years, range 9-31). Semistructured interviews were held and transcripts were independently analysed and coded by the first two authors. The third and fourth authors discussed and agreed or disagreed with the results to give a consensus agreement. Doctors were recruited by maximum variation sampling until thematic saturation was achieved. Six themes emerged: (1)'Medical ability': includes psychological issues and difficult cases in addition to basic medical problems. High medical ability gives confidence to other medical professionals. (2)'Long term perspective': the ability to develop a long-term, comprehensive vision and to continuously work to achieve the vision. Cultivation of future generations of doctors is included. (3) 'Team building':the ability to drive forward programmes that include residents and local government workers, to elucidate a vision, to communicate and to accept other medical professionals. (4)'Ability to negotiate': the ability to negotiate with others to ensure that programmes and visions progress smoothly (5) 'Management ability': the ability to run a clinic, medical unit or medical association. (6) 'Enjoying oneself': doctors need to feel an attraction to community medicine, that it be fun and challenging for them. We found six competencies that are needed by leaders in the field of community medicine. The results of this study will contribute to designing a curriculum that develops such leaders. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial

  9. Uptake of breast cancer preventive therapy in the UK: results from a multicentre prospective survey and qualitative interviews.

    Science.gov (United States)

    Hackett, Julia; Thorneloe, Rachael; Side, Lucy; Wolf, Michael; Horne, Rob; Cuzick, Jack; Smith, Samuel G

    2018-04-24

    Uptake of preventive therapy for women at increased breast cancer risk in England is unknown following the introduction of UK clinical guidelines in 2013. Preventive therapy could create socioeconomic inequalities in cancer incidence if it is more readily accepted by particular socio-demographic groups. In this multicentre study, we investigated uptake of tamoxifen and evaluated socio-demographic and clinical factors associated with initiation. We explored women's experiences of treatment decision-making using qualitative interview data. Between September 2015 and December 2016, women (n = 732) attending an appointment at one of 20 centres in England to discuss breast cancer risk were approached to complete a survey containing socio-demographic details and nulliparity. Of the baseline survey respondents (n = 408/732, 55.7% response rate), self-reported uptake of tamoxifen at 3-month follow-up was reported in 258 (63.2%). Sixteen women participated in semi-structured interviews. One in seven (38/258 = 14.7%) women initiated tamoxifen. Women who had children were more likely to report use of tamoxifen than those without children (OR = 5.26; 95%CI: 1.13-24.49, p = 0.035). Interview data suggested that women weigh up risks and benefits of tamoxifen within the context of familial commitments, with exposure to significant other's beliefs and experiences of cancer and medication a basis for their decision. Uptake of tamoxifen is low in clinical practice. There were no socio-demographic differences in uptake, suggesting that the introduction of breast cancer preventive therapy is unlikely to create socioeconomic inequalities in cancer incidence. Women's decision-making was influenced by familial priorities, particularly having children.

  10. The development of a model of dignity in illness based on qualitative interviews with seriously ill patients.

    Science.gov (United States)

    van Gennip, Isis E; Pasman, H Roeline W; Oosterveld-Vlug, Mariska G; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

    2013-08-01

    While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine patients' dignity, and that is applicable to a wide patient population. Qualitative interview study. 34 patients with either cancer, early stage dementia, or a severe chronic illness were selected from an extensive cohort study into advance directives. In-depth interviews were carried out exploring the experiences of seriously ill patients with regard to their personal dignity. The interview transcripts were analyzed using thematic analysis and a conceptual model was constructed based on the resulting themes. We developed a two-step dignity model of illness. According to this model, illness related conditions do not affect patients' dignity directly but indirectly by affecting the way patients perceive themselves. We identified three components shaping self-perception: (a) the individual self: the subjective experiences and internally held qualities of the patient; (b) the relational self: the self within reciprocal interaction with others; and, (c) the societal self: the self as a social object in the eyes of others. The merits of the model are two-folded. First, it offers an organizing framework for further research into patients' dignity. Secondly, the model can serve to facilitate care for seriously ill patients in practice by providing insight into illness and dignity at the level of the individual patient where intervention can be effectively targeted. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Non-technical skills for obstetricians conducting forceps and vacuum deliveries: qualitative analysis by interviews and video recordings.

    Science.gov (United States)

    Bahl, Rachna; Murphy, Deirdre J; Strachan, Bryony

    2010-06-01

    Non-technical skills are cognitive and social skills required in an operational task. These skills have been identified and taught in the surgical domain but are of particular relevance to obstetrics where the patient is awake, the partner is present and the clinical circumstances are acute and often stressful. The aim of this study was to define the non-technical skills of an operative vaginal delivery (forceps or vacuum) to facilitate transfer of skills from expert obstetricians to trainee obstetricians. Qualitative study using interviews and video recordings. The study was conducted at two university teaching hospitals (St. Michael's Hospital, Bristol and Ninewells Hospital, Dundee). Participants included 10 obstetricians and eight midwives identified as experts in conducting or supporting operative vaginal deliveries. Semi-structured interviews were carried out using routine clinical scenarios. The experts were also video recorded conducting forceps and vacuum deliveries in a simulation setting. The interviews and video recordings were transcribed verbatim and analysed using thematic coding. The anonymised data were independently coded by the three researchers and then compared for consistency of interpretation. The experts reviewed the coded data for respondent validation and clarification. The themes that emerged were used to identify the non-technical skills required for conducting an operative vaginal delivery. The final skills list was classified into seven main categories. Four categories (situational awareness, decision making, task management, and team work and communication) were similar to the categories identified in surgery. Three further categories unique to obstetrics were also identified (professional relationship with the woman, maintaining professional behaviour and cross-monitoring of performance). This explicitly defined skills taxonomy could aid trainees' understanding of the non-technical skills to be considered when conducting an operative

  12. Advance Care Planning in Nursing Home Patients With Dementia: A Qualitative Interview Study Among Family and Professional Caregivers.

    Science.gov (United States)

    van Soest-Poortvliet, Mirjam C; van der Steen, Jenny T; Gutschow, Giselka; Deliens, Luc; Onwuteaka-Philipsen, Bregje D; de Vet, Henrica C W; Hertogh, Cees M P M

    2015-11-01

    The aim of this study was to describe the process of advance care planning (ACP) and to explore factors related to the timing and content of ACP in nursing home patients with dementia, as perceived by family, physicians, and nurses. A qualitative descriptive study. A total of 65 in-depth qualitative interviews were held with families, on-staff elderly care physicians, and nurses of 26 patients with dementia who died in the Dutch End Of Life in Dementia (DEOLD) study. Interviews were coded and analyzed to find themes. Family, nurses, and physicians of all patients indicated they had multiple contact moments during nursing home stay in which care goals and treatment decisions were discussed. Nearly all interviewees indicated that physicians took the initiative for these ACP discussions. Care goals discussed and established during nursing home stay and the terminology to describe care goals varied between facilities. Regardless of care goals and other factors, cardiopulmonary resuscitation (CPR) and hospitalization were always discussed in advance with family and commonly resulted in a do-not-resuscitate (DNR) and a do-not-hospitalize (DNH) order. The timing of care planning discussions about other specific treatments or conditions and the content of treatment decisions varied. The factors that emerged from the interviews as related to ACP were general strategies that guided physicians in initiating ACP discussions, patient's condition, wishes expressed by patient or family, family's willingness, family involvement, continuity of communication, consensus with or within family, and general nursing home policy. Two influential underlying strategies guided physicians in initiating ACP discussions: (1) wait for a reason to initiate discussions, such as a change in health condition and (2) take initiative to discuss possible treatments (actively, including describing scenarios). ACP is a multifactorial process, which may lean on professional caregivers' guidance. The most

  13. Euthanasia and related practices worldwide.

    Science.gov (United States)

    Kelleher, M J; Chambers, D; Corcoran, P; Keeley, H S; Williamson, E

    1998-01-01

    The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The "slippery slope" argument is briefly considered.

  14. Should Pediatric Euthanasia be Legalized?

    NARCIS (Netherlands)

    Brouwer, Marije; Kaczor, Christopher; Battin, Margaret P; Maeckelberghe, Els; Lantos, John D; Verhagen, Eduard

    Voluntary active euthanasia for adults at their explicit request has been legal in Belgium and the Netherlands since 2002. In those countries, acceptance of the practice for adults has been followed by acceptance of the practice for children. Opponents of euthanasia see this as a dangerous slippery

  15. Illness, suffering and voluntary euthanasia.

    Science.gov (United States)

    Varelius, Jukka

    2007-02-01

    It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering.

  16. [Active euthanasia, or assisted suicide?

    Science.gov (United States)

    Julesz, Máté

    2016-10-01

    Both active euthanasia and assisted suicide are legal in The Netherlands, Belgium, Luxemburg and, most recently, in Canada. Examination of national legislations of countries where both active euthanasia and assisted suicide are legal. The number of accomplished active euthanasia cases and that of assisted suicide cases. Analysis of national statistical data. Comparison of statistical data before and after 2010. Comparison of the related practices in the surveyed countries. The number of active euthanasia cases markedly predominates over the number of assisted suicide cases. Cancer is a main reason for active euthanasia, or assisted suicide. In countries with a larger population, the number of active euthanasia cases is higher than that in countries with a smaller population. Regarding the fact that the applicants for active euthanasia withdraw their requests in a smaller number than the applicants for assisted suicide, patients prefer the choice of active euthanasia. Since the related legislative product is too recent in Canada at present, it may be only presumed that a certain preference will also develop in the related practices in Canada. Orv. Hetil., 2016, 157(40), 1595-1600.

  17. Age and Acceptance of Euthanasia.

    Science.gov (United States)

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  18. Euthanasia for Detainees in Belgium.

    Science.gov (United States)

    Devolder, Katrien

    2016-07-01

    In 2011, Frank Van Den Bleeken became the first detainee to request euthanasia under Belgium's Euthanasia Act of 2002. This article investigates whether it would be lawful and morally permissible for a doctor to accede to this request. Though Van Den Bleeken has not been held accountable for the crimes he committed, he has been detained in an ordinary prison, without appropriate psychiatric care, for more than 30 years. It is first established that Van Den Bleeken's euthanasia request plausibly meets the relevant conditions of the Euthanasia Act and that, consequently, a doctor could lawfully fulfill it. Next, it is argued that autonomy-based reasons for euthanizing him outweigh complicity-based reasons against doing so, and that, therefore, it is also morally permissible for a doctor to carry out the euthanasia request.

  19. Terminal sedation and euthanasia: A comparison of clinical practices

    NARCIS (Netherlands)

    J.A.C. Rietjens (Judith); J.J.M. van Delden (Hans); A. van der Heide (Agnes); A.M. Vrakking (Astrid); B.D. Onwuteaka-Philipsen (Bregje); P.J. van der Maas (Paul); G. van der Wal (Gerrit)

    2006-01-01

    textabstractBackground: An important issue in the debate about terminal sedation is the extent to which it differs from euthanasia. We studied clinical differences and similarities between both practices in the Netherlands. Methods: Personal interviews were held with a nationwide stratified sample

  20. Assisted suicide and euthanasia.

    Science.gov (United States)

    van der Heide, Agnes

    2013-01-01

    Several countries have adopted laws that regulate physician assistance in dying. Such assistance may consist of providing a patient with a prescription of lethal medication that is self-administered by the patient, which is usually referred to as (physician) assistance in suicide, or of administering lethal medication to a patient, which is referred to as euthanasia. The main aim of regulating physician assistance in dying is to bring these practices into the open and to provide physicians with legal certainty. A key condition in all jurisdictions that have regulated either assistance in suicide or euthanasia is that physicians are only allowed to engage in these acts upon the explicit and voluntary request of the patient. All systems that allow physician assistance in dying have also in some way included the notion that physician assistance in dying is only accepted when it is the only means to address severe suffering from an incurable medical condition. Arguments against the legal regulation of physician assistance in dying include principled arguments, such as the wrongness of hastening death, and arguments that emphasize the negative consequences of allowing physician assistance in dying, such as a devaluation of the lives of older people, or people with chronic disease or disabilities. Opinion polls show that some form of accepting and regulating euthanasia and physician assistance in suicide is increasingly supported by the general population in most western countries. Studies in countries where physician assistance in dying is regulated suggest that practices have remained rather stable in most jurisdictions and that physicians adhere to the legal criteria in the vast majority of cases. © 2013 Elsevier B.V. All rights reserved.

  1. The use of patient experience survey data by out-of-hours primary care services: a qualitative interview study.

    Science.gov (United States)

    Barry, Heather E; Campbell, John L; Asprey, Anthea; Richards, Suzanne H

    2016-11-01

    English National Quality Requirements mandate out-of-hours primary care services to routinely audit patient experience, but do not state how it should be done. We explored how providers collect patient feedback data and use it to inform service provision. We also explored staff views on the utility of out-of-hours questions from the English General Practice Patient Survey (GPPS). A qualitative study was conducted with 31 staff (comprising service managers, general practitioners and administrators) from 11 out-of-hours primary care providers in England, UK. Staff responsible for patient experience audits within their service were sampled and data collected via face-to-face semistructured interviews. Although most providers regularly audited their patients' experiences by using patient surveys, many participants expressed a strong preference for additional qualitative feedback. Staff provided examples of small changes to service delivery resulting from patient feedback, but service-wide changes were not instigated. Perceptions that patients lacked sufficient understanding of the urgent care system in which out-of-hours primary care services operate were common and a barrier to using feedback to enable change. Participants recognised the value of using patient experience feedback to benchmark services, but perceived weaknesses in the out-of-hours items from the GPPS led them to question the validity of using these data for benchmarking in its current form. The lack of clarity around how out-of-hours providers should audit patient experience hinders the utility of the National Quality Requirements. Although surveys were common, patient feedback data had only a limited role in service change. Data derived from the GPPS may be used to benchmark service providers, but refinement of the out-of-hours items is needed. 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/.

  2. The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.

    Science.gov (United States)

    Pearson, Jennifer; Richardson, Jane; Calnan, Michael; Salisbury, Chris; Foster, Nadine E

    2016-03-28

    In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions. We conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data. The PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants' preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable. The PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for

  3. The use of semi-structured interviews for collection of qualitative and quantitative data in hydrological studies

    Science.gov (United States)

    O'Keeffe, Jimmy; Buytaert, Wouter; Mijic, Ana; Brozovic, Nicholas

    2015-04-01

    To build an accurate, robust understanding of the environment, it is important to not only collect information describing its physical characteristics, but also the drivers which influence it. As environmental change, from increasing CO2 levels to decreasing water levels, is often heavily influenced by human activity, gathering information on anthropogenic as well as environmental variables is extremely important. This can mean collecting qualitative, as well as quantitative information. In reality studies are often bound by financial and time constraints, limiting the depth and detail of the research. It is up to the researcher to determine what the best methodology to answer the research questions is likely to be. Here we present a methodology of collecting qualitative and quantitative information in tandem for hydrological studies through the use of semi-structured interviews. This is applied to a case study in two districts of Uttar Pradesh, North India, one of the most intensely irrigated areas of the world. Here, decreasing water levels exacerbated by unchecked water abstraction, an expanding population and government subsidies, have put the long term resilience of the farming population in doubt. Through random selection of study locations, combined with convenience sampling of the participants therein, we show how the data collected can provide valuable insight into the drivers which have led to the current water scenario. We also show how reliable quantitative information can, using the same methodology, be effectively and efficiently extracted for modelling purposes, which along with developing an understanding of the characteristics of the environment is vital in coming up with realistic and sustainable solutions for water resource management in the future.

  4. Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

    Science.gov (United States)

    Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

    2017-08-04

    The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

  5. Identifying the conditions needed for integrated knowledge translation (IKT) in health care organizations: qualitative interviews with researchers and research users.

    Science.gov (United States)

    Gagliardi, Anna R; Dobrow, Mark J

    2016-07-12

    Collaboration among researchers and research users, or integrated knowledge translation (IKT), enhances the relevance and uptake of evidence into policy and practice. However, it is not widely practiced and, even when well-resourced, desired impacts may not be achieved. Given that large-scale investment is not the norm, further research is needed to identify how IKT can be optimized. Interviews were conducted with researchers and research users (clinicians, managers) in a health care delivery (HCDO) and health care monitoring (HCMO) organization that differed in size and infrastructure, and were IKT-naïve. Basic qualitative description was used. Participants were asked about IKT activities and challenges, and recommendations for optimizing IKT. Data were analysed inductively using constant comparative technique. Forty-three interviews were conducted (28 HCDO, 15 HCMO) with 13 researchers, 8 clinicians, and 22 managers. Little to no IKT took place. Participants articulated similar challenges and recommendations revealing that a considerable number of changes were needed at the organizational, professional and individual levels. Given the IKT-absent state of participating organizations, this research identified a core set of conditions which must be addressed to prepare an environment conducive to IKT. These conditions were compiled into a framework by which organizations can plan for, or evaluate their capacity for IKT. The IKT capacity framework is relevant for organizations in which there is no current IKT activity. Use of the IKT framework may result in more organizations that are ready to initiate and establish IKT, perhaps ultimately leading to more, and higher-quality collaboration for health system innovation. Further research is needed to confirm these findings in other organizations not yet resourced for, or undertaking IKT, and to explore the resource implications and mechanisms for establishing the conditions identified here as essential to preparing for

  6. Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing.

    Science.gov (United States)

    McNulty, Cliodna; Ricketts, Ellie J; Fredlund, Hans; Uusküla, Anneli; Town, Katy; Rugman, Claire; Tisler-Sala, Anna; Mani, Alix; Dunais, Brigitte; Folkard, Kate; Allison, Rosalie; Touboul, Pia

    2017-09-25

    To determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England. Qualitative interviews. European primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013. 45 GP staff, 13 trainers and 18 stakeholders. The iterative interview schedule explored participants' personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis. Findings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country's health services. A common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu. © Article author(s) (or their

  7. Thinking ahead – the need for early Advance Care Planning for people on haemodialysis: A qualitative interview study

    Science.gov (United States)

    Horsley, Helen L; Shepherd, Kate; Brown, Heather; Carey, Irene; Matthews, Beverley; O’Donoghue, Donal; Vinen, Katie; Murtagh, Felicity EM

    2015-01-01

    Background: There is a need to improve end-of-life care for people with end-stage kidney disease, particularly due to the increasingly elderly, frail and co-morbid end-stage kidney disease population. Timely, sensitive and individualised Advance Care Planning discussions are acceptable and beneficial for people with end-stage kidney disease and can help foster realistic hopes and goals. Aim: To explore the experiences of people with end-stage kidney disease regarding starting haemodialysis, its impact on quality of life and their preferences for future care and to explore the Advance Care Planning needs of this population and the timing of this support. Study design: Semi-structured qualitative interview study of people receiving haemodialysis. Interviews were analysed using thematic analysis. Recruitment ceased once data saturation was achieved. Setting/participants: A total of 20 patients at two UK National Health Service hospitals, purposively sampled by age, time on haemodialysis and symptom burden. Results: Themes emerged around: Looking Back, emotions of commencing haemodialysis; Current Experiences, illness and treatment burdens; and Looking Ahead, facing the realities. Challenges throughout the trajectory included getting information, communicating with staff and the ‘conveyor belt’ culture of haemodialysis units. Participants reported a lack of opportunity to discuss their future, particularly if their health deteriorated, and variable involvement in treatment decisions. However, discussion of these sensitive issues was more acceptable to some than others. Conclusion: Renal patients have considerable unmet Advance Care Planning needs. There is a need to normalise discussions about preferences and priorities in renal and haemodialysis units earlier in the disease trajectory. However, an individualised approach is essential – one size does not fit all. PMID:25527527

  8. Added value of involving patients in the first step of multidisciplinary guideline development: a qualitative interview study among infertile patients.

    Science.gov (United States)

    den Breejen, Elvira M E; Hermens, Rosella P M G; Galama, Wienke H; Willemsen, Wim N P; Kremer, Jan A M; Nelen, Willianne L D M

    2016-06-01

    Patient involvement in scoping the guideline is emphasized, but published initiatives actively involving patients are generally limited to the writing and reviewing phase. To assess patients' added value to the scoping phase of a multidisciplinary guideline on infertility. Qualitative interview study. We conducted interviews among 12 infertile couples and 17 professionals. We listed and compared the couples' and professionals' key clinical issues (=care aspects that need improvement) to be addressed in the guideline according to four domains: current guidelines, professionals, patients and organization of care. Main key clinical issues suggested by more than three quarters of the infertile couples and/or at least two professionals were identified and compared. Overall, we identified 32 key clinical issues among infertile couples and 23 among professionals. Of the defined main key clinical issues, infertile couples mentioned eight issues that were not mentioned by the professionals. These main key clinical issues mainly concerned patient-centred (e.g. poor information provision and poor alignment of care) aspects of care on the professional and organizational domain. Both groups mentioned two main key clinical issues collectively that were interpreted differently: the lack of emotional support and respect for patients' values. Including patients from the first phase of the guideline development process leads to valuable additional main key clinical issues for the next step of a multidisciplinary guideline development process and broadens the scope of the guideline, particularly regarding patient-centredness and organizational issues from a patients' perspective. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  9. Help seeking for cancer ‘alarm’ symptoms: a qualitative interview study of primary care patients in the UK

    Science.gov (United States)

    Whitaker, Katriina L; Macleod, Una; Winstanley, Kelly; Scott, Suzanne E; Wardle, Jane

    2015-01-01

    Background Delay in help seeking for cancer ‘alarm’ symptoms has been identified as a contributor to delayed diagnosis. Aim To understand people’s help-seeking decision making for cancer alarm symptoms, without imposing a cancer context. Design and setting Community-based, qualitative interview study in the UK, using purposive sampling by sex, socioeconomic status, and prior help seeking, with framework analysis of transcripts. Method Interviewees (n = 48) were recruited from a community-based sample (n = 1724) of adults aged ≥50 years who completed a health survey that included a list of symptoms. Cancer was not mentioned. Participants reporting any of 10 cancer alarm symptoms (n = 915) and who had consented to contact (n = 482) formed the potential pool from which people were invited to an interview focusing on their symptom experiences. Results Reasons for help seeking included symptom persistence, social influence, awareness/fear of a link with cancer, and ‘just instinct’. Perceiving the symptom as trivial or ‘normal’ was a deterrent, as was stoicism, adopting self-management strategies, and fear of investigations. Negative attitudes to help seeking were common. Participants did not want to be seen as making a fuss, did not want to waste the doctor’s time, and were sometimes not confident that the GP could help. Conclusion Decision making about cancer alarm symptoms was complex. Recognition of cancer risk almost always motivated help seeking (more so than the fear of cancer being a deterrent), assisted by recent public-awareness campaigns. As well as symptom persistence motivating help seeking, it could also have the reverse effect. Negative attitudes to help seeking were significant deterrents. PMID:25624313

  10. Help seeking for cancer 'alarm' symptoms: a qualitative interview study of primary care patients in the UK.

    Science.gov (United States)

    Whitaker, Katriina L; Macleod, Una; Winstanley, Kelly; Scott, Suzanne E; Wardle, Jane

    2015-02-01

    Delay in help seeking for cancer 'alarm' symptoms has been identified as a contributor to delayed diagnosis. To understand people's help-seeking decision making for cancer alarm symptoms, without imposing a cancer context. Community-based, qualitative interview study in the UK, using purposive sampling by sex, socioeconomic status, and prior help seeking, with framework analysis of transcripts. Interviewees (n = 48) were recruited from a community-based sample (n = 1724) of adults aged ≥50 years who completed a health survey that included a list of symptoms. Cancer was not mentioned. Participants reporting any of 10 cancer alarm symptoms (n = 915) and who had consented to contact (n = 482) formed the potential pool from which people were invited to an interview focusing on their symptom experiences. Reasons for help seeking included symptom persistence, social influence, awareness/fear of a link with cancer, and 'just instinct'. Perceiving the symptom as trivial or 'normal' was a deterrent, as was stoicism, adopting self-management strategies, and fear of investigations. Negative attitudes to help seeking were common. Participants did not want to be seen as making a fuss, did not want to waste the doctor's time, and were sometimes not confident that the GP could help. Decision making about cancer alarm symptoms was complex. Recognition of cancer risk almost always motivated help seeking (more so than the fear of cancer being a deterrent), assisted by recent public-awareness campaigns. As well as symptom persistence motivating help seeking, it could also have the reverse effect. Negative attitudes to help seeking were significant deterrents. © British Journal of General Practice 2015.

  11. Using Qualitative Comparative Analysis of Key Informant Interviews in Health Services Research: Enhancing a Study of Adjuvant Therapy Use in Breast Cancer Care.

    Science.gov (United States)

    McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra D; Bickell, Nina A

    2016-04-01

    Qualitative comparative analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. To explore the strengths and weaknesses of using QCA for HSR. Using data from semistructured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Ninety administrative and clinical key informants interviewed across 10 NYC area safety net hospitals. Transcribed interviews were coded by 3 investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods.

  12. A description of the "event manager" role in resuscitations: A qualitative study of interviews and focus groups of resuscitation participants.

    Science.gov (United States)

    Taylor, Katherine L; Parshuram, Christopher S; Ferri, Susan; Mema, Briseida

    2017-06-01

    Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication. This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital. The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred. "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Perceived Changes in Communication as an Effect of STN Surgery in Parkinson's Disease: A Qualitative Interview Study

    Directory of Open Access Journals (Sweden)

    Emilia Ahlberg

    2011-01-01

    Full Text Available The aim of the present study was to explore four individuals' perspective of the way their speech and communication changed as a result of subthalamic nucleus deep brain stimulation treatment for Parkinson's disease. Interviews of two men and two women were analyzed using qualitative content analysis. Three themes emerged as a result of the analysis. The first theme included sub-themes describing both increased and unexpected communication difficulties such as a more vulnerable speech function, re-emerging stuttering and cognitive difficulties affecting communication. The second theme comprised strategies to improve communication, using different speech techniques and communicative support, as well as trying to achieve changes in medical and stimulation parameters. The third theme included descriptions of mixed feelings surrounding the surgery. Participants described the surgery as an unavoidable dramatic change, associated both with improved quality of life but also uncertainty and lack of information, particularly regarding speech and communication changes. Despite negative effects on speech, the individuals were generally very pleased with the surgical outcome. More information before surgery regarding possible side effects on speech, meeting with a previously treated patient and possibly voice and speech therapy before or after surgery are suggested to facilitate the adjustment to the new speech conditions.

  14. Barriers and facilitators to parents seeking and accessing professional support for anxiety disorders in children: qualitative interview study.

    Science.gov (United States)

    Reardon, Tessa; Harvey, Kate; Young, Bridget; O'Brien, Doireann; Creswell, Cathy

    2018-01-25

    Anxiety disorders are among the most common mental health disorders experienced by children, but only a minority of these children access professional help. Understanding the difficulties parents face seeking support for child anxiety disorders could inform targeted interventions to improve treatment access. The aims of the study were to identify barriers and facilitators to seeking and accessing professional support for child anxiety disorders, and ways to minimise these barriers. A qualitative interview study was conducted with parents of 16 children (aged 7-11 years) with anxiety disorders identified through screening in schools. Barriers and facilitators were identified in relation to four distinct stages in the help-seeking process: parents recognising the anxiety difficulty, parents recognising the need for professional support, parents contacting professionals, and families receiving professional support. Barriers and facilitators at each stage related to the child's difficulties, the role of the parent, and parent perceptions of professionals and services. Findings illustrate the need (1) for readily available tools to help parents and professionals identify clinically significant anxiety in children, (2) to ensure that families and professionals can easily access guidance on the help-seeking process and available support, and (3) to ensure existing services offer sufficient provision for less severe difficulties that incorporates direct support for parents.

  15. What constitutes consent when parents and daughters have different views about having the HPV vaccine: qualitative interviews with stakeholders.

    Science.gov (United States)

    Wood, Fiona; Morris, Lucy; Davies, Myfanwy; Elwyn, Glyn

    2011-08-01

    The UK Human Papillomavirus (HPV) vaccine programme commenced in the autumn of 2008 for year 8 (age 12-13 years) schoolgirls. We examine whether the vaccine should be given when there is a difference of opinion between daughters and parents or guardians. Qualitative study using semi-structured interviews. A sample of 25 stakeholders: 14 professionals involved in the development of the HPV vaccination programme and 11 professionals involved in its implementation. Overriding the parents' wishes was perceived as problematic and could damage the relationship between school and parents. A number of practical problems were raised in relation to establishing whether parents were genuinely against their daughter receiving the vaccine. Although many respondents recognised that the Gillick guidelines were relevant in establishing whether a girl could provide consent herself, they still felt that there were significant problems in establishing whether girls could be assessed as Gillick competent. In some areas school nurses had been advised not to give the vaccine in the absence of parental consent. None of the respondents suggested that a girl should be vaccinated against her consent even if her parents wanted her to have the vaccine. While the Gillick guidelines provide a legal framework to help professionals make judgements about adolescents consenting to medical treatment, in practice there appears to be variable and confused interpretation of this guidance. Improved legal structures, management procedures and professional advice are needed to support those who are assessing competence and establishing consent to vaccinate adolescents in a school setting.

  16. Gender-related aspects of transmasculine people's vocal situations: insights from a qualitative content analysis of interview transcripts.

    Science.gov (United States)

    Azul, David

    2016-11-01

    Transmasculine people assigned female gender at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Existing analyses tend to be focused on evaluating speaker voice characteristics, whereas other factors that contribute to the production of vocal gender have remained underexplored. Most studies rely on researcher-centred perspectives, whereas very little is known about how transmasculine people themselves experience and make sense of their vocal situations. To explore how participants described their subjective gender positionings; which gender attributions they wished to receive from others; which gender they self-attributed to their voices; which gender attributions they had received from others; and how far participants were satisfied with the gender-related aspects of their vocal situations. Transcripts of semi-structured interviews with 14 German-speaking transmasculine people served as the original data corpus. Sections in which participants described the gender-related aspects of their vocal situations and that were relevant to the current research objectives were selected and explored using qualitative content analysis. The analysis revealed diverse accounts pertaining to the factors that contribute to the production of vocal gender for individual participants and variable levels of satisfaction with vocal gender presentation and attribution. Transmasculine people need to be regarded as a heterogeneous population and clinical practice needs to follow a client-centred, individualized approach. © 2016 Royal College of Speech and Language Therapists.

  17. How can professionals carry out recognition towards children of parents with alcohol problems? A qualitative interview study.

    Science.gov (United States)

    Werner, Anne; Malterud, Kirsti

    2017-02-01

    The aim of this study was to explore informal adult support experienced by children with parental alcohol problems to understand how professionals can show recognition in a similar way. We conducted a qualitative interview study with retrospective accounts from nine adults growing up with problem-drinking parents. Data were analysed with systematic text condensation. Goffman's concept "frame" offered a lens to study how supportive situations were defined and to understand opportunities and limitations for translation of recognition acts and attitudes to professional contexts. Analysis demonstrated frames of commonplace interaction where children experienced that adults recognised and responded to their needs. However, the silent support from an adult who recognised the problems without responding was an ambiguous frame. The child sometimes felt betrayed. Concentrating on frames of recognition which could be passed over to professional interactions, we noticed that participants called for a safe harbour, providing a sense of normality. Being with friends and their families, escaping difficulties at home without having to tell, was emphasised as important. Recognition was experienced when an adult with respect and dignity offered an open opportunity to address the problems, without pushing towards further communication. Our study indicates some specific lessons to be learnt about recognition for professional service providers from everyday situations. Frames of recognition, communicating availability and normality, and also unconditional confidentiality and safety when sharing problems may also be offered by professionals in public healthcare within their current frames of competency and time.

  18. Exploring perspectives on restraint during medical procedures in paediatric care: a qualitative interview study with nurses and physicians.

    Science.gov (United States)

    Svendsen, Edel Jannecke; Pedersen, Reidar; Moen, Anne; Bjørk, Ida Torunn

    2017-12-01

    The aim of this study was to explore nurses' and physicians' perspectives on and reasoning about the use of restraint during medical procedures on newly admitted preschoolers in somatic hospital care. We analysed qualitative data from individual interviews with a video recall session at the end with seven physicians and eight nurses. They had earlier participated in video recorded peripheral vein cannulations on preschool children. The data were collected between May 2012 and May 2013 at a paediatric hospital unit in Norway. The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint. Perspectives from both healthcare professions were represented in all the main themes and had many similarities. The results of this study may facilitate more informed and reflective discussions of restraint and contribute to higher awareness of restraint in clinical practice. Lack of guidance and scientific attention to restraint combined with conflicting interests and values among healthcare providers may result in insecurity, individual dogmatism, and a lack of shared discussions, language, and terminology.

  19. How do scientists perceive the current publication culture? A qualitative focus group interview study among Dutch biomedical researchers.

    Science.gov (United States)

    Tijdink, J K; Schipper, K; Bouter, L M; Maclaine Pont, P; de Jonge, J; Smulders, Y M

    2016-02-17

    To investigate the biomedical scientist's perception of the prevailing publication culture. Qualitative focus group interview study. Four university medical centres in the Netherlands. Three randomly selected groups of biomedical scientists (PhD, postdoctoral staff members and full professors). Main themes for discussion were selected by participants. Frequently perceived detrimental effects of contemporary publication culture were the strong focus on citation measures (like the Journal Impact Factor and the H-index), gift and ghost authorships and the order of authors, the peer review process, competition, the funding system and publication bias. These themes were generally associated with detrimental and undesirable effects on publication practices and on the validity of reported results. Furthermore, senior scientists tended to display a more cynical perception of the publication culture than their junior colleagues. However, even among the PhD students and the postdoctoral fellows, the sentiment was quite negative. Positive perceptions of specific features of contemporary scientific and publication culture were rare. Our findings suggest that the current publication culture leads to negative sentiments, counterproductive stress levels and, most importantly, to questionable research practices among junior and senior biomedical scientists. 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/

  20. 'Two sides of the coin'--the value of personal continuity to GPs: a qualitative interview study.

    Science.gov (United States)

    Ridd, Matthew; Shaw, Alison; Salisbury, Chris

    2006-08-01

    Continuity is thought to be important to GPs but the values behind this are unknown. To explore the values that doctors working in general practice attach to continuity of patient care and to outline how these values are applied in practice. In-depth qualitative interview with 24 GPs in England. Participants were purposefully sampled according to personal and practice characteristics. Analysis was thematic, drawing on the constant comparative method. The majority of doctors valued doctor-patient, or personal, continuity in their everyday work. It was most valued in patients with serious, complex or psychological problems. GPs believed that through their personal knowledge of the patient and the doctor-patient relationship, personal continuity enabled them to provide higher quality care. However, the benefits of personal continuity were balanced against problems, and GPs identified personal, professional and external constraints that limited its provision. GPs seemed to have resolved the tension between the benefits, limits and constraints they described by accepting an increased reliance on continuity being provided within teams. Personal continuity may offer important benefits to doctors and patients, but we do not know how unique its values are. In particular, it is not clear whether the same benefits can be achieved within teams, the level at which continuity is increasingly being provided. The relative advantages and limits of the different means of delivering continuity need to be better understood, before further policy changes that affect personal continuity are introduced.

  1. Euthanasia: An Indian perspective

    Science.gov (United States)

    Sinha, Vinod K.; Basu, S.; Sarkhel, S.

    2012-01-01

    In our society, the palliative care and quality of life issues in patients with terminal illnesses like advanced cancer and AIDS have become an important concern for clinicians. Parallel to this concern has arisen another controversial issue-euthanasia or “mercy –killing” of terminally ill patients. Proponents of physician-assisted suicide (PAS) feel that an individual's right to autonomy automatically entitles him to choose a painless death. The opponents feel that a physician's role in the death of an individual violates the central tenet of the medical profession. Moreover, undiagnosed depression and possibility of social ‘coercion’ in people asking for euthanasia put a further question mark on the ethical principles underlying such an act. These concerns have led to strict guidelines for implementing PAS. Assessment of the mental state of the person consenting to PAS becomes mandatory and here, the role of the psychiatrist becomes pivotal. Although considered illegal in our country, PAS has several advocates in the form of voluntary organizations like “death with dignity” foundation. This has got a fillip in the recent Honourable Supreme Court Judgment in the Aruna Shaunbag case. What remains to be seen is how long it takes before this sensitive issue rattles the Indian legislature. PMID:22988327

  2. [Euthanasia through history and religion].

    Science.gov (United States)

    Gajić, Vladimir

    2012-01-01

    INTRODUCTION Euthanasia represents an ethical, social, legal and medical issue, which is being disputed more and more frequently worldwide. In Serbia, it is illegal and punishable by law and subject to a prison sentence. Euthanasia verbatim, meaning "good death", refers to the practice of ending a life in order to relieve pain and suffering. It can be voluntary, when a person knowingly declares the wish to end life, and involuntary, when relatives and family make decisions on behalf of patients in coma. It can be active, when a person applies a medical procedure to end life and passive, when medical procedures which can extend a patient's life are not applied. EUTHANASIA THROUGH HISTORY: The term was known in old Greece, and Hippocrates mentioned it in his oath, which is now taken by all doctors in the world, by which they pledge not to apply a medicine which can lead to death of the patients, nor to give such counsel. Euthanasia had its most vigorous impetus in the mid-20th century when it was being carried out deliberately in Nazi Germany. All leading religions from Christianity, over Buddhism, to Islam, are directly or indirectly against any kind of euthanasia. EUTHANASIA TODAY: At the beginning of the 21st century, euthanasia was legalized in several most developed countries in the world, among them the Netherlands, Belgium, Germany, Switzerland, Japan, India and some American and Mexican federal states. The World Medical Association from 82 countries has condemned euthanasia, and called all medical workers who practice euthanasia to reconsider their attitudes and to stop this practice.

  3. Attitudes towards, and wishes for, euthanasia in advanced cancer patients at a palliative medicine unit.

    Science.gov (United States)

    Johansen, Sissel; Hølen, Jacob Chr; Kaasa, Stein; Loge, Håvard Jon; Materstvedt, Lars Johan

    2005-09-01

    Most studies on attitudes towards euthanasia and physician-assisted suicide (PAS) have been conducted in healthy populations. The aim of this study is to explore and describe attitudes towards, and wishes for, euthanasia/PAS in cancer patients with short life expectancy. Semi-structured interviews with 18 cancer patients with a life expectancy of less than nine months. All patients were recruited from an inpatient palliative medicine unit. Patients holding a positive attitude towards euthanasia/PAS do not necessarily want euthanasia/PAS for themselves. Wishes are different from requests for euthanasia/PAS. Fear of future pain and a painful death were the main reasons given for a possible wish for euthanasia/PAS. Worries about minimal quality of life and lack of hope also contributed to such thoughts. Wishes for euthanasia/PAS were hypothetical; they were future oriented and with a prerequisite that intense pain, lack of quality of life and/or hope had to be present. Additionally, wishes were fluctuating and ambivalent. The wish to die in these patients does not seem to be constant. Rather, this wish is more appropriately seen as an ambivalent and fluctuating mental 'solution' for the future. Health care providers should be aware of this when responding to utterances regarding euthanasia/PAS.

  4. Trends in acceptance of euthanasia among the general public in 12 European countries (1981-1999).

    Science.gov (United States)

    Cohen, Joachim; Marcoux, Isabelle; Bilsen, Johan; Deboosere, Patrick; van der Wal, Gerrit; Deliens, Luc

    2006-12-01

    We wanted to examine how the acceptance of euthanasia among the general public in Western Europe has changed in the last decades, and we wanted to look for possible explanations. We analysed data from the European Values Surveys, held in 1981, 1990, and 1999-2000 in 12 West European countries. In each country, representative samples of the general public were interviewed using the same structured questionnaire in all countries. Euthanasia was explained in the questionnaires as 'terminating the life of the incurably sick'. A total of 46 199 respondents participated in the surveys. A significant increase in acceptance of euthanasia could be observed in all countries except (West) Germany. While the average increase in euthanasia acceptance was 22%, the increase was particularly obvious in Belgium, Italy, Spain, and Sweden. Although changes in several characteristics of respondents, such as decrease in religious beliefs, rising belief in the right to self-determination, and (to a lesser extent) rise in levels of education, were associated with growing acceptance of euthanasia, they could only partly explain the increase of euthanasia acceptance over the years. An increase of euthanasia acceptance among the general public took place over the last two decades in almost all West European countries, possibly indicating a growing support for personal autonomy regarding medical end-of-life decisions. If this trend continues, it is likely to increase the public and political debate about the (legal) regulation of euthanasia under certain conditions of careful medical practice in several West European countries.

  5. Timeline interviews

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine

    2012-01-01

    The aim of this paper is to explain and discuss timeline interviews as a method for doing life history research. It is a ‘how to’ article explaining the strengths and weaknesses of using a timeline when conducting qualitative interviews. The method allows the interviewee to participate...... for life story research, it can also be used for ther types of studies where interviews are made....... in the reporting of the interview which may give raise to ownership and sharing of the analytical power in the interview situation. Exactly for this reason, it may not be the most appropriate method for interviewing elites or for conducting insider interviews where positionality can be at play. The use...

  6. Staying well with bipolar disorder: A qualitative analysis of five-year follow-up interviews with young people.

    Science.gov (United States)

    Crowe, M; Inder, M

    2018-05-01

    WHAT IS ALREADY KNOWN ABOUT THE TOPIC?: Bipolar disorder is a long-term condition which causes ongoing disruptions to the individual's life. Current evidence suggests that a combination of medication in combination with psychotherapy is more effective than medication alone. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There are few published reports of the effects of interventions (pharmacological or psychotherapeutic) for treatment in bipolar disorder. While both psychotherapies provided a framework for understanding bipolar disorder each had specific strategies that participants identified as effective. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Because bipolar disorder is a long-term condition, its treatment needs to incorporate psychotherapeutic approaches that address the unique nature of its impact on each individual and provide individualized strategies for managing the disorder. Both Interpersonal and Social Rhythm Therapy and Specialist Supportive Care provide strategies that promote personal recovery. Introduction The primary outcomes from this study of psychotherapy for young people with bipolar disorder identified that most participants had continued to remain well. Given that up to 80% of people relapse within 2 years, it was important to establish how these participants described the process of staying well. Aim To examine how participants in a psychotherapy for young people with bipolar disorder study at 5-year follow-up described their experiences of the intervention and its impact on living with the disorder. Methods This qualitative study was conducted 5 years after participants had completed a psychotherapy intervention in a randomized controlled trial for young people with bipolar disorder. Thirty people were recruited into this qualitative study and interviewed regarding their experiences. The data were analysed using an inductive thematic analysis. Findings Three themes were identified from the data: self-awareness in the context of bipolar

  7. Being Human: A Qualitative Interview Study Exploring Why a Telehealth Intervention for Management of Chronic Conditions Had a Modest Effect.

    Science.gov (United States)

    O'Cathain, Alicia; Drabble, Sarah J; Foster, Alexis; Horspool, Kimberley; Edwards, Louisa; Thomas, Clare; Salisbury, Chris

    2016-06-30

    Evidence of benefit for telehealth for chronic conditions is mixed. Two linked randomized controlled trials tested the Healthlines Service for 2 chronic conditions: depression and high risk of cardiovascular disease (CVD). This new telehealth service consisted of regular telephone calls from nonclinical, trained health advisers who followed standardized scripts generated by interactive software. Advisors facilitated self-management by supporting participants to use Web-based resources and helped to optimize medication, improve treatment adherence, and encourage healthier lifestyles. Participants were recruited from primary care. The trials identified moderate (for depression) or partial (for CVD risk) effectiveness of the Healthlines Service. An embedded qualitative study was undertaken to help explain the results of the 2 trials by exploring mechanisms of action, context, and implementation of the intervention. Qualitative interview study of 21 staff providing usual health care or involved in the intervention and 24 patients receiving the intervention. Interviewees described improved outcomes in some patients, which they attributed to the intervention, describing how components of the model on which the intervention was based helped to achieve benefits. Implementation of the intervention occurred largely as planned. However, contextual issues in patients' lives and some problems with implementation may have reduced the size of effect of the intervention. For depression, patients' lives and preferences affected engagement with the intervention: these largely working-age patients had busy and complex lives, which affected their ability to engage, and some patients preferred a therapist-based approach to the cognitive behavioral therapy on offer. For CVD risk, patients' motivations adversely affected the intervention whereby some patients joined the trial for general health improvement or from altruism, rather than motivation to make lifestyle changes to address

  8. (In-)formal caregivers' and general practitioners' views on hospitalizations of people with dementia - an exploratory qualitative interview study.

    Science.gov (United States)

    Pohontsch, Nadine Janis; Scherer, Martin; Eisele, Marion

    2017-08-04

    Dementia is an irreversible chronic disease with wide-ranging effects on patients', caregivers' and families' lives. Hospitalizations are significant events for people with dementia. They tend to have poorer outcomes compared to those without dementia. Most of the previous studies focused on diagnoses leading to hospitalizations using claims data. Further factors (e.g. context factors) for hospitalizations are not reproduced in this data. Therefore, we investigated the factors leading to hospitalization with an explorative, qualitative study design. We interviewed informal caregivers (N = 12), general practitioners (GPs, N = 12) and formal caregivers (N = 5) of 12 persons with dementia using a semi-structured interview guideline. The persons with dementia were sampled using criteria regarding their living situation (home care vs. nursing home care) and gender. The transcripts were analyzed using the method of structuring content analysis. Almost none of the hospitalizations, discussed with the (in-)formal caregivers and GPs, seemed to have been preventable or seemed unjustifiable from the interviewees' points of view. We identified several dementia-specific factors promoting hospitalizations (e.g. the neglect of constricted mobility, the declining ability to communicate about symptoms/accidents and the shift of responsibility from person with dementia to informal or formal caregivers) and context-specific factors promoting hospitalizations (e.g. qualification of nursing home personal, the non-availability of the GP and hospitalizations for examinations/treatments also available in ambulatory settings). Hospitalizations were always the result of the interrelation of two factors: illnesses/accidents and context factors. The impact of both seems to be stronger in presence of dementia. Points for action in terms of reducing hospitalization rates were: better qualified nurses, a 24-h-GP-emergency service and better compensation for ambulatory monitoring

  9. Qualitative interview study of parents' perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care

    NARCIS (Netherlands)

    Halls, Amy; Van'T Hoff, Catherine; Little, Paul; Verheij, Theo; Leydon, Geraldine M.

    2017-01-01

    Objective To explore parents' perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care. Design Qualitative semistructured interview study. Setting UK primary care. Participants 23 parents of children aged 6 months to 10 years

  10. Exploring men's and women's experiences of depression and engagement with health professionals: more similarities than differences? A qualitative interview study

    Directory of Open Access Journals (Sweden)

    Ziebland Sue

    2007-07-01

    Full Text Available Abstract Background It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis was to explore how men and women with depression articulate their emotional distress, and examine whether there are gender differences or similarities in the strategies that respondents found useful when engaging with health professionals. Methods In-depth qualitative interviews with 22 women and 16 men in the UK who identified themselves as having had depression, recruited through general practitioners, psychiatrists and support groups. Results We found gender similarities and gender differences in our sample. Both men and women found it difficult to recognise and articulate mental health problems and this had consequences for their ability to communicate with health professionals. Key gender differences noted were that men tended to value skills which helped them to talk while women valued listening skills in health professionals, and that men emphasised the importance of getting practical results from talking therapies in their narratives, as opposed to other forms of therapy which they conceptualised as 'just talking'. We also found diversity among women and among men; some respondents valued a close personal relationship with health professionals, while others felt that this personal relationship was a barrier to communication and preferred 'talking to a stranger'. Conclusion Our findings suggest that there is not a straightforward relationship between gender and engagement with health professionals for people with depression. Health professionals need to be sensitive to patients who have difficulties in expressing emotional distress and critical of gender stereotypes which suggest that women invariably find it easy to

  11. Explaining engagement in self-monitoring among participants of the DESMOND Self-monitoring Trial: a qualitative interview study.

    Science.gov (United States)

    Eborall, Helen C; Dallosso, Helen M; McNicol, Sarah; Speight, Jane; Khunti, Kamlesh; Davies, Melanie J; Heller, Simon R

    2015-10-01

    The Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) Self-monitoring Trial reported that people with newly diagnosed type 2 diabetes attending community-based structured education and randomized to self-monitoring of blood glucose (SMBG) or urine monitoring had comparable improvements in biomedical outcomes, but differences in satisfaction with, and continued use of monitoring method, well-being and perceived threat from diabetes. To explore experiences of SMBG and urine monitoring following structured education. We specifically addressed the perceived usefulness of each monitoring method and the associated well-being. Qualitative semi-structured interviews with 18 adults with newly diagnosed type 2 diabetes participating in the DESMOND Self-monitoring Trial (SMBG, N=10; urine monitoring, N=8)~12 months into the trial. Analysis was informed by the constant comparative approach. Interviewees reported SMBG as accurate, convenient and useful. Declining use was explained by having established a pattern of managing blood glucose with less frequent monitoring or lack of feedback or encouragement from health care professionals. Many initially positive views of urine monitoring progressively changed due to perceived inaccuracy, leading some to switch to SMBG. Perceiving diabetes as less serious was attributable to lack of symptoms, treatment with diet alone and-in the urine-monitoring group-consistently negative readings. Urine monitoring also provided less visible evidence of diabetes and of the effect of behaviour on glucose. The findings highlight the importance for professionals of considering patients' preferences when using self-monitoring technologies, including how these change over time, when supporting the self-care behaviours of people with type 2 diabetes. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Attitudes, access and anguish: a qualitative interview study of staff and patients' experiences of diabetic retinopathy screening.

    Science.gov (United States)

    Hipwell, A E; Sturt, J; Lindenmeyer, A; Stratton, I; Gadsby, R; O'Hare, P; Scanlon, P H

    2014-12-15

    To examine the experiences of patients, health professionals and screeners; their interactions with and understandings of diabetic retinopathy screening (DRS); and how these influence uptake. Purposive, qualitative design using multiperspectival, semistructured interviews and thematic analysis. Three UK Screening Programme regions with different service-delivery modes, minority ethnic and deprivation levels across rural, urban and inner-city areas, in general practitioner practices and patients' homes. 62 including 38 patients (22 regular-screening attenders, 16 non-regular attenders) and 24 professionals (15 primary care professionals and 9 screeners). Antecedents to attendance included knowledge about diabetic retinopathy and screening; antecedents to non-attendance included psychological, pragmatic and social factors. Confusion between photographs taken at routine eye tests and DRS photographs was identified. The differing regional invitation methods and screening locations were discussed, with convenience and transport safety being over-riding considerations for patients. Some patients mentioned significant pain and visual disturbance from mydriasis drops as a deterrent to attendance. In this, the first study to consider multiperspectival experiential accounts, we identified that proactive coordination of care involving patients, primary care and screening programmes, prior to, during and after screening is required. Multiple factors, prior to, during and after screening, are involved in the attendance and non-attendance for DRS. Further research is needed to establish whether patient self-management educational interventions and the pharmacological reformulation of shorter acting mydriasis drops, may improve uptake of DRS. This might, in turn, reduce preventable vision loss and its associated costs to individuals and their families, and to health and social care providers, reducing current inequalities. Published by the BMJ Publishing Group Limited. For

  13. Exploring educational needs and design aspects of internet-enabled patient education for persons with diabetes: a qualitative interview study.

    Science.gov (United States)

    Jafari, Javad; Karimi Moonaghi, Hosein; Zary, Nabil; Masiello, Italo

    2016-10-31

    The objective of this article is to explore the educational needs and design aspects of personalised internet-enabled education for patients with diabetes in Iran. Data were collected using semistructured interviews and then qualitatively analysed using inductive content analysis. 9 patients with type 2 diabetes were included. Inclusion criteria were access to and knowledge on how to use the internet. The selection ensured representation based on gender, age, occupation and educational background. The sample population was patients with diabetes who were admitted to an outpatient diabetes clinic in Mashhad, a large city of Iran with about 3 million inhabitants. 4 core categories emerged from the data: (1) seeking knowledge about diabetes, including specific knowledge acquisition, patient's interactions and learning requirements; (2) teaching and learning, including using different teaching methods and different ways to learn about the disease; (3) facilitators, including internet and mobile phone use to learn about the disease; and (4) barriers, including lack of internet access, uncertainty of access to the internet and lack of website in the local language and also perceived cultural barriers, such as patients' fears of the internet, lack of time and awareness. This study provides a better understanding of the patient's educational expectations and technical needs in relation to internet-enabled education. This knowledge will inform the development of functional mock-ups in the next research phase using a design-based research approach in order to design internet-enabled patient education for self-management of diabetes. 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/.

  14. Dealing with taste and smell alterations-A qualitative interview study of people treated for lung cancer.

    Directory of Open Access Journals (Sweden)

    Kerstin Belqaid

    Full Text Available Taste and smell alterations have been recognized as common symptoms in relation to various cancers. However, previous research suggests that patients do not receive sufficient support in managing taste and smell alterations. Therefore, the objective of this study is to investigate how persons with experience from lung cancer-related taste and smell alterations reason about resources and strategies offered and used to manage these symptoms. Data from semi-structured individual interviews with 13 women and four men were analyzed with qualitative content analysis. We used Kleinman's now classic medical anthropological model of local health care systems, consisting of the personal, professional, and folk sector, to interpret and understand how people respond to sickness experiences in their daily lives. By presenting the findings using this model, we demonstrate that most strategies for dealing with taste and smell alterations were undertaken in the personal sector, i.e. in participants' daily lives, on an individual level and in interaction with family, social networks and communities. Taste and smell alterations implied two overarching challenges: 1 adjusting to no longer being able to trust information provided by one's own senses of taste and/or smell, and 2 coming to terms with taste and smell alterations as a part of having lung cancer. Health care professionals' involvement was described as limited, but appeared to fulfil most participants' expectations. However, through provision of normalizing information, practical advice, and to some extent, emotional support, health care professionals had potential to influence strategies and resources used for dealing with taste and smell alterations. With this study, we further the understanding of how people deal with lung cancer-related taste and smell alterations and discuss the role of health care professionals for this process.

  15. Dealing with taste and smell alterations-A qualitative interview study of people treated for lung cancer.

    Science.gov (United States)

    Belqaid, Kerstin; Tishelman, Carol; Orrevall, Ylva; Månsson-Brahme, Eva; Bernhardson, Britt-Marie

    2018-01-01

    Taste and smell alterations have been recognized as common symptoms in relation to various cancers. However, previous research suggests that patients do not receive sufficient support in managing taste and smell alterations. Therefore, the objective of this study is to investigate how persons with experience from lung cancer-related taste and smell alterations reason about resources and strategies offered and used to manage these symptoms. Data from semi-structured individual interviews with 13 women and four men were analyzed with qualitative content analysis. We used Kleinman's now classic medical anthropological model of local health care systems, consisting of the personal, professional, and folk sector, to interpret and understand how people respond to sickness experiences in their daily lives. By presenting the findings using this model, we demonstrate that most strategies for dealing with taste and smell alterations were undertaken in the personal sector, i.e. in participants' daily lives, on an individual level and in interaction with family, social networks and communities. Taste and smell alterations implied two overarching challenges: 1) adjusting to no longer being able to trust information provided by one's own senses of taste and/or smell, and 2) coming to terms with taste and smell alterations as a part of having lung cancer. Health care professionals' involvement was described as limited, but appeared to fulfil most participants' expectations. However, through provision of normalizing information, practical advice, and to some extent, emotional support, health care professionals had potential to influence strategies and resources used for dealing with taste and smell alterations. With this study, we further the understanding of how people deal with lung cancer-related taste and smell alterations and discuss the role of health care professionals for this process.

  16. UNderstanding uptake of Immunisations in TravellIng aNd Gypsy communities (UNITING): a qualitative interview study.

    Science.gov (United States)

    Jackson, Cath; Dyson, Lisa; Bedford, Helen; Cheater, Francine M; Condon, Louise; Crocker, Annie; Emslie, Carol; Ireland, Lana; Kemsley, Philippa; Kerr, Susan; Lewis, Helen J; Mytton, Julie; Overend, Karen; Redsell, Sarah; Richardson, Zoe; Shepherd, Christine; Smith, Lesley

    2016-09-01

    Gypsies, Travellers and Roma (referred to as Travellers) are less likely to access health services, including immunisation. To improve immunisation rates, we need to understand what helps and hinders individuals in these communities in taking up immunisations. (1) Investigate the barriers to and facilitators of acceptability and uptake of immunisations among six Traveller communities across four UK cities; and (2) identify possible interventions to increase uptake of immunisations in these Traveller communities that could be tested in a subsequent feasibility study. Three-phase qualitative study underpinned by the social ecological model. Phase 1: interviews with 174 Travellers from six communities: Romanian Roma (Bristol); English Gypsy/Irish Traveller (Bristol); English Gypsy (York); Romanian/Slovakian Roma (Glasgow); Scottish Showpeople (Glasgow); and Irish Traveller (London). Focus on childhood and adult vaccines. Phase 2: interviews with 39 service providers. Data were analysed using the framework approach. Interventions were identified using a modified intervention mapping approach. Phase 3: 51 Travellers and 25 service providers attended workshops and produced a prioritised list of potentially acceptable and feasible interventions. There were many common accounts of barriers and facilitators across communities, particularly across the English-speaking communities. Scottish Showpeople were the most similar to the general population. Roma communities experienced additional barriers of language and being in a new country. Men, women and service providers described similar barriers and facilitators. There was widespread acceptance of childhood and adult immunisation, with current parents perceived as more positive than their elders. A minority of English-speaking Travellers worried about multiple/combined childhood vaccines, adult flu and whooping cough. Cultural concerns about vaccines offered during pregnancy and about human papillomavirus were most evident in

  17. Ethical And Religious Analysis On Euthanasia

    Directory of Open Access Journals (Sweden)

    Abdi Omar Shuriye

    2012-01-01

    Full Text Available This paper is an analysis on euthanasia from ethical and religious perspectives. Historically, the classical Greek thinkers including Aristotle had categorically accepted euthanasia with the main reason of minimizing pain. However, as science develops ethical and religious isuues related to the subject have increasingly created fervent debates on euthanesia. ABSTRAK: Kertas ini mengkaji euthanasia dari perspektif agama dan etika. Sejarah telah melihat para pemikir Greek termasuk Aristotle secara kategorinya menerima Euthanasia dengan sebab utama untuk mengurangkan kesakitan. Bagaimanapun, apabila sains berkembang, perbahasan mengenai isu-isu agama dan etika tentang Euthanasia telah meningkat dengan nyata.KEYWORDS: mercy killing; religion; ethics; morality; euthanasia

  18. Perceptions and employment intentions among aged care nurses and nursing assistants from diverse cultural backgrounds: A qualitative interview study.

    Science.gov (United States)

    Gao, Fengsong; Tilse, Cheryl; Wilson, Jill; Tuckett, Anthony; Newcombe, Peter

    2015-12-01

    The residential aged care industry faces shortages and high turnover rates of direct care workers. This situation is further complicated by the increasing cultural diversity of residents and staff. To retain direct care workers, it is crucial to explore their perceptions of the rewards and difficulties of care work, and their employment intentions in multicultural environments. A qualitative descriptive study was used to understand perceptions of the rewards and difficulties of residential aged care work for core direct care workers (i.e. nurses and nursing assistants), how these were related to their intentions to stay or leave, and how these varied between nurses and nursing assistants, and between locally and overseas born workers. Individual interviews were conducted between June and September 2013 with 16 direct care workers in an Australian residential aged care facility with a specific focus on people from culturally and linguistically diverse backgrounds. It was found that direct care workers' employment intentions were related to their perceptions and management of the rewards and difficulties of care work. Their experiences of care work, the employment characteristics, and the organizational resources that fitted their personality, ability, expectations, and essential needs were viewed as rewards. Evaluating their jobs as meaningful was a shared perception for direct care workers who intended to stay. Individual workers' perceptions of the rewarding aspects of care work served to counterbalance the challenges of care work, and promoted their intentions to stay. Perceptions and employment intentions varied by occupational groups and by cultural backgrounds. Overseas born direct care workers are valuable resources in residential aged care facility rather than a limitation, but they do require organizational support, such as cultural awareness of the management, English language support, a sense of family, and appropriate job responsibility. The findings

  19. Perceptions of general practitioners towards the use of a new system for treating back pain: a qualitative interview study.

    Science.gov (United States)

    Sanders, Tom; Foster, Nadine E; Ong, Bie Nio

    2011-05-09

    Changing clinicians' behaviour is recognised as a major challenge. It is clear that behaviour change not only depends on demonstrating the proven effectiveness of clinical interventions; contextual and occupational factors, such as 'change readiness', may be central to their implementation. This paper highlights the context of behaviour change in relation to a healthcare innovation introduced within primary care, highlighting the importance of organisational and interpersonal factors that may help explain the dynamics of implementation. Qualitative interviews were conducted with general practitioners (GPs) before (n = 32) and after (n = 9) the introduction of a subgrouping for targeted treatment system. GPs were offered an electronic six-item subgrouping tool, to identify patients according to their risk of poor outcome ('high', 'low') in order to help inform their decision making about treatment approaches. Recruitment was based on a 'maximum diversification sample', to obtain a wide representation of views across all five practices. A coding scheme was developed based on the emergent findings, and the data were analysed using 'constant comparison', drawing upon insights and developing connections between themes. We adopted the normalisation process theory (NPT) to explain the uptake of the new system and to examine the relevance of coherence for the implementation of innovations in organisations. GPs perceived back pain as a low clinical priority, and highlighted the importance of 'practical' and 'relational' coherence in decisions to adopt and engage with the new subgrouping for targeted treatment system. Health professionals often engage in 'sense making' about new innovations to 'road test' their applicability or relevance to daily clinical routines. Low back pain was generally perceived as an 'uninteresting' and clinically unchallenging health problem by GPs, which may partly explain their lack of engagement with the new subgrouping for targeted treatment

  20. Perceptions of general practitioners towards the use of a new system for treating back pain: a qualitative interview study

    Directory of Open Access Journals (Sweden)

    Foster Nadine E

    2011-05-01

    Full Text Available Abstract Background Changing clinicians' behaviour is recognised as a major challenge. It is clear that behaviour change not only depends on demonstrating the proven effectiveness of clinical interventions; contextual and occupational factors, such as 'change readiness', may be central to their implementation. This paper highlights the context of behaviour change in relation to a healthcare innovation introduced within primary care, highlighting the importance of organisational and interpersonal factors that may help explain the dynamics of implementation. Methods Qualitative interviews were conducted with general practitioners (GPs before (n = 32 and after (n = 9 the introduction of a subgrouping for targeted treatment system. GPs were offered an electronic six-item subgrouping tool, to identify patients according to their risk of poor outcome ('high', 'low' in order to help inform their decision making about treatment approaches. Recruitment was based on a 'maximum diversification sample', to obtain a wide representation of views across all five practices. A coding scheme was developed based on the emergent findings, and the data were analysed using 'constant comparison', drawing upon insights and developing connections between themes. We adopted the normalisation process theory (NPT to explain the uptake of the new system and to examine the relevance of coherence for the implementation of innovations in organisations. Results GPs perceived back pain as a low clinical priority, and highlighted the importance of 'practical' and 'relational' coherence in decisions to adopt and engage with the new subgrouping for targeted treatment system. Health professionals often engage in 'sense making' about new innovations to 'road test' their applicability or relevance to daily clinical routines. Low back pain was generally perceived as an 'uninteresting' and clinically unchallenging health problem by GPs, which may partly explain their lack of engagement

  1. The realities of partnership in person-centred care: a qualitative interview study with patients and professionals.

    Science.gov (United States)

    Wolf, Axel; Moore, Lucy; Lydahl, Doris; Naldemirci, Öncel; Elam, Mark; Britten, Nicky

    2017-07-17

    Although conceptual definitions of person-centred care (PCC) vary, most models value the involvement of patients through patient-professional partnerships. While this may increase patients' sense of responsibility and control, research is needed to further understand how this partnership is created and perceived. This study aims to explore the realities of partnership as perceived by patients and health professionals in everyday PCC practice. Qualitative study employing a thematic analysis of semistructured interviews with professionals and patients. Four internal medicine wards and two primary care centres in western Sweden. 16 health professionals based at hospital wards or primary care centres delivering person-centred care, and 20 patients admitted to one of the hospital wards. Our findings identified both informal and formal aspects of partnership. Informal aspects, emerging during the interaction between healthcare professionals and patients, without any prior guidelines or regulations, incorporated proximity and receptiveness of professionals and building a close connection and confidence. This epitomised a caring, respectful relationship congruent across accounts. Formal aspects, including structured ways of sustaining partnership were experienced differently. Professionals described collaborating with patients to encourage participation, capture personal goals, plan and document care. However, although patients felt listened to and informed, they were content to ask questions and felt less involved in care planning, documentation or exploring lifeworld goals. They commonly perceived participation as informed discussion and agreement, deferring to professional knowledge and expertise in the presence of an empathetic and trusting relationship. In our study, patients appear to value a process of human connectedness above and beyond formalised aspects of documenting agreed goals and care planning. PCC increases patients' confidence in professionals who are

  2. Using Qualitative Comparative Analysis (QCA) of Key Informant Interviews in Health Services Research: Enhancing a Study of Adjuvant Therapy Use in Breast Cancer Care

    Science.gov (United States)

    McAlearney, Ann Scheck; Walker, Daniel; Moss, Alexandra DeNardis; Bickell, Nina A.

    2015-01-01

    Background Qualitative Comparative Analysis (QCA) is a methodology created to address causal complexity in social sciences research by preserving the objectivity of quantitative data analysis without losing detail inherent in qualitative research. However, its use in health services research (HSR) is limited, and questions remain about its application in this context. Objective To explore the strengths and weaknesses of using QCA for HSR. Research Design Using data from semi-structured interviews conducted as part of a multiple case study about adjuvant treatment underuse among underserved breast cancer patients, findings were compared using qualitative approaches with and without QCA to identify strengths, challenges, and opportunities presented by QCA. Subjects Ninety administrative and clinical key informants interviewed across ten NYC area safety net hospitals. Measures Transcribed interviews were coded by three investigators using an iterative and interactive approach. Codes were calibrated for QCA, as well as examined using qualitative analysis without QCA. Results Relative to traditional qualitative analysis, QCA strengths include: (1) addressing causal complexity, (2) results presentation as pathways as opposed to a list, (3) identification of necessary conditions, (4) the option of fuzzy-set calibrations, and (5) QCA-specific parameters of fit that allow researchers to compare outcome pathways. Weaknesses include: (1) few guidelines and examples exist for calibrating interview data, (2) not designed to create predictive models, and (3) unidirectionality. Conclusions Through its presentation of results as pathways, QCA can highlight factors most important for production of an outcome. This strength can yield unique benefits for HSR not available through other methods. PMID:26908085

  3. Narrative interviewing.

    Science.gov (United States)

    Anderson, Claire; Kirkpatrick, Susan

    2016-06-01

    Introduction Narrative interviews place the people being interviewed at the heart of a research study. They are a means of collecting people's own stories about their experiences of health and illness. Narrative interviews can help researchers to better understand people's experiences and behaviours. Narratives may come closer to representing the context and integrity of people's lives than more quantitative means of research. Methodology Researchers using narrative interview techniques do not set out with a fixed agenda, rather they tend to let the interviewee control the direction, content and pace of the interview. The paper describes the interview process and the suggested approach to analysis of narrative interviews, We draw on the example from a study that used series of narrative interviews about people's experiences of taking antidepressants. Limitations Some people may find it particularly challenging to tell their story to a researcher in this way rather than be asked a series of questions like in a television or radio interview. Narrative research like all qualitative research does not set out to be generalisable and may only involve a small set of interviews.

  4. Exploring the role of practical nursing wisdom in the care of patients with urinary problems at the end of life: a qualitative interview study.

    Science.gov (United States)

    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.

  5. A concept analysis of voluntary active euthanasia.

    Science.gov (United States)

    Guo, Fenglin

    2006-01-01

    Euthanasia has a wide range of classifications. Confusion exists in the application of specific concepts to various studies. To analyze the concept of voluntary active euthanasia using Walker and Avant's concept analysis method. A comprehensive literature review from various published literature and bibliographies. Clinical, ethical, and policy differences and similarities of euthanasia need to be debated openly, both within the medical profession and publicly. Awareness of the classifications about euthanasia may help nurses dealing with "end of life issues" properly.

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

    Science.gov (United States)

    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.

  7. Do the Physcians Defend Euthanasia

    Directory of Open Access Journals (Sweden)

    Tarık Gündüz

    1996-07-01

    Full Text Available In this study, after the definition and short historical development of Euthanasia, a questionnaire was given to 510 medical staff; 208 of whom are medical students who are in the 5th form and 302 of whom are physcians. In this questionnaire 6 multiple choice questions were asked about the knowledge level, social groups to comment and argue on the subject, the right of person to decide about his/her own life, opinions about current applications of euthanasia, whether he/she would agree on the application of the process and whether he would accept to get a responsibility in it or not. It was determined that among the people who attended the questionnaire, one third didn't have enough knowledge about the subject while 325 (63.72 % of them supported the application, still 351 (68.82 % of them refused to get a responsibility in the application of euthanasia, even if the process becomes legal. Opinions of the people who are with and against the idea were collected and summarized, it was determined that although passive euthanasia is not legal it is currently being applied when it is necessary and that physcians are biased to the legalization of the subject while they refuse to take a role in the application. Keywords : Euthanasia, Self Deliverance, Right to Life, Mercy Killing, Informed Consent

  8. The Legitimacy of Prohibiting Euthanasia

    Directory of Open Access Journals (Sweden)

    Gildenhuys, Peter

    2015-10-01

    Full Text Available ohn Arras argues against the legalization of physician- assisted suicide and active euthanasia on the basis of social costs that he anticipates will result from legalization. Arras believes that the legalization of highly restricted physician-assisted suicide will result in the legalization of active euthanasia without special restrictions, a prediction I grant for the sake of argument. Arras further anticipates that the practices of physician-assisted suicide and euthanasia will be abused, so that many patients who engage in these practices will lose out as a result. He refers to these losses as social costs to legalization. But the social costs at play in typical public policy debates are borne by individuals other than the agent who engages in the controversial activity, specifically by people who cannot be held responsible for enduring those costs. Even if plausible interpretations of Arras’ predictions about the abuse of the practice are granted, legalization of physician-assisted suicide or euthanasia brings no social costs of this latter sort. For this reason, and also because a ban on euthanasia is unfair to those who would profit from it, the losses in utility brought about by legalization would have to be very great to justify a ban.

  9. The Voluntary Euthanasia (Legalization) Bill (1936) revisited.

    Science.gov (United States)

    Helme, T

    1991-01-01

    In view of the continuing debate on euthanasia, the restrictions and safeguards which were introduced into the Voluntary Euthanasia (Legislation) Bill 1936 are discussed. Proposals for a new Terminal Care and Euthanasia Bill are suggested, based on some of the principles of the Mental Health Act 1983. PMID:2033626

  10. The Voluntary Euthanasia (Legalization) Bill (1936) revisited.

    OpenAIRE

    Helme, T

    1991-01-01

    In view of the continuing debate on euthanasia, the restrictions and safeguards which were introduced into the Voluntary Euthanasia (Legislation) Bill 1936 are discussed. Proposals for a new Terminal Care and Euthanasia Bill are suggested, based on some of the principles of the Mental Health Act 1983.

  11. 21 CFR 522.900 - Euthanasia solution.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Euthanasia solution. 522.900 Section 522.900 Food... Euthanasia solution. (a) Specifications. Each milliliter (mL) of solution contains: (1) 390 milligrams (mg.... For humane, painless, and rapid euthanasia. (2) Amount. One mL per 10 pounds of body weight. (3...

  12. Transition from an asylum seeker–specific health service to mainstream primary care for community-based asylum seekers: a qualitative interview study

    OpenAIRE

    Genevieve L Fair; Mark F Harris; Mitchell M Smith

    2018-01-01

    Background and aim: Transition of asylum seekers from special-purpose health services to mainstream primary care is both necessary and difficult. This study explores the issues encountered by asylum seekers undergoing this transition in Sydney, Australia. Methods: Qualitative semistructured interviews were conducted with nine asylum seeker patients and nine staff working in the sector. Results: Asylum seekers faced significant challenges in the transition to mainstream primary care. C...

  13. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses' practice in three European countries

    OpenAIRE

    Seymour, J.; Rietjens, J.; Bruinsma, S.; Deliens, L.; Sterckx, S.; Mortier, F.; Brown, J.; Mathers, N.; van der Heide, A.; Consortium, UNBIASED

    2015-01-01

    Background: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses.\\ud Methods: Qualitative case studies using interviews.\\ud Setting: Hospitals, the domestic home and hospices or palliative care units.\\ud Participants: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer patients.\\ud Results: UK respondents repor...

  14. Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries

    OpenAIRE

    Seymour, Jane; Rietjens, Judith; Bruinsma, Sophie; Deliens, Luc; Sterckx, Sigrid; Mortier, Freddy; Brown, Jayne; Mathers, Nigel; van der Heide, Agnes

    2014-01-01

    Open access article BACKGROUND: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. METHODS: Qualitative case studies using interviews. SETTING: Hospitals, the domestic home and hospices or palliative care units. PARTICIPANTS: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer pati...

  15. Euthanasia: a summary of the law in England and Wales.

    Science.gov (United States)

    Simillis, Constantinos

    2008-07-01

    When medical treatment becomes futile, or the patient's suffering is intractable, doctors face the agonising dilemma of whether to proceed with euthanasia. It is important for a doctor to be familiar with the law surrounding euthanasia, in order to avoid prosecution. This paper explores the law in England and Wales regarding the different categories of euthanasia: voluntary euthanasia, nonvoluntary euthanasia, passive euthanasia, and active euthanasia.

  16. Euthanasia of Danish dairy cows evaluated in two questionnaire surveys

    Directory of Open Access Journals (Sweden)

    Sørensen Jan

    2008-08-01

    Full Text Available Abstract Background Mortality risk in Danish dairy cows has more than doubled since 1990 (from 2% in 1990 to 5% in 2005. Until now, registrations about dead cows in the Danish Cattle Database have not included information about whether the cow died unassisted or was euthanized. Methods We interviewed a random sample of 196 Danish dairy farmers that had reported a dead cow to the Danish Cattle Database in 2002 and 196 dairy farmers that had reported a dead cow in 2006. Our objectives were to evaluate the proportion of euthanized cows, changes in the behaviour of farmers regarding euthanasia of cows over the years and possible reasons for these changes. Results It seems that the threshold for euthanasia of cows among farmers has changed. Farmers generally reported a lower threshold for euthanasia compared to 5–10 years ago. Conclusion The threshold for euthanasia of cows has, according to the dairy farmers, become lower. This might have positive impacts on animal welfare as more seriously ill cows are euthanized in the herds and not put through a period of suffering associated with disease and treatment or transported to a slaughterhouse in poor condition.

  17. Euthanasia: India's position in the global scenario.

    Science.gov (United States)

    Shekhar, Skand; Goel, Ashish

    2013-11-01

    Euthanasia requests have increased as the number of debilitated patients rises in both developed and developing countries such as India due to medical, psychosocial-emotional, socioenvironmental, and existential issues amid fears of potential misuse. WORLD'S POSITION: Albania, Colombia, the Netherlands, and Switzerland permit euthanasia conditionally. Australia's legalization of euthanasia has been withdrawn. The United States permits withdrawal of life support. Mexico and Norway permit active euthanasia. INDIA'S POSITION: Following the Aruna Shanbaug case the Supreme Court granted legal sanction to passive, but not active, euthanasia that is valid till the Parliament legislates on euthanasia. HANDLING EUTHANASIA REQUESTS: Acknowledging the complexity of the problem; individualizing the palliative approach; and accepting the 'There is no alternative' or 'There is no answer' (TINA) factor.

  18. 'Oral health is not my department'. Perceptions of elderly patients' oral health by general medical practitioners in primary health care centres: a qualitative interview study.

    Science.gov (United States)

    Andersson, Kerstin; Furhoff, Anna-Karin; Nordenram, Gunilla; Wårdh, Inger

    2007-03-01

    The purpose of this study was to explore general medical practitioners' (GPs) perceptions of the oral health of their elderly patients. The design was a qualitative study based on individual in-depth interviews with GPs. The criterion for inclusion in the study was that the GP was a specialist in family medicine working in a primary health care centre (PHCC:s) in the county of Stockholm. The participants took part in the study after informed consent. Eleven GPs were interviewed. The interview started with semi-structured questions about the respondents' clinical presentation of their elderly patients', e.g. medication, medical treatment and socioeconomic status. The interview concluded with questions about the respondents' experiences of and perceptions of the oral health of their patients. This process started with the first interview and proceeded with successive interviews until no new relevant information was forthcoming. The initial semi-structured part of the interview guide was analysed for content with special reference to descriptive answers. The final open questions were analysed by a method inspired by grounded theory (GT) and comprised three stages: open coding, axial coding and selective coding. In the GT influenced analysis process, three categories, health perspective, working conditions and cultural differences, each in turn containing subcategories, were identified and labelled. The most significant category, cultural differences, was identified as the core category, explaining the central meaning of the respondents' perceptions of the oral health of their elderly patients. The GPs in this study showed little or no awareness of the oral health of their elderly patients. The interviews disclosed several contributing factors. Barriers to closer integration of oral and general health in the elderly were identified. There existed a cultural gap between the disciplines of dentistry and medicine, which does not enhance and may be detrimental to the

  19. Considerations and recommendations for conducting qualitative research interviews with palliative and end-of-life care patients in the home setting: a consensus paper.

    Science.gov (United States)

    Sivell, Stephanie; Prout, Hayley; Hopewell-Kelly, Noreen; Baillie, Jessica; Byrne, Anthony; Edwards, Michelle; Harrop, Emily; Noble, Simon; Sampson, Catherine; Nelson, Annmarie

    2015-12-08

    To present and discuss the views of researchers at an academic palliative care research centre on research encounters with terminally ill patients in the home setting and to generate a list of recommendations for qualitative researchers working in palliative and end-of-life care. Eight researchers took part in a consensus meeting to discuss their experiences of undertaking qualitative interviews. The researchers were of varying backgrounds and all reported having experience in interviewing terminally ill patients, and all but one had experience of interviewing patients in their home environment. The main areas discussed by researchers included: whether participation in end-of-life research unintentionally becomes a therapeutic experience or an ethical concern; power relationships between terminally ill patients and researchers; researcher reflexivity and reciprocity; researchers' training needs. Qualitative methods can complement the home environment; however, it can raise ethical and practical challenges, which can be more acute in the case of research undertaken with palliative and patients at the end-of-life. The ethical and practical challenges researchers face in this context has the potential to place both participant and researcher at risk for their physical and psychological well-being. We present a set of recommendations for researchers to consider prior to embarking on qualitative research in this context and advocate researchers in this field carefully consider the issues presented on a study-by-study basis. 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/

  20. What constitutes consent when parents and daughters have different views about having the HPV vaccine: qualitative interviews with stakeholders

    NARCIS (Netherlands)

    Wood, F.; Morris, L.; Davies, M.; Elwyn, G.

    2011-01-01

    OBJECTIVE: The UK Human Papillomavirus (HPV) vaccine programme commenced in the autumn of 2008 for year 8 (age 12-13 years) schoolgirls. We examine whether the vaccine should be given when there is a difference of opinion between daughters and parents or guardians. DESIGN: Qualitative study

  1. [Guideline 'Organ donation following euthanasia"

    NARCIS (Netherlands)

    Mulder, H.; Olthuis, G.J.; Siebelink, M.; Gerritsen, R; Heurn, E. van

    2017-01-01

    - The multidisciplinary guideline 'Organ donation following euthanasia' was published in March 2017 at request of the Minister of Health, Welfare and Sport.- This guideline provides recommendations for the organisation and implementation of a request to donate organs expressed by a patient who asks

  2. Voluntary euthanasia: a utilitarian perspective.

    Science.gov (United States)

    Singer, Peter

    2003-10-01

    Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life--if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

  3. [Passive euthanasia and living will].

    Science.gov (United States)

    Julesz, Máté

    2014-07-06

    This article deals with the intentional distinction between murder of first degree and passive euthanasia. In Hungary, active euthanasia is considered to be a murder of first degree, whilst the Netherlands, Belgium, Luxemburg and Switzerland have legalized the active form of mercy killing in Europe. The palliative terminal care, when e.g. giving pain-killer morphine to the patient, might result in decreasing the patient's life-span, and thus causing indirect euthanasia. However, the legal institution of living will exists in several counter-euthanasia countries. The living will allows future patients to express their decision in advance to refuse a life-sustaining treatment, e.g. in case of irreversible coma. The institution of living will exists in Germany and in Hungary too. Nevertheless, the formal criteria of living will make it hardly applicable. The patient ought to express his/her will before a notary public in advance, and he/she should hand it over when being hospitalized. If the patient is not able to present his/her living will to his/her doctor in the hospital, then his/her only hope remains that he/she has given a copy of the living will to the family doctor previously, and the family doctor will notify the hospital.

  4. Killing, letting die and euthanasia.

    Science.gov (United States)

    Husak, D N

    1979-12-01

    Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible.

  5. Killing, letting die and euthanasia.

    Science.gov (United States)

    Husak, D N

    1979-01-01

    Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible. PMID:541821

  6. Palliative care for cancer patients in a primary health care setting:Bereaved relatives' experience, a qualitative group interview study

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Jensen, Anders Bonde

    2008-01-01

    care setting to explore barriers and facilitators for delivery of good palliative home care. Methods: Three focus group interviews with fourteen bereaved relatives in Aarhus County, Denmark. Results: Three main categories of experience were identified: 1) The health professionals' management, where...

  7. Qualitative Investigation of the "Cooking with Kids" Program: Focus Group Interviews with Fourth-Grade Students, Teachers, and Food Educators

    Science.gov (United States)

    Lukas, Catherine V.; Cunningham-Sabo, Leslie

    2011-01-01

    Objective: Focus group (FG) interviews with students and adults were used to obtain a rich understanding of the "Cooking with Kids" classroom experience from the child and adult participant perspectives. Methods: FG topics included students' cooking experiences at school and home and perceptions of "Cooking with Kids". Verified transcripts of…

  8. Drugs used for euthanasia in Flanders, Belgium.

    Science.gov (United States)

    Vander Stichele, R H; Bilsen, J J R; Bernheim, J L; Mortier, F; Deliens, L

    2004-02-01

    Our aim was to describe and assess the medicinal products and doses used for euthanasia in a series of cases, identified within an epidemiological death certificate study in Belgium, where euthanasia was until recently legally forbidden and where guidelines for euthanasia are not available. In a random sample of the deaths in 1998 in Belgium, the physicians who signed the death certificates were identified and sent an anonymous mail questionnaire. The questionnaires of the deaths classified as euthanasia cases were reviewed by a multi-disciplinary panel. A total of 22 among 1925 questionnaires pertained to voluntary euthanasia. In 17 cases, detailed information on the euthanatics (medicinal substances used for euthanasia) used was provided. Opioids were used in 13 cases (in 7 as a single drug). Time between last dose and expiry ranged from 4 to 900 min. The panel judged that only in 4 cases effective euthanatics were used. In the end-of-life decision cases perceived by Belgian physicians as euthanasia, pharmacological practices were disparate, although dominated by the use of morphine, in the very late phase of dying, in doses which were unlikely to be lethal. Most physicians clandestinely engaging in euthanasia in Belgium seemed unaware of procedures for guaranteeing a quick, mild and certain death. Information on the pharmacological aspects of euthanasia should be included in the medical curriculum and continuing medical education, at least in countries with a legal framework permitting euthanasia under specified conditions.

  9. The practice of euthanasia and physician-assisted suicide in the United States: adherence to proposed safeguards and effects on physicians.

    Science.gov (United States)

    Emanuel, E J; Daniels, E R; Fairclough, D L; Clarridge, B R

    1998-08-12

    Despite intense debates about legalization, there are few data examining the details of actual euthanasia and physician-assisted suicide (PAS) cases in the United States. To determine whether the practices of euthanasia and PAS are consistent with proposed safeguards and the effect on physicians of having performed euthanasia or PAS. Structured in-depth telephone interviews. Randomly selected oncologists in the United States. Adherence to primary and secondary safeguards for the practice of euthanasia and PAS; regret, comfort, and fear of prosecution from performing euthanasia or PAS. A total of 355 oncologists (72.6% response rate) were interviewed on euthanasia and PAS. On 2 screening questions, 56 oncologists (15.8%) reported participating in euthanasia or PAS; 53 oncologists (94.6% response rate) participated in in-depth interviews. Thirty-eight of 53 oncologists described clearly defined cases of euthanasia or PAS. Twenty-three patients (60.5%) both initiated and repeated their request for euthanasia or PAS, but 6 patients (15.8%) did not participate in the decision for euthanasia or PAS. Thirty-seven patients (97.4%) were experiencing unremitting pain or such poor physical functioning they could not perform self-care. Physicians sought consultation in 15 cases (39.5%). Overall, oncologists adhered to all 3 main safeguards in 13 cases (34.2%): (1) having the patient initiate and repeat the request for euthanasia or PAS, (2) ensuring the patient was experiencing extreme physical pain or suffering, and (3) consulting with a colleague. Those who adhered to the safeguards had known their patients longer and tended to be more religious. In 28 cases (73.7%), the family supported the decision. In all cases of pain, patients were receiving narcotic analgesia. Fifteen patients (39.5%) were enrolled in a hospice. While 19 oncologists (52.6%) received comfort from having helped a patient with euthanasia or PAS, 9 (23.7%) regretted having performed euthanasia or PAS, and

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

    Science.gov (United States)

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

    2018-02-09

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

  11. Support for Voluntary Euthanasia with No Logical Slippery Slope to Non-Voluntary Euthanasia.

    Science.gov (United States)

    Daskal, Steven

    2018-01-01

    This paper demonstrates that acceptance of voluntary euthanasia does not generate commitment to either non-voluntary euthanasia or euthanasia on request. This is accomplished through analysis of John Keown's and David Jones's slippery slope arguments, and rejection of their view that voluntary euthanasia requires physicians to judge patients as better off dead. Instead, voluntary euthanasia merely requires physicians to judge patients as within boundaries of appropriate deference. This paper develops two ways of understanding and defending voluntary euthanasia on this model, one focused on the independent value of patients' autonomy and the other on the evidence of well-being provided by patients' requests. Both avoid the purported slippery slopes and both are independently supported by an analogy to uncontroversial elements of medical practice. Moreover, the proposed analyses of voluntary euthanasia suggest parameters for the design of euthanasia legislation, both supporting and challenging elements of existing laws in Oregon and the Netherlands.

  12. The Qualitative Interview Study of Persistent and Nonpersistent Substance Use in the MTA: Sample Characteristics, Frequent Use, and Reasons for Use.

    Science.gov (United States)

    Swanson, James M; Wigal, Timothy; Jensen, Peter S; Mitchell, John T; Weisner, Thomas S; Murray, Desiree; Arnold, L Eugene; Hechtman, Lily; Molina, Brooke S G; Owens, Elizabeth B; Hinshaw, Stephen P; Belendiuk, Katherine; Howard, Andrea; Wigal, Sharon B; Sorensen, Page; Stehli, Annamarie

    2017-10-01

    To evaluate participants' perceptions about frequent use and reasons for substance use (SU) in the qualitative interview study, an add-on to the multimodal treatment study of ADHD (MTA). Using the longitudinal MTA database, 39 ADHD cases and 19 peers with Persistent SU, and 86 ADHD cases and 39 peers without Persistent SU were identified and recruited. In adulthood, an open-ended interview was administered, and SU excerpts were indexed and classified to create subtopics (frequent use and reasons for use of alcohol, marijuana, and other drugs). For marijuana, the Persistent compared with Nonpersistent SU group had a significantly higher percentage of participants describing frequent use and giving reasons for use, and the ADHD group compared with the group of peers had a significantly higher percentage giving "stability" as a reason for use. Motivations for persistent marijuana use may differ for adults with and without a history of ADHD.

  13. Sample-Größe und Sättigung in PhD-Studien, in denen qualitative Interviews zum Einsatz kommen

    OpenAIRE

    Mason, Mark

    2010-01-01

    Sample-Größen sind in qualitativen Forschungsarbeiten von verschiedenen Einflüssen abhängig. Das Leitprinzip sollte jedoch immer die Sättigung, bezogen auf das jeweilige Forschungsthema sein. Diese Frage, mit der sich viele Autor/innen beschäftigt haben, wird weiter heiß diskutiert und – so einige – kaum hinreichend verstanden. Für eine eigene Untersuchung habe ich ein Sample von PhD-Studien, in denen qualitative Interviews als Erhebungsmethode genutzt wurde, aus theses.com gezogen und ...

  14. Patient-reported Symptom Experiences in Patients With Carcinoid Syndrome After Participation in a Study of Telotristat Etiprate: A Qualitative Interview Approach.

    Science.gov (United States)

    Gelhorn, Heather L; Kulke, Matthew H; O'Dorisio, Thomas; Yang, Qi M; Jackson, Jessica; Jackson, Shanna; Boehm, Kristi A; Law, Linda; Kostelec, Jacqueline; Auguste, Priscilla; Lapuerta, Pablo

    2016-04-01

    Telotristat etiprate, a tryptophan hydroxylase inhibitor, was previously evaluated in a Phase II randomized, placebo-controlled clinical trial in patients with carcinoid syndrome (CS) and diarrhea not adequately controlled by octreotide. The objective of the current study was to characterize the symptom experiences of patients participating in that trial. Consenting patients participated in one-on-one, qualitative interviews focused on eliciting symptoms they had experienced in association with their CS diagnosis and recollection of symptom changes they experienced while participating in the Phase II trial. Among the 23 patients who participated in the previous 4-week dose-escalation study, 16 were eligible for interviews and 11 participated in the present study. The median time from study completion to the interview was 31 months; 4 of 11 patients were receiving telotristat etiprate in a follow-up, open-label trial at the time of interview. All of the patients (100%) described diarrhea as a symptom of CS, with effects on the emotional, social, and physical aspects of their lives. Improvement in diarrhea during the study was described by 82% of participants, and was very impactful in several patients. Results led to the design and implementation of a larger interview program in Phase III and helped to establish a definition of clinically meaningful change for the clinical development program. The diarrhea associated with CS can have a large impact on daily lives, and patient interviews can characterize and capture clinically meaningful improvements with treatment. ClinicalTrials.gov Identifier: NCT00853047. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Patient Experience of Symptoms and Side Effects when Treated with Osimertinib for Advanced Non-Small-Cell Lung Cancer: A Qualitative Interview Substudy.

    Science.gov (United States)

    Rydén, Anna; Blackhall, Fiona; Kim, Hye Ryun; Pillai, Rathi N; Braam, Lauren; Martin, Mona L; Walding, Andrew

    2017-10-01

    Capturing the patient experience during treatment is important to both regulatory authorities and to patients starting treatment. We identified the symptoms and side effects experienced by patients with advanced non-small-cell lung cancer during osimertinib treatment, to understand treatment expectations, satisfaction, and the level of difficulty coping with the side effects experienced during treatment. Qualitative interviews (approximately 4-6 weeks after treatment initiation and again after approximately 4 months of treatment) were conducted during the phase I/II AURA clinical trial of osimertinib, a tyrosine kinase inhibitor of epidermal growth factor receptor-sensitizing and T790M resistance mutations. During the first interview (23 patients), the most commonly reported symptoms/side effects were coughing, itching, tiredness (each reported by 56.5% of patients), and rash (43.5%). During the second interview (21 patients), compared with the first interview, shortness of breath and diarrhea were reported by more patients (57.1 and 38.1%, respectively; both increased from 34.8%); tiredness remained predominant (42.9%); and itching (38.1%), coughing (38.1%), and rash (14.3%) were reported by fewer patients. At both interviews, the most frequently reported symptoms/side effects were also those most often rated by patients for bothersomeness and severity, and generally received mean scores in the low-to-moderate range. However, several rarely expressed symptoms/side effects (e.g., abdominal pain, frequent day time urination) received high bothersomeness ratings. At the second interview, patients were highly satisfied with osimertinib and had a low level of difficulty in coping with side effects during treatment. These data enhance our understanding of patients' experiences of symptoms/side effects, which could increase the accuracy of the osimertinib benefit-risk assessment, guide management of adverse events, and improve the information given to patients

  16. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Science.gov (United States)

    2013-01-01

    Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV) and how they want to give birth if the baby remains breech, either by planned caesarean section (CS) or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11) and health professionals who manage breech presentation (n=11) recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the differences between evidence

  17. A qualitative interview study exploring pregnant women’s and health professionals’ attitudes to external cephalic version

    Directory of Open Access Journals (Sweden)

    Say Rebecca

    2013-01-01

    Full Text Available Abstract Background Women who have a breech presentation at term have to decide whether to attempt external cephalic version (ECV and how they want to give birth if the baby remains breech, either by planned caesarean section (CS or vaginal breech birth. The aim of this study was to explore the attitudes of women with a breech presentation and health professionals who manage breech presentation to ECV. Methods We carried out semi-structured interviews with pregnant women with a breech presentation (n=11 and health professionals who manage breech presentation (n=11 recruited from two hospitals in North East England. We used purposive sampling to include women who chose ECV and women who chose planned CS. We analysed data using thematic analysis, comparing between individuals and seeking out disconfirming cases. Results Four main themes emerged from the data collected during interviews with pregnant women with a breech presentation: ECV as a means of enabling natural birth; concerns about ECV; lay and professional accounts of ECV; and breech presentation as a means of choosing planned CS. Some women’s attitudes to ECV were affected by their preferences for how to give birth. Other women chose CS because ECV was not acceptable to them. Two main themes emerged from the interview data about health professionals’ attitudes towards ECV: directive counselling and attitudes towards lay beliefs about ECV and breech presentation. Conclusions Women had a range of attitudes to ECV informed by their preferences for how to give birth; the acceptability of ECV to them; and lay accounts of ECV, which were frequently negative. Most professionals described having a preference for ECV and reported directively counselling women to choose it. Some professionals were dismissive of lay beliefs about ECV. Some key challenges for shared decision making about breech presentation were identified: health professionals counselling women directively about ECV and the

  18. What affects authors' and editors' use of reporting guidelines? Findings from an online survey and qualitative interviews.

    Directory of Open Access Journals (Sweden)

    Thomas Fuller

    Full Text Available To identify and understand, through data from multiple sources, some of the factors that affect authors' and editors' decisions to use reporting guidelines in the publication of health research.Mixed methods study comprising an online survey and semi-structured interviews with a sample of authors (online survey: n = 56; response rate = 32%; semi-structured interviews: n = 5 and journal editors (online survey: n = 43; response rate = 27%; semi-structured interviews: n = 6 involved in publishing health and medical research. Participants were recruited from an earlier study examining the effectiveness of the TREND reporting guideline.Four types of factors interacted to affect authors' and editors' likelihood of reporting guideline use; individual (e.g., having multiple reasons for use of reporting guidelines; the professional culture in which people work; environmental (e.g., policies of journals; and, practical (e.g., having time to use reporting guidelines. Having multiple reasons for using reporting guidelines was a particularly salient factor in facilitating reporting guidelines use for both groups of participants.Improving the completeness and consistency of reporting of research studies is critical to the integrity and synthesis of health research. The use of reporting guidelines offers one potentially efficient and effective means for achieving this, but decisions to use (or not use reporting guidelines take many factors into account. These findings could be used to inform future studies that might, for example, test the factors that we have identified within a wider theoretical framework for understanding changes in professional practices. The use of reporting guidelines by senior professionals appears to shape the expectations of what constitutes best practice and can be assimilated into the culture of a field or discipline. Without evidence of effectiveness of reporting guidelines, and sustained, multifaceted efforts to improve reporting

  19. Responses to provision of personalised cancer risk information: a qualitative interview study with members of the public.

    Science.gov (United States)

    Usher-Smith, Juliet A; Silarova, Barbora; Lophatananon, Artitaya; Duschinsky, Robbie; Campbell, Jackie; Warcaba, Joanne; Muir, Kenneth

    2017-12-22

    It is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the past five years if people had healthier lifestyles. A number of theories of behaviour change suggest that before people will change health behaviours, they must accept that a risk applies to them. This study aimed to explore the views of the public on receiving personalised cancer risk information and the potential for that information to motivate behaviour change. We conducted 27 interviews with members of the public (mean age 49 ± 23 years). Each participant completed a questionnaire to allow calculation of their risk of developing the most common cancers (10 for women, 8 for men). During the interviews we presented their risk using a web-based tool developed for the study and discussions covered their views on receiving that information. Each interview was audio-recorded and then analysed using thematic analysis. Participants generally viewed the concept of personalised cancer risk positively. The first reaction of almost all when presented with their 10-year risk of an individual cancer without any further context was that it was low and not concerning. Views on what constituted a high risk ranged widely, from 0.5 to 60%. All felt seeing the impact of changes in lifestyle was helpful. For some this led to intentions to change behaviour, but reductions in risk were not always motivating as the risks were considered low and differences small. Provision of personalised cancer risk was well received and may be a useful addition to other cancer prevention initiatives. Further work is needed in particular to develop ways to present cancer risk that reflect the general perception of what constitutes a risk high enough to motivate behaviour change and help patients contextualise a less well known health risk by providing a frame of reference.

  20. Motivational interviewing in respiratory therapy: What do clinicians need to make it part of routine care? A qualitative study.

    Directory of Open Access Journals (Sweden)

    Robert Shannon

    Full Text Available Motivational interviewing (MI is a method for building motivation for behaviour change that has potential for use in respiratory contexts. There is a paucity of published research exploring the feasibility of this intervention from the clinicians' perspective. This study aimed to explore respiratory clinicians' views of MI: Is it perceived as useful? Could it be integrated into practice? What training would be required to make it part of routine care? Nine respiratory clinicians attended a one-day MI workshop and a semi-structured face-to-face interview two weeks later. All interviews were audio-recorded, transcribed verbatim and analysed with thematic analysis. Four main themes are presented-1 MI's suitability for use in respiratory contexts: participants saw potential in using MI to motivate their patients to engage with prescribed respiratory interventions, such as increased physical activity. Those who experimented with new skills post-workshop were encouraged by patient responsiveness and outcomes. 2 MI's relationship with routine clinical practice: some believed they already used elements of MI, but most participants felt MI was fundamentally 'different' to their normal style of working. 3 Implementation issues: additional time would need to be made available to enable an appropriate depth of conversation. 4 Training issues: Participants sensed the complexity of MI could make it difficult to learn and that it would take them time to become competent. On-going supervision was perceived as necessary. One key challenge identified was how to suppress behaviours that are antithetical to MI. These findings lend support to the feasibility of using MI in respiratory contexts such as pulmonary rehabilitation programmes, but highlight implementation and training issues that would need to be overcome. The insights have informed the development of another study, testing the effect of a tailored training package on MI skill, specifically for

  1. Euthanasia: the perceptions of nurses in India.

    Science.gov (United States)

    Poreddi, Vijayalakshmi; Nagarajaiah; Konduru, Reddemma; Math, Suresh Bada

    2013-04-01

    Euthanasia provokes controversies in various domains, such as the moral, ethical, legal, religious, scientific, and economic. India legalised passive euthanasia (withdrawal of life support) for patients with brain death or who are in a permanent vegetative state in 2011, but research on perceptions of euthanasia among people in India is limited. This study aimed to examine nurses' perceptions of the practice of euthanasia as well as factors influencing those perceptions. A non-probability quantitative, cross-sectional design was adopted for a sample of 214 nurses working at a tertiary care centre. Data was collected through self-reported questionnaires at the nurses workplace.The findings revealed mixed opinions on euthanasia among the nurses. However, the majority of the participants did not agree with the practice of euthanasia. Nonetheless, further research is needed on this issue across the country among various health professionals in the context of current legislation.

  2. [Euthanasia/assisted suicide. Ethical and socio-religious aspects].

    Science.gov (United States)

    Chiriţă, V; Chiriţă, Roxana; Duică, Lavinia; Talau, Gh

    2009-01-01

    Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001).

  3. Nursing Students' Attitudes Towards Euthanasia: A Study In Yozgat, Turkey

    Directory of Open Access Journals (Sweden)

    Aysegül Koç

    2012-01-01

    Full Text Available Background and Purpose: In Turkish culture, death is an integral part of life. This study aims to examine perceptions andattitudes towards euthanasia among student nurses pursuing bachelor’s degrees. As part of the study, interviews wereconducted with 147 student nurses using a questionnaire.Methodology: This descriptive study was conducted after obtaining the required permits, with the participation of 147student nurses, who volunteered to participate.Results: In all, 147 of the 173 questionnaires were obtained. A total of 84.4% of the participants (n:124 were female; 32.7%were 1st year students (n:48, 23.1% were 2nd year students (n:34, 20.4% were 3rd year students (n:30, and 23.8% were 4thyear students (n:35. Question 1 asked student nurses to identify their sources of information about euthanasia prior tobeginning their university education. A total of 70.7% of the students responded to this question (n:104 and 29.3% failed torespond (n:43. A total of 10.2% of the students said their main source of information on euthanasia was their family/relatives(n:15, 49.2% of the students said it was media (TV, newspaper, etc., 31.3% said it was health workers (n:46, and 8.8% saidit was their own research (n:13.Conclusion: This study aimed to examine the views of student nurses on euthanasia. It seems to be the case that euthanasiaand its related concepts will continue to be sources of ethical dilemmas. Future studies should make use of larger sampleswith similar characteristics, and conduct in-depth interviews, particularly with nurses employed in intensive care units.

  4. Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?

    NARCIS (Netherlands)

    de Boer, M.E.; Dröes, R.M.; Jonker, C.; Eefsting, J.A.; Hertogh, C.M.P.M.

    2010-01-01

    Objective: To obtain insight into current practices regarding compliance with advance directives for euthanasia (ADEs) in cases of incompetent patients with dementia in Dutch nursing homes, in light of the legal possibility offered by the new euthanasia law to perform euthanasia in these cases.

  5. Euthanasia, National and International Perspectives

    Directory of Open Access Journals (Sweden)

    Rustin-Petru Ciasc

    2013-08-01

    Full Text Available The topic of euthanasia can be defined and analyzed upon considering several perspectives, such as the legal, religious, historical, philosophical, medical or ethical ones. This article attempts to supply a brief presentation of these perspectives, indicating the existing trends and standpoints at world level in connection to perceptions regarding the phenomenon mentioned, exemplified by opinions described in the doctrine and relevant jurisprudence. At the same time, in this article I will try to indicate the weak spots of the Romanian legislation in the euthanasia area, upon supplying some proposals for legislative intervention. Concomitantly, it should appear the idea that not the right to die per se is to receive motivations and be included in the law, but the duty to live. This should be done first by drafting an adequate law to the terminal states that would guide their medical practice and comply with the world legislative trends.

  6. Euthanasia and Death with Dignity

    Directory of Open Access Journals (Sweden)

    Yuvraj Dilip Patil

    2016-07-01

    Full Text Available Dying has become imposition upon humans, who seek to avoid it as they encounter the inevitably fatal aging process. After the case of Aruna Shanbag a nurse who spent 42 years in a vegetative state as a result of sexual assault, the issue of euthanasia-mercy killing gained attention. The formulation of regulatory provision for euthanasia was earlier examined in Health Ministry in th 2006 based on the 196 report of the law commission of India however; health ministry at that time had opted not to make law on it. Interestingly the health ministry has enacted bill for terminally ill patient in 2016. In this article author has discussed The Medical Treatment of Terminally Ill Patients (Protection of patients and medical practitioners bill- 2016 with position in other countries.

  7. Euthanasia, dying well and the slippery slope.

    Science.gov (United States)

    Allmark, P

    1993-08-01

    Arguments in favour of voluntary euthanasia tend to be put in utilitarian terms. This paper suggests an alternative, neo-Aristotelian argument justifying certain individual acts of both suicide and voluntary euthanasia. It goes on to examine the slippery slope arguments against legalizing euthanasia. It is suggested that such arguments cut both ways. However, the suggestion that we ought therefore to permit a social experiment in voluntary euthanasia is set alongside the Dutch experience. The latter seems to imply that if such experiments are to take place then great caution needs to be applied.

  8. Voluntary euthanasia: ethical concepts and definitions.

    Science.gov (United States)

    Sanders, K; Chaloner, C

    Euthanasia is a highly emotive and contentious subject, giving rise to a great deal of debate. However, despite its frequent exposure in public and professional media, there appears to be a lack of clarity about the concepts and definitions used in the euthanasia debate. This suggests that discussions on this subject are inadequately informed and ineffectual. The ethical focus of the euthanasia debate concerns the moral legitimacy of 'voluntary euthanasia'. This article provides an overview and clarification of some of the key ethical issues at the centre of that debate.

  9. Declarations on euthanasia and assisted dying.

    Science.gov (United States)

    Inbadas, Hamilton; Zaman, Shahaduz; Whitelaw, Sandy; Clark, David

    2017-10-01

    Declarations on end-of-life issues are advocacy interventions that seek to influence policy, raise awareness and call others to action. Despite increasing prominence, they have attracted little attention from researchers. This study tracks the emergence, content, and purpose of declarations concerned with assisted dying and euthanasia, in the global context. The authors identified 62 assisted dying/euthanasia declarations covering 1974-2016 and analyzed them for originating organization, geographic scope, format, and stated viewpoint on assisted dying/euthanasia. The declarations emerged from diverse organizational settings and became more frequent over time. Most opposed assisted dying/euthanasia.

  10. [Euthanasia - an attempt to organize issue].

    Science.gov (United States)

    Kirmes, Tomasz; Wilk, Mateusz; Chowaniec, Czesław

    This article is an attempt to complete and holistically discuss problem of euthanasia, especially its ethical and legal aspects, comparing to Polish law. The subject of euthanasia arouse interest of the society because it touches one of the most important aspects of life, which is the death. Even bigger emotions are aroused amongst physicians. They are forced to put on the line the life as biggest value on the one side and autonomy of human being on the other. It also touches the empathy for suffering. The euthanasia was divided into three forms: active euthanasia, passive euthanasia and assisted suicide. Any form of euthanasia is illegal in Poland according to both the Penal Code and Code of Medical Ethics. Range of possible penal consequences perpetrator is very wide from waiver of punishment to life imprisonment and it comes from different penal qualification of the euthanasia. Qualification of the euthanasia is based on terms of intent of perpetrator's act, request of patient, strong empathy for suffering if the patient and decision based on up-to-date medical knowledge. It is valuable to mention "do-not-resuscitate" DNR procedure, which in case of medical futility is legally accepted in Poland, but in other form may be qualified as passive euthanasia.

  11. Declarations on euthanasia and assisted dying

    Science.gov (United States)

    Inbadas, Hamilton; Zaman, Shahaduz; Whitelaw, Sandy; Clark, David

    2017-01-01

    ABSTRACT Declarations on end-of-life issues are advocacy interventions that seek to influence policy, raise awareness and call others to action. Despite increasing prominence, they have attracted little attention from researchers. This study tracks the emergence, content, and purpose of declarations concerned with assisted dying and euthanasia, in the global context. The authors identified 62 assisted dying/euthanasia declarations covering 1974–2016 and analyzed them for originating organization, geographic scope, format, and stated viewpoint on assisted dying/euthanasia. The declarations emerged from diverse organizational settings and became more frequent over time. Most opposed assisted dying/euthanasia. PMID:28398131

  12. Experiences with tele-health follow-up in patients with rheumatoid arthritis: a qualitative interview study

    DEFF Research Database (Denmark)

    Raunsbæk Knudsen, Line; Thurah, Annette De; Lomborg, Kirsten

    2017-01-01

    the patients' different needs, wishes and abilities to take part in tele-health follow-up. Our findings reveal a need for more insight into how tele-health follow-up could be integrated in routine clinical practice, paying special attention to how reluctant patients may be supported.......: Adopting a strategy of interpretive description, we conducted individual, semi-structured interviews with 15 RA patients participating in a tele-health follow-up. Participants were selected purposively and consecutive from both genders and with various ages, disease durations and disease severity....... The analysis was inductive with a constant comparative approach. First, we identified the main themes conveying the participants' experiences. Then, we constructed patient typologies to explain different perspectives on the tele-health follow-up. RESULTS: Five themes covered the participants' experiences: 'A...

  13. Situating mental health work in place: Qualitative findings from interviews with Veterans in Southeastern Louisiana and Northern California.

    Science.gov (United States)

    Abraham, Traci H; Koenig, Christopher J; Zamora, Kara; Hill, Coleen; Uddo, Madeline; Kelly, Adam P; Hamilton, Michelle F; Curran, Geoffrey M; Pyne, Jeffrey M; Seal, Karen H

    2017-09-01

    Most chronic illness management occurs outside clinics and hospitals, in the everyday lives of individuals. We use data from semi-structured interviews with 37 veterans from Southeastern Louisiana and Northern California to illustrate how "health work" for mental health concerns are shaped by place. Using health work as an orienting concept for analysis, we discerned variation between the two study sites in how Veterans used interacting with the natural environment, cultivating time alone, and religious practice to manage their mental health and well-being. Through these findings, we advocate for a situated notion of health work that is mindful of how health-related behaviors are shaped by place and the attributes that constitute place. Published by Elsevier Ltd.

  14. Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

    Science.gov (United States)

    Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

    2013-01-01

    By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

  15. Chronic kidney disease in Nicaragua: a qualitative analysis of semi-structured interviews with physicians and pharmacists.

    Science.gov (United States)

    Ramirez-Rubio, Oriana; Brooks, Daniel R; Amador, Juan Jose; Kaufman, James S; Weiner, Daniel E; Scammell, Madeleine Kangsen

    2013-04-16

    Northwestern Nicaragua has a high prevalence of chronic kidney disease (CKD) of unknown cause among young adult men. In addition, frequent occurrence of urinary tract infections (UTI) among men and a dysuria syndrome described by sugarcane workers as "chistata" are both reported. This study examines health professionals´ perceptions regarding etiology of these conditions and their treatment approaches, including use of potentially nephrotoxic medications. Nineteen in-person semi-structured interviews were conducted in November 2010 among ten physicians and nine pharmacists practicing in the region. Health professionals perceived CKD as a serious and increasing problem in the region, primarily affecting young men working as manual laborers. All interviewees regarded occupational and environmental exposure to sun and heat, and dehydration as critical factors associated with the occurrence of CKD. These factors were also considered to play a role in the occurrence of chistata in the region. Health professionals indicated that reluctance among workers to hydrate might be influenced by perceptions of water contamination. Symptoms often were treated with non-steroidal anti-inflammatory drugs (NSAIDs), diuretics and antibiotics. Physicians acknowledged that the diagnosis of UTI usually was not based on microbial culture and opined that the use of potentially nephrotoxic medications may be contributing to CKD. Interviews provided evidence suggesting that medications such as diuretics, antibiotics and NSAIDs are widely used and sold over the counter for symptoms that may be related to dehydration and volume depletion. These factors, alone or in combination, may be possible contributors to kidney damage. Acute kidney damage coupled with volume depletion and exposures including medications and infectious agents should be further evaluated as causal factors for CKD in this region.

  16. Patients' preferences for participation in treatment decision-making at the end of life: qualitative interviews with advanced cancer patients.

    Science.gov (United States)

    Brom, Linda; Pasman, H Roeline W; Widdershoven, Guy A M; van der Vorst, Maurice J D L; Reijneveld, Jaap C; Postma, Tjeerd J; Onwuteaka-Philipsen, Bregje D

    2014-01-01

    Patients are often encouraged to participate in treatment decision-making. Most studies on this subject focus on choosing between different curative treatment types. In the last phase of life treatment decisions differ as they often put more emphasis on weighing quantity against quality of life, such as whether or not to start treatment aimed at life prolongation but with the possibility of side effects. This study aimed to obtain insight into cancer patients' preferences and the reasons for patients' preferred role in treatment decision-making at the end of life. 28 advanced cancer patients were included at the start of their first line treatment. In-depth interviews were held prior to upcoming treatment decisions whether or not to start a life prolonging treatment. The Control Preference Scale was used to start discussing the extent and type of influence patients wanted to have concerning upcoming treatment decision-making. Interviews were audio taped and transcribed. All patients wanted their physician to participate in the treatment decision-making process. The extent to which patients themselves preferred to participate seemed to depend on how patients saw their own role or assessed their own capabilities for participating in treatment decision-making. Patients foresaw a shift in the preferred level of participation to a more active role depending in the later phase of illness when life prolongation would become more limited and quality of life would become more important. Patients vary in how much involvement they would like to have in upcoming treatment decision-making. Individual patients' preferences may change in the course of the illness, with a shift to more active participation in the later phases. Communication about patients' expectations, wishes and preferences for participation in upcoming treatment decisions is of great importance. An approach in which these topics are openly discussed would be beneficial.

  17. Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project).

    Science.gov (United States)

    Sverker, Annette; Östlund, Gunnel; Thyberg, Mikael; Thyberg, Ingrid; Valtersson, Eva; Björk, Mathilda

    2015-01-01

    To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

  18. Intentions and experiences of effective practice in mental health specific supported accommodation services: a qualitative interview study.

    Science.gov (United States)

    Sandhu, Sima; Priebe, Stefan; Leavey, Gerard; Harrison, Isobel; Krotofil, Joanna; McPherson, Peter; Dowling, Sarah; Arbuthnott, Maurice; Curtis, Sarah; King, Michael; Shepherd, Geoff; Killaspy, Helen

    2017-07-11

    Deinstitutionalisation in Europe has led to the development of community-based accommodation for people with mental health problems. The type, setting, and intensity of support provided vary and the costs are substantial. Yet, despite the large investment in these services, there is little clarity on their aims and outcomes or how they are regarded by staff and the clients. We interviewed 30 staff and 30 clients from the three main types of supported accommodation in England (residential care, supported housing, floating outreach) to explore their perspectives on the purpose of these services, and the components of care considered most helpful. The interviews were coded and analysed using thematic analysis. There were generally consistent understandings amongst clients and staff across service types on the goals and purposes of supported accommodation services as: building independence and confidence; supporting people with their mental health; and providing safety and stability. We also noted a competing theme of anxiety about the continuity of support when clients move on from a service. Themes on the experience of what aided effective practice centred on: the supportive presence of others; incremental steps to progress; working together to avoid deskilling and dependency; feeling known and personally understood; tailoring support for social and community engagement; and building confidence through encouragement. The findings provide an understanding of the commonalities in service approach, and goals of clients in these services, as well as the facilitators of goal attainment. However, they also highlight a common tension between providing safe and supportive living environments, whilst also promoting independence and facilitating rehabilitative change.

  19. Social and Physical Environmental Factors Influencing Adolescents’ Physical Activity in Urban Public Open Spaces: A Qualitative Study Using Walk-Along Interviews

    Science.gov (United States)

    Van Hecke, Linde; Deforche, Benedicte; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Veitch, Jenny; Van Cauwenberg, Jelle

    2016-01-01

    Most previous studies examining physical activity in Public Open Spaces (POS) focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents’ visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12–16 years, 64% boys) were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium). Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active) friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people), the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents’ behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents’ home or school may

  20. Social and Physical Environmental Factors Influencing Adolescents' Physical Activity in Urban Public Open Spaces: A Qualitative Study Using Walk-Along Interviews.

    Directory of Open Access Journals (Sweden)

    Linde Van Hecke

    Full Text Available Most previous studies examining physical activity in Public Open Spaces (POS focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents' visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12-16 years, 64% boys were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium. Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people, the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents' behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents' home or school

  1. Social and Physical Environmental Factors Influencing Adolescents' Physical Activity in Urban Public Open Spaces: A Qualitative Study Using Walk-Along Interviews.

    Science.gov (United States)

    Van Hecke, Linde; Deforche, Benedicte; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Veitch, Jenny; Van Cauwenberg, Jelle

    2016-01-01

    Most previous studies examining physical activity in Public Open Spaces (POS) focused solely on the physical environment. However, according to socio-ecological models the social environment is important as well. The aim of this study was to determine which social and physical environmental factors affect adolescents' visitation and physical activity in POS in low-income neighbourhoods. Since current knowledge on this topic is limited, especially in Europe, qualitative walk-along interviews were used to obtain detailed and context-specific information. Participants (n = 30, aged 12-16 years, 64% boys) were recruited in POS in low-income neighbourhoods in Brussels, Ghent and Antwerp (Belgium). Participants were interviewed while walking in the POS with the interviewer. Using this method, the interviewer could observe and ask questions while the participant was actually experiencing the environment. All audio-recorded interviews were transcribed and analysed using Nvivo 10 software and thematic analysis was used to derive categories and subcategories using a grounded theory approach. The most important subcategories that were supportive of visiting POS and performing physical activity in POS were; accessibility by foot/bicycle/public transport, located close to home/school, presence of (active) friends and family, cleanliness of the POS and features, availability of sport and play facilities, large open spaces and beautiful sceneries. The most important subcategories that were unsupportive of visiting POS and physical activity in POS were; presence of undesirable users (drug users, gangs and homeless people), the behaviour of other users and the cleanliness of the POS and features. Social factors appeared often more influential than physical factors, however, it was the combination of social and physical factors that affected adolescents' behaviour in POS. Easily accessible POS with high quality features in the proximity of adolescents' home or school may stimulate

  2. The Rest of the Story: A Qualitative Study of Complementing Standardized Assessment Data with Informal Interviews with Older Patients and Families.

    Science.gov (United States)

    Lafortune, Claire; Elliott, Jacobi; Egan, Mary Y; Stolee, Paul

    2017-04-01

    While standardized health assessments capture valuable information on patients' demographic and diagnostic characteristics, health conditions, and physical and mental functioning, they may not capture information of most relevance to individual patients and their families. Given that patients and their informal caregivers are the experts on that patient's unique context, it is important to ensure they are able to convey all relevant personal information to formal healthcare providers so that high-quality, patient-centered care may be delivered. This study aims to identify information that older patients and families consider important but that might not be included in standardized assessments. Transcripts were analyzed from 29 interviews relating to eight patients with hip fractures from three sites (large urban, smaller urban, rural) in two provinces in Canada. These interviews were conducted as part of a larger ethnographic study. Each transcript was analyzed by two researchers using content analysis. Results were reviewed in two focus group interviews with older adults and family caregivers. Identified themes were compared with items from two standardized assessments used in healthcare settings. Three broad themes emerged from the qualitative analysis that were not covered in the standardized assessments: informal caregiver and family considerations, insider healthcare knowledge, and patients' healthcare attitudes and experiences. The importance of these themes was confirmed through focus group interviews. Focus group participants also emphasized the importance of conducting assessments in a patient-centered way and the importance of open-ended questions. A less structured interview approach may yield information that would otherwise be missed in standardized assessments. Combining both sources could yield better-informed healthcare planning and quality-improvement efforts.

  3. Euthanasia – a Contemporary Issue

    Directory of Open Access Journals (Sweden)

    Florentina PUSCĂ

    2010-03-01

    Full Text Available The right to life is one of the fundamental rights of people that have to be respected and protected by each state’s legislation. The connection between the right to life and criminal law is a significant one, as the Criminal Code incriminates a few categories of crimes that can prejudice it. Although that as an object of crimes against life, a person’s life is recognized, the right to life remains a value that can suffer from criminal attempts. Often, in literature, the correlation or the relation between certain criminal acts is discussed, such as the genocide, illegal abortion, euthanasia, infanticide and the right to life, the possibility of mutual influence and their coexistence. Furthermore, the problem ofeuthanasia involves also the examination of practical and juridical connotations connected to the free accomplishment of the human fundamental rights and the right to life in particular. Can thecompatibility or the incompatibility of euthanasia with the right to law be decisive? The answer can only be an affirmative one, as through this approach the judicial statute and the scope of euthanasia can be determined.

  4. 'Wouldn't it be easier if you continued to be a guy?' - a qualitative interview study of transsexual persons' experiences of encounters with healthcare professionals.

    Science.gov (United States)

    von Vogelsang, Ann-Christin; Milton, Camilla; Ericsson, Ingrid; Strömberg, Lars

    2016-12-01

    To describe transsexual persons' experiences of encounters with healthcare professionals during the sex reassignment process. Transsexual persons are individuals who use varying means to alter their natal sex via hormones and/or surgery. Transsexual persons may experience stigma, which increases the risk of psychological distress. Mistreatments by healthcare professionals are common. Qualitative studies addressing transsexual persons' experiences of healthcare are scarce. Qualitative descriptive design. A Swedish non-clinical convenience sample was used, consisting of six persons who had been diagnosed as transsexual, gone through sex reassignment surgery or were at the time of the interview awaiting surgery. Semi-structured interviews were undertaken, and data were analysed using manifest qualitative content analysis. Three categories and 15 subcategories were identified. The encounters were perceived as good when healthcare professionals showed respect and preserved the transsexual person's integrity, acted in a professional manner and were responsive and built trust and confidence. However, the participants experienced that healthcare professionals varied in their level of knowledge, exploited their position of power, withheld information, expressed gender stereotypical attitudes and often used the wrong name. They felt vulnerable by having a condescending view of themselves, and they could not choose not to be transsexual. They felt dependent on healthcare professionals, and that the external demands were high. Transsexual persons are in a vulnerable position during the sex reassignment surgery process. The encounters in healthcare could be negatively affected if healthcare professionals show inadequate knowledge, exploit their position of power or express gender stereotypical attitudes. A good encounter is characterised by preserved integrity, respect, responsiveness and trust. Improved education on transgender issues in nursing and medical education is

  5. eHealth Technologies, Multimorbidity, and the Office Visit: Qualitative Interview Study on the Perspectives of Physicians and Nurses.

    Science.gov (United States)

    Macdonald, Graham G; Townsend, Anne F; Adam, Paul; Li, Linda C; Kerr, Sheila; McDonald, Michael; Backman, Catherine L

    2018-01-26

    eHealth is a broad term referring to the application of information and communication technologies in the health sector, ranging from health records to telemedicine and multiple forms of health education and digital tools. By providing increased and anytime access to information, opportunities to exchange experiences with others, and self-management support, eHealth has been heralded as transformational. It has created a group of informed, engaged, and empowered patients as partners, equipped to take part in shared decision making and effectively self-manage chronic illness. Less attention has been given to health care professionals' (HCPs) experiences of the role of eHealth in patient encounters. The objective of this study was to examine HCPs' perspectives on how eHealth affects their relationships with patients living with multiple chronic conditions, as well as its ethical and practical ramifications. We interviewed HCPs about their experiences with eHealth and its impact on the office visit. Eligible participants needed to report a caseload of ≥25% of patients with multimorbidity to address issues of managing complex chronic conditions and coordination of care. We used a semistructured discussion guide for in-depth interviews, and follow-up interviews served to clarify and expand upon initial discussions. Constant comparisons and a narrative approach guided the analyses, and a relational ethics conceptual lens was applied to the data to identify emergent themes. A total of 12 physicians and nurses (6 male, 6 female; median years of practice=13) participated. eHealth tools most frequently described were Web-based educational resources for patients and Web-based resources for HCPs such as curated scientific summaries on diagnostic criteria, clinical therapies, and dosage calculators. Analysis centered on a grand theme of the two-way conversation between HCPs and patients, which addresses a general recentering of the ethical relationship between HCPs and

  6. Understanding barriers to the introduction of precision medicines in non-small cell lung cancer: A qualitative interview protocol [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Stuart Wright

    2018-03-01

    Full Text Available Background: While precision medicines targeting genetic mutations and alterations in non-small cell lung cancer (NSCLC have been available since 2010, their adoption into clinical practice has been slow. Evidence suggests that a number of barriers, such as insufficient clinician knowledge, a need for training of test providers, or a lack of specific clinical guidelines, may slow the implementation of precision in general. However, little attention has been given to the barriers to providing precision medicines in NSCLC. The purpose of this protocol is to outline the design for a qualitative interview study to identify the barriers and facilitators to the provision of precision medicines for NSCLC.   Methods: This study will use semi-structured interviews with clinicians (n=10, test providers (n=10, and service commissioners (n=10 to identify the perceived barriers and facilitators to providing historical, current, and future precision medicines in NSCLC. Participants will be identified through mailing list advertisements and snowball sampling. Recruitment will continue until data saturation, indicated by no new themes arising from the data. Interviews will be conducted by telephone to facilitate geographical diversity. The qualitative data will be analysed using a framework analysis with themes anticipated to relate to; relevant barriers to providing precision medicines, the impact of different barriers on medicine provision, changes in the ability to provide precision medicines over time, and strategies to facilitate the provision of precision medicines.   Ethics: This study has been approved by the University of Manchester Proportionate Review Research Ethics Committee (Reference number: 2017-1885-3619. Written consent will be obtained from all participants.   Conclusion: This study is the first to explore the barriers and facilitators to providing precision medicines for NSCLC in the English NHS. The findings will inform strategies to

  7. Show what you know and deal with stress yourself: a qualitative interview study of medical interns' perceptions of stress and gender.

    Science.gov (United States)

    Verdonk, Petra; Räntzsch, Viktoria; de Vries, Remko; Houkes, Inge

    2014-05-17

    Medical students report high stress levels and in particular, the clinical phase is a demanding one. The field of medicine is still described as having a patriarchal culture which favors aspects like a physicians' perceived certainty and rationalism. Also, the Effort-Recovery Model explains stress as coming from a discrepancy between job demands, job control, and perceived work potential. Gendered differences in stress are reported, but not much is known about medical interns' perceptions of how gender plays in relation to stress. The aim of this study is to explore how medical interns experience and cope with stress, as well as how they reflect on the gendered aspects of stress. In order to do this, we have performed a qualitative study. In 2010-2011, semi-structured qualitative interviews were conducted with seventeen medical interns across all three years of the Masters programme (6 male, 11 female) at a Dutch medical school. The interview guide is based on gender theory, the Effort-Recovery Model, and empirical literature. Transcribed interviews have been analyzed thematically. First, stress mainly evolves from having to prove one's self and show off competencies and motivation ("Show What You Know…"). Second, interns seek own solutions for handling stress because it is not open for discussion (… "And Deal With Stress Yourself"). Patient encounters are a source of pride and satisfaction rather than a source of stress. But interns report having to present themselves as 'professional and self-confident', remaining silent about experiencing stress. Female students are perceived to have more stress and to study harder in order to live up to expectations. The implicit message interns hear is to remain silent about insecurities and stress, and, in particular, female students might face disadvantages. Students who feel less able to manifest the 'masculine protest' may benefit from a culture that embraces more collaborative styles, such as having open conversation

  8. Implications of Patient Portal Transparency in Oncology: Qualitative Interview Study on the Experiences of Patients, Oncologists, and Medical Informaticists.

    Science.gov (United States)

    Alpert, Jordan M; Morris, Bonny B; Thomson, Maria D; Matin, Khalid; Brown, Richard F

    2018-03-26

    Providing patients with unrestricted access to their electronic medical records through patient portals has impacted patient-provider communication and patients' personal health knowledge. However, little is known about how patient portals are used in oncology. The aim of this study was to understand attitudes of the portal's adoption for oncology and to identify the advantages and disadvantages of using the portal to communicate and view medical information. In-depth semistructured interviews were conducted with 60 participants: 35 patients, 13 oncologists, and 12 medical informaticists. Interviews were recorded, transcribed, and thematically analyzed to identify critical incidents and general attitudes encountered by participants. Two primary themes were discovered: (1) implementation practices influence attitudes, in which the decision-making and execution process of introducing portals throughout the hospital did not include the input of oncologists. Lack of oncologists' involvement led to a lack of knowledge about portal functionality, such as not knowing the time period when test results would be disclosed to patients; (2) perceptions of portals as communication tools varies by user type, meaning that each participant group (patients, oncologists, and medical informaticists) had varied opinions about how the portal should be used to transmit and receive information. Oncologists and medical informaticists had difficulty understanding one another's culture and communication processes in their fields, while patients had preferences for how they would like to receive communication, but it largely depended upon the type of test being disclosed. The majority of patients (54%, 19/35) who participated in this study viewed lab results or scan reports via the portal before being contacted by a clinician. Most were relatively comfortable with this manner of disclosure but still preferred face-to-face or telephone communication. Findings from this study indicate that

  9. 'Personal Care' and General Practice Medicine in the UK: A qualitative interview study with patients and General Practitioners.

    Science.gov (United States)

    Adam, Rachel

    2007-08-31

    Recent policy and organisational changes within UK primary care have emphasised graduated access to care, speed of access to the first available general practitioner (GP) and care being provided by a range of healthcare professionals. These trends have been strengthened by the current GP contract and Quality and Outcomes Framework (QOF). Concern has been expressed that the potential for personal care is being diminished as a result and that this will reduce quality standards. This paper presents data from a study that explored with patients and GPs what personal care means and whether it has continuing importance to them. A semi-structured questionnaire was used to interview participants and Framework Analysis supported analysis of emerging themes. Twenty-nine patients, mainly women with young children, and twenty-three GPs were interviewed from seven practices in Lothian, Scotland, ranged by practice size and relative deprivation score. Personal care was defined mainly, though not exclusively, as care given within the context of a continuing relationship in which there is an interpersonal connection and the doctor adopts a particular consultation style. Defined in this way, it was reported to have benefits for both health outcomes and patients' experience of care. In particular, such care was thought to be beneficial in attending to the emotions that can be elicited when seeking and receiving health care and in enabling patients to be known by doctors as legitimate seekers of care from the health service. Its importance was described as being dependent upon the nature of the health problem and patients' wider familial and social circumstances. In particular, it was found to provide support to patients in their parenting and other familial caring roles. Personal care has continuing salience to patients and GPs in modern primary care in the UK. Patients equate the experience of care, not just outcomes, with high quality care. As it is mainly conceptualised and

  10. Patients' views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury-A qualitative interview-based study.

    Science.gov (United States)

    Scheel-Sailer, Anke; Post, Marcel W; Michel, Franz; Weidmann-Hügle, Tatjana; Baumann Hölzle, Ruth

    2017-10-01

    Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared decision making is challenging as a point in case for persons with spinal cord injury (SCI). The aim of this study was to retrospectively explore the patients' views on their participation in decision making during their first inpatient rehabilitation after onset of SCI, in order to optimize treatment concepts. A total of 22 participants with SCI were interviewed in-depth using a semi-structured interview scheme between 6 months and 35 years post-onset. Interviews were transcribed verbatim and analysed with the Mayring method for qualitative content analysis. Participants experienced a substantially reduced ability to participate in decision making during the early phase after SCI. They perceived physical, psychological and environmental factors to have impacted upon this ability. Patients mentioned regaining their ability to make decisions was an important goal during their first rehabilitation. Receiving adequate information in an understandable and personalized way was a prerequisite to achieve this goal. Other important factors included medical and psychological condition, personal engagement, time and dialogue with peers. During the initial rehabilitation of patients with SCI, professionals need to deal with the discrepancy between the obligation to respect a patient's autonomy and their diminished ability for decision making. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

    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.

  12. Prejudice and Health Anxiety about Radiation Exposure from Second-Generation Atomic Bomb Survivors: Results from a Qualitative Interview Study

    Directory of Open Access Journals (Sweden)

    Yuka Kamite

    2017-08-01

    Full Text Available The effect of atomic bomb radiation exposure on the survivors and their children has been a worrisome problem since soon after the 1945 Hiroshima and Nagasaki bombings. Researchers have examined physical and genetic effects; however, no research has focused on second-generation survivors’ (SGS psychological effects. Consequently, this study shed light on the SGS’ experience of discrimination and prejudice and their anxiety concerning the genetic effects of radiation exposure. This study utilized semi-structured interviews with 14 SGS (10 women, mean age = 56 ± 6.25 years, range = 46–68 years. Data were analyzed using a modified version of the grounded theory approach. Three categories were extracted: low awareness as an SGS, no health anxiety regarding the effect of radiation, and health anxiety regarding the effect of radiation. The results did not reveal that SGS who grew up in the bombed areas experienced discrimination or prejudice. They had little health anxiety from childhood to adolescence. In this study, some of the SGS developed health anxiety about their third-generation children, but only among female participants. Perhaps the transgenerational transmission of anxiety concerning the genetic effects of radiation exposure causes stress, particularly among women with children. However, a change was seen in adulthood health anxiety regarding the effects of radiation, suggesting the possibility that changes in the psychological experiences of SGS can be observed throughout their lifetimes and that their own health status, and that of their children, the third-generation survivors, affects their health anxiety regarding radiation.

  13. Motivation to Reduce Risk Behaviors While in Prison: Qualitative Analysis of Interviews with Current and Formerly Incarcerated Women.

    Science.gov (United States)

    Abad, Neetu; Carry, Monique; Herbst, Jeffrey H; Fogel, Catherine I

    2013-10-01

    Prison is an environment in which programs can be implemented to change harmful behaviors among high-risk populations. Incarcerated women experience high rates of HIV and other sexually transmitted diseases (STDs), yet little research has examined women's motivation to reduce risky behaviors during incarceration. In-depth individual interviews were conducted with former and current women prisoners in two North Carolina correctional facilities and analyzed to identify barriers and facilitators of behavior change while in prison. Analyses revealed key motivators of behavior change: Viewing prison as a place to recover from past trauma, removing oneself from negative social networks, gaining access to needed mental and physical health services, and engaging in self-care and self-reflection. Barriers to behavior change include fear of recidivism, stigma of being in prison, and return to undesirable social networks post-release. Moreover, women noted that the provision of mental health services, educational enhancement and housing assistance could help them reduce engagement in high-risk behaviors after their incarceration. These findings can be incorporated into HIV/STD risk reduction interventions to facilitate positive behavior change among incarcerated women prisoners. Prison itself is a tremendous education in the need for patience and perseverance. It is above all a test of one's commitment.-Nelson Mandela, 1995.

  14. Valuing technology: A qualitative interview study with physicians about insulin pump therapy for children with type 1 diabetes.

    Science.gov (United States)

    Shulman, Rayzel; Miller, Fiona A; Daneman, Denis; Guttmann, Astrid

    2016-01-01

    Insulin pumps for children with type 1 diabetes have been broadly adopted despite equivocal evidence about comparative effectiveness. To understand why and inform policy related to public funding for new technologies, we explored how physicians interpret the value of pumps. We conducted open-ended, semi-structured interviews with 16 physicians from a pediatric diabetes network in Ontario, Canada, and analyzed the data using interpretive description. Respondents recognized that pumps fell short of expectations because they required hard work, as well as family and school support. Yet, pumps were valued for their status as new technologies and as a promising step in developing future technology. In addition, they were valued for their role within a therapeutic relationship, given the context of chronic childhood disease. These findings identify the types of beliefs that influence the adoption and diffusion of technologies. Some beliefs bear on hopes for new technology that may inappropriately hasten adoption, creating excess cost with little benefit. On the other hand, some beliefs identify potential benefits that are not captured in effectiveness studies, but may warrant consideration in resource allocation decisions. Still others suggest the need for remediation, such as those bearing on disparity in pump use by socioeconomic status. Understanding how technologies are valued can help stakeholders decide how to address such beliefs and expectations in funding decisions and implementation protocols. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Impact of euthanasia rates, euthanasia practices, and human resource practices on employee turnover in animal shelters.

    Science.gov (United States)

    Rogelberg, Steven G; Reeve, Charlie L; Spitzmüller, Christiane; DiGiacomo, Natalie; Clark, Olga L; Teeter, Lisa; Walker, Alan G; Starling, Paula G; Carter, Nathan T

    2007-03-01

    To examine the effects of euthanasia rates, euthanasia practices, and human resource practices on the turnover rate among employees with euthanasia responsibilities at animal shelters. Cross-sectional original study. 36 shelters across the United States that employed at least 5 full-time employees and performed euthanasia on site. By mail, 1 survey was sent to each shelter. Surveys were completed by a senior member of management and were returned by mail. Questions assessed characteristics (eg, euthanasia rates) and practices of the animal shelter, along with employee turnover rates. By use of correlation coefficients and stepwise regression analyses, key predictors of turnover rates among employees with euthanasia responsibilities were investigated. Employee turnover rates were positively related to euthanasia rate. Practices that were associated with decreased turnover rates included provision of a designated euthanasia room, exclusion of other live animals from vicinity during euthanasia, and removal of euthanized animals from a room prior to entry of another animal to be euthanized. Making decisions regarding euthanasia of animals on the basis of factors other than behavior and health reasons was related to increased personnel turnover. With regard to human resources practices, shelters that used a systematic personnel selection procedure (eg, standardized testing) had comparatively lower employee turnover. Data obtained may suggest several specific avenues that can be pursued to mitigate turnover among employees with euthanasia responsibilities at animal shelters and animal control or veterinary medical organizations.

  16. From Advance Euthanasia Directive to Euthanasia: Stable Preference in Older People?

    Science.gov (United States)

    Bolt, Eva E; Pasman, H Roeline W; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D

    2016-08-01

    To determine whether older people with advance directive for euthanasia (ADEs) are stable in their advance desire for euthanasia in the last years of life, how frequently older people with an ADE eventually request euthanasia, and what factors determine this. Mortality follow-back study nested in a cohort study. The Netherlands. Proxies of deceased members of a cohort representative of Dutch older people (n = 168) and a cohort of people with advance directives (n = 154). Data from cohort members (possession of ADE) combined with after-death proxy information on cohort members' last 3 months of life. Multiple logistic regression analysis was performed on determinants of a euthanasia request in individuals with an ADE. Response rate was 65%. One hundred forty-two cohort members had an ADE at baseline. Three months before death, 87% remained stable in their desire for euthanasia; 47% eventually requested euthanasia (vs 6% without an ADE), and 16% died after euthanasia. People with an ADE were more likely to request euthanasia if they worried about loss of dignity. The majority of older adults who complete an ADE will have a stable preference over time, but an advance desire for euthanasia does not necessarily result in a euthanasia request. Writing an ADE may reflect a person's need for reassurance that they can request euthanasia in the future. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  17. Transitional journeys into, and through medical education for First-in-Family (FiF) students: a qualitative interview study.

    Science.gov (United States)

    Bassett, Andrew Mark; Brosnan, Caragh; Southgate, Erica; Lempp, Heidi

    2018-05-09

    There has been much interest in the transitions along the medical education continuum. However, little is known about how students from non-traditional backgrounds experience both the move to, and through Medical School, and their ambitions post-graduation. This research sought to understand the transitional journey into, and through undergraduate medical education, and future career aspirations for first-in-family (FiF) medical students. Based on a interpretivist epistemological perspective, 20 FiF students from one English Medical School participated in semi-structured interviews. Participants were identified according to purposive inclusion criteria and were contacted by email via the student association at the Medical School and academic year leaders. The team approach to the thematic analysis enhanced the findings credibility. This research was part of an international collaboration. In the first transition, 'The Road to Medical School', a passion for science with an interest in people was a motivator to study medicine. Participants' parents' shared the elation of acceptance into Medical School, however, the support from school/college teachers was a mixed experience. In 'The Medical School Journey' transition, knowledge about the medical curriculum was variable. 'Fitting' in at Medical School was a problem for some, but studying for an elite degree elevated social status for many study participants. A source of support derived from senior medical student peers, but a medical degree could sacrifice students' own health. In the final transition, 'Future Plans', a medical career was perceived to have intrinsic value. Clarity about future aspirations was related to clinical experience. For some, career trajectories were related to a work-life balance and future NHS working conditions for Junior Doctors. The transitions highlighted in this article have important implications for those educators interested in a life cycle approach to widening participation in

  18. Qualitative Assessment of Learning Strategies among Medical Students Using Focus Group Discussions and In-depth Interviews.

    Science.gov (United States)

    Joshi, Anuradha Sujai; Ganjiwale, Jaishree Deepak; Varma, Jagdish; Singh, Praveen; Modi, Jyoti Nath; Singh, Tejinder

    2017-12-01

    Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. The objective is to identify effective learning strategies used by medical students. This study was carried out among the MBBS students of Final Professional Part I. Students were categorized into three groups namely: high, average, and low rankers based on overall academic performance in second Professional University examination. First, a questionnaire consisting of closed- and open-ended questions was administered to students, to find their learning strategies. Subsequently, focus group discussion and in-depth interviews were conducted for high- and low-rankers. Discussions were audio-recorded, transcribed, and analyzed. Key statements were highlighted, collated, and categorized into general themes and sub-themes. Evident themes which emerged as effective strategies were hard work in the form of regularity of studies, meticulous preparation of notes, constructive use of time, utilization of e-learning, learning styles and deep learning approach and regular ward visits. Intrinsic motivation, family support, balancing physical activities and studies, guidance by seniors, teachers, dealing with nonacademic issues such as language barriers and stress were also identified as important strategies. Disseminating effective learning strategies in a systematic manner may be helpful to students in achieving better academic outcomes. Furthermore, educationists need to modulate their teaching strategies based on students' feedback.

  19. Patients' initial steps to cancer diagnosis in Denmark, England and Sweden: what can a qualitative, cross-country comparison of narrative interviews tell us about potentially modifiable factors?

    Science.gov (United States)

    MacArtney, John; Malmström, Marlene; Overgaard Nielsen, Trine; Evans, Julie; Bernhardson, Britt-Marie; Hajdarevic, Senada; Chapple, Alison; Eriksson, Lars E; Locock, Louise; Rasmussen, Birgit; Vedsted, Peter; Tishelman, Carol; Andersen, Rikke Sand; Ziebland, Sue

    2017-11-19

    To illuminate patterns observed in International Cancer Benchmarking Programme studies by extending understanding of the various influences on presentation and referral with cancer symptoms. Cross-country comparison of Denmark, England and Sweden with qualitative analysis of in-depth interview accounts of the prediagnostic process in lung or bowel cancer. 155 women and men, aged between 35 and 86 years old, diagnosed with lung or bowel cancer in 6 months before interview. Participants recruited through primary and secondary care, social media and word of mouth. Interviews collected by social scientists or nurse researchers during 2015, mainly in participants' homes. Participants reported difficulties in interpreting diffuse bodily sensations and symptoms and deciding when to consult. There were examples of swift referrals by primary care professionals in all three countries. In all countries, participants described difficulty deciding if and when to consult, highlighting concerns about access to general practitioner appointments and overstretched primary care services, although this appears less prominent in the Swedish data. It was not unusual for there to be more than one consultation before referral and we noted two distinct patterns of repeated consultation: (1) situations where the participant left the primary care consultation with a plan of action about what should happen next; (2) participants were unclear about under which conditions to return to the doctors. This second pattern sometimes extended over many weeks during which patients described uncertainty, and sometimes frustration, about if and when they should return and whether there were any other feasible investigations. The latter pattern appeared more evident in the interviews in England and Denmark than Sweden. We suggest that if clear action plans, as part of safety netting, were routinely used in primary care consultations then uncertainty, false reassurance and the inefficiency and distress

  20. Barriers to and facilitators for implementing quality improvements in palliative care - results from a qualitative interview study in Norway.

    Science.gov (United States)

    Sommerbakk, Ragni; Haugen, Dagny Faksvåg; Tjora, Aksel; Kaasa, Stein; Hjermstad, Marianne Jensen

    2016-07-15

    Implementation of quality improvements in palliative care (PC) is challenging, and detailed knowledge about factors that may facilitate or hinder implementation is essential for success. One part of the EU-funded IMPACT project (IMplementation of quality indicators in PAlliative Care sTudy) aiming to increase the knowledge base, was to conduct national studies in PC services. This study aims to identify factors perceived as barriers or facilitators for improving PC in cancer and dementia settings in Norway. Individual, dual-participant and focus group interviews were conducted with 20 employees working in different health care services in Norway: two hospitals, one nursing home, and two local medical centers. Thematic analysis with a combined inductive and theoretical approach was applied. Barriers and facilitators were connected to (1) the innovation (e.g. credibility, advantage, accessibility, attractiveness); (2) the individual professional (e.g. motivation, PC expertise, confidence); (3) the patient (e.g. compliance); (4) the social context (e.g. leadership, culture of change, face-to-face contact); (5) the organizational context (e.g. resources, structures/facilities, expertise); (6) the political and economic context (e.g. policy, legislation, financial arrangements) and (7) the implementation strategy (e.g. educational, meetings, reminders). Four barriers that were particular to PC were identified: the poor general condition of patients in need of PC, symptom assessment tools that were not validated in all patient groups, lack of PC expertise and changes perceived to be at odds with staff's philosophy of care. When planning an improvement project in PC, services should pay particular attention to factors associated with their chosen implementation strategy. Leaders should also involve staff early in the improvement process, ensure that they have the necessary training in PC and that the change is consistent with the staff's philosophy of care. An important

  1. Women's experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study.

    Science.gov (United States)

    Macey, Kat; Gregory, Angela; Nunns, David; das Nair, Roshan

    2015-06-20

    Recent research has highlighted controversies in the conceptualisation, diagnosis and treatment of vaginismus. Vaginal trainers are currently the most widely used treatment. Critiques have highlighted concerns that the evidence-base of its effectiveness is limited, with controlled trials reporting disappointing results, and its prescription promotes 'performance-based' sexuality which may be detrimental. Despite this, little has been done to seek women's views about their treatment. This study set out to explore women's experiences of vaginismus treatment with vaginal trainers, and to use their voices to propose guidelines for improving treatment. 13 women who had used vaginal trainers for vaginal penetration difficulties diagnosed as vaginismus were recruited through a specialist clinic, university campuses, and online forums. The women took part in semi-structured individual interviews (face-to-face/telephone/Skype), which were audio-recorded, transcribed verbatim and analysed using Thematic Analysis. Four superordinate themes were elicited and used to draft 'better treatment' guidelines. Themes were: (1) Lack of knowledge, (2) Invalidation of suffering by professionals, (3) Difficult journey, and (4) Making the journey easier. This paper describes themes (3) and (4). Difficult Journey describes the long and arduous 'Journey into treatment', including difficulties asking for help, undergoing physical investigations and negotiating 'the system' of medical referrals. It also describes the sometimes demoralising process of 'being in treatment', which includes emotional and practical demands of treatment. Making the journey easier highlights the importance of and limits to 'partner support'. 'Professional support' comprises personal qualities of professionals/therapeutic relationship, the value of specialist skills and knowledge and the need for facilitating couple communication about vaginismus. 'Peer support/helping each other' describes the importance of

  2. Mechanisms of change of a novel weight loss programme provided by a third sector organisation: a qualitative interview study.

    Science.gov (United States)

    McMahon, Naoimh E; Visram, Shelina; Connell, Louise A

    2016-05-10

    There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session). Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme), alumni support (face-to-face and online) and family attendance at exercise sessions. Data were collected through interviews with programme providers (n = 2) and focus groups with participants (n = 12). Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Clients' interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. There is an urgent need to establish robust interventions that can support people who are overweight and obese to achieve a healthy weight and maintain this change. Third

  3. Mechanisms of change of a novel weight loss programme provided by a third sector organisation: a qualitative interview study

    Directory of Open Access Journals (Sweden)

    Naoimh E. McMahon

    2016-05-01

    Full Text Available Abstract Background There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session. Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme, alumni support (face-to-face and online and family attendance at exercise sessions. Methods Data were collected through interviews with programme providers (n = 2 and focus groups with participants (n = 12. Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Results Clients’ interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. Conclusions There is an urgent need to establish robust interventions that can support people who are overweight and

  4. Using the eSexual Health Clinic to access chlamydia treatment and care via the internet: a qualitative interview study.

    Science.gov (United States)

    Aicken, Catherine R H; Sutcliffe, Lorna J; Gibbs, Jo; Tickle, Laura J; Hone, Kate; Harding-Esch, Emma M; Mercer, Catherine H; Sonnenberg, Pam; Sadiq, S Tariq; Estcourt, Claudia S; Shahmanesh, Maryam

    2018-06-01

    We developed the eSexual Health Clinic (eSHC), an innovative, complex clinical and public health intervention, embedded within a specialist sexual health service. Patients with genital chlamydia access their results online and are offered medical management via an automated online clinical consultation, leading to antibiotic collection from community pharmacy. A telephone helpline, staffed by Sexual Health Advisers, is available to support patients and direct them to conventional services if appropriate. We sought to understand how patients used this ehealth intervention. Within exploratory studies of the eSHC (2014-2015), we conducted in-depth interviews with a purposive sample of 36 patients diagnosed with chlamydia, who had chosen to use the eSHC (age 18-35, 20 female, 16 male). Thematic analysis was conducted. Participants described choosing to use this ehealth intervention to obtain treatment rapidly, conveniently and privately, within busy lifestyles that hindered clinic access. They described completing the online consultation promptly, discreetly and with ease. The information provided online was considered comprehensive, reassuring and helpful, but some overlooked it in their haste to obtain treatment. Participants generally described being able to collect treatment from pharmacies discreetly and promptly, but for some, poor awareness of the eSHC by pharmacy staff undermined their ability to do this. Those unsuitable for remote management, who were directed to clinic, described frustration and concern about health implications and clinic attendance. However, the helpline was a highly valued source of information, assistance and support. The eSHC is a promising adjunct to traditional care. Its users have high expectations for convenience, speed and privacy, which may be compromised when transitioning from online to face-to-face elements of the eSHC. Managing expectations and improving implementation of the pharmacy process, could improve their experiences

  5. Young people's perceptions of smartphone-enabled self-testing and online care for sexually transmitted infections: qualitative interview study.

    Science.gov (United States)

    Aicken, Catherine R H; Fuller, Sebastian S; Sutcliffe, Lorna J; Estcourt, Claudia S; Gkatzidou, Voula; Oakeshott, Pippa; Hone, Kate; Sadiq, S Tariq; Sonnenberg, Pam; Shahmanesh, Maryam

    2016-09-13

    Control of sexually transmitted infections (STI) is a global public health priority. Despite the UK's free, confidential sexual health clinical services, those at greatest risk of STIs, including young people, report barriers to use. These include: embarrassment regarding face-to-face consultations; the time-commitment needed to attend clinic; privacy concerns (e.g. being seen attending clinic); and issues related to confidentiality. A smartphone-enabled STI self-testing device, linked with online clinical care pathways for treatment, partner notification, and disease surveillance, is being developed by the eSTI(2) consortium. It is intended to benefit public health, and could do so by increasing testing among populations which underutilise existing services and/or by enabling rapid provision of effective treatment. We explored its acceptability among potential users. In-depth interviews were conducted in 2012 with 25 sexually-experienced 16-24 year olds, recruited from Further Education colleges in an urban, high STI prevalence area. Thematic analysis was undertaken. Nine females and 16 males participated. 21 self-defined as Black; three, mixed ethnicity; and one, Muslim/Asian. 22 reported experience of STI testing, two reported previous STI diagnoses, and all had owned smartphones. Participants expressed enthusiasm about the proposed service, and suggested that they and their peers would use it and test more often if it were available. Utilizing sexual healthcare was perceived to be easier and faster with STI self-testing and online clinical care, which facilitated concealment of STI testing from peers/family, and avoided embarrassing face-to-face consultations. Despite these perceived advantages to privacy, new privacy concerns arose regarding communications technology: principally the risk inherent in having evidence of STI testing or diagnosis visible or retrievable on their phone. Some concerns arose regarding the proposed self-test's accuracy, related to

  6. Euthanasia in the Netherlands: a slippery slope?

    NARCIS (Netherlands)

    Toebes, Brigit

    2017-01-01

    The Dutch euthanasia legislation has been lauded as well as criticized by legal scholars and physicians in the Netherlands and abroad. The legal framework so established is renowned for setting a number of valuable due-care criteria for the physician to follow when performing euthanasia on a

  7. Euthanasia and Mental Retardation: Suggesting the Unthinkable.

    Science.gov (United States)

    Hollander, Russell

    1989-01-01

    The article examines current opinions toward euthanasia of persons with mental retardation in light of the history of public and professional attitudes. It also discusses the rejection of euthanasia on moral and religious grounds, and notes the use of lifelong incarceration, based on eugenics principles, to accomplish similar ends. (DB)

  8. Techniques to Pass on: Technology and Euthanasia

    Science.gov (United States)

    Martin, Brian

    2010-01-01

    Proponents and opponents of euthanasia have argued passionately about whether it should be legalized. In Australia in the mid-1990s, following the world's first legal euthanasia deaths, Dr. Philip Nitschke initiated a different approach: a search for do-it-yourself technological means of dying with dignity. The Australian government has opposed…

  9. Euthanasia in Belgium, the Netherlands and Luxembourg.

    Science.gov (United States)

    2013-11-01

    Each of the Benelux countries (Belgium, Luxembourg, Netherlands) has enacted legislation that partially decriminalises euthanasia, defined as an act that intentionally terminates someone's life at their request. In the Netherlands and Luxembourg, but not in Belgium, the legislation partially decriminalised assisted suicide at the same time. In all three countries, euthanasia can only be performed by a doctor, in response to the patient's voluntary and well-considered request, and for patients who have an incurable disease that causes unbearable suffering, without any prospect of relief. In the Netherlands, minors can request euthanasia as of the age of 12 years. In 2011, reported euthanasia accounted for about 1% of deaths in Belgium and 3% in the Netherlands. In 75% of cases, cancer was the disease leading to a request for euthanasia. In the Netherlands, the number of cases of euthanasia reported by doctors in surveys matches the number that is officially declared. In Belgium, it is thought that there are as many unreported as reported cases of euthanasia. Since the enactment of euthanasia legislation, fewer deaths involve the intentional administration of lethal drugs without an explicit request from the patient.

  10. Dame Cicely Saunders: An Omega Interview.

    Science.gov (United States)

    Kastenbaum, Robert

    1993-01-01

    Presents interview with Dame Cicely Saunders, founder of international hospice care movement. Saunders describes her background and experiences that led her to form the hospice movement and discusses the need for pain control for terminally ill patients. Saunders also notes her opposition to euthanasia and physician-assisted suicide. (NB)

  11. Optimising mobility through the sit-to-stand activity for older people living in residential care facilities: A qualitative interview study of healthcare aide experiences.

    Science.gov (United States)

    Kagwa, Sharon A; Boström, Anne-Marie; Ickert, Carla; Slaughter, Susan E

    2018-03-01

    To explore the experience of HCAs encouraging residents living in residential care to complete the sit-to-stand activity and to identify the strategies HCAs used to integrate the activity into their daily work routines. Decreased mobility in advanced ageing is further reduced when entering a residential care facility. Interventions such as the sit-to-stand activity have been shown to have a positive effect on the mobility of older people. There is evidence to suggest that healthcare aides are able to support residents to complete the sit-to-stand activity as part of their daily work routines; however, little is known about how healthcare aides actually do this with residents living in residential care. A qualitative interview study included seven purposively sampled HCAs working in residential care facilities. Semistructured interviews were analysed using inductive qualitative content analysis. The HCAs' experience with the sit-to-stand activity was represented by the following four categories: Resident participation, Feeling misunderstood and disrespected, Time and workload, and Management involvement. HCAs identified three strategies to help them support residents to complete the sit-to-stand activity: Motivating residents, Completing activity in a group and Using time management skills. HCAs reported some encouragement from managers and cooperation from residents to complete the sit-to-stand activity with residents; however, they also felt constrained by time limitations and workload demands and they felt misunderstood and disrespected. HCAs were able to identify several strategies that helped them to integrate the sit-to-stand activity into their daily routines. This study highlights the challenges and supportive factors of implementing the sit-to-stand activity into the daily work routine of HCAs. The study also identifies the strategic role of nurse managers when implementing interventions in residential care facilities. © 2017 John Wiley & Sons Ltd.

  12. New perspectives on patient expectations of treatment outcomes: results from qualitative interviews with patients seeking complementary and alternative medicine treatments for chronic low back pain.

    Science.gov (United States)

    Hsu, Clarissa; Sherman, Karen J; Eaves, Emery R; Turner, Judith A; Cherkin, Daniel C; Cromp, DeAnn; Schafer, Lisa; Ritenbaugh, Cheryl

    2014-07-30

    Positive patient expectations are often believed to be associated with greater benefits from complementary and alternative medicine (CAM) treatments. However, clinical studies of CAM treatments for chronic pain have not consistently supported this assumption, possibly because of differences in definitions and measures of expectations. The goal of this qualitative paper is to provide new perspectives on the outcome expectations of patients prior to receiving CAM therapies for chronic low back pain. We conducted semi-structured interviews with 64 individuals receiving massage, chiropractic, acupuncture or yoga for chronic low back pain. Interviews were recorded and transcribed. Transcripts were analyzed by a team of experienced qualitative researchers using an immersion/crystallization approach to coding and analysis. Overall, participants' expectations of treatment outcomes tended to cluster in four key domains: pain relief, improved function (including an increase in ability to engage in meaningful activities), improved physical fitness, and improved overall well-being (including mental well-being). Typically, patients had modest expectations for outcomes from treatment. Furthermore, outcome expectations were complex on several levels. First, the concept of expectations overlapped with several related concepts; in particular, hopes. Participants sometimes used expectations and hopes interchangeably and at other times made clear distinctions between these two terms depending on context. A related finding was that participants were cautious about stating that they expected positive outcomes. Finally, participants articulated strong interrelationships among the four key domains and often discussed how changes in one domain might affect other domains. Overall, these findings contribute to a growing body of literature exploring the role of expectations in patient outcomes. This paper provides important guidance that may help refine the way treatment expectations are

  13. End-of-Life Decision Making in Palliative Care and Recommendations of the Council of Europe: Qualitative Secondary Analysis of Interviews and Observation Field Notes.

    Science.gov (United States)

    Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo

    2018-05-01

    End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.

  14. The Roles of Motivation and Coping Behaviours in Managing Stress: Qualitative Interview Study of Hong Kong Expatriate Construction Professionals in Mainland China

    Science.gov (United States)

    Chan, Isabelle Yee Shan; Leung, Mei-yung; Liang, Qi

    2018-01-01

    Driven by fast-growing economies worldwide, the number of international construction projects is booming, and employing expatriates has inevitably become a strategy used by construction firms. However, stress arising from expatriate assignments can lead to early return, assignment failure, and staff turnover, causing in significant losses to an organisation. Extensive research has focused on the effectiveness of coping behaviours in relation to stress. However, studies investigating the antecedents of coping are rare. The limited studies to date tend to focus on content-based motivations (identifying what), instead of on how coping behaviours can be motivated in the stress management process (identifying how). Focus on expatriate construction professionals (ECPs) is further limited. Hence, this study aims to investigate from a process theory perspective the role of motivation in the stress management process. Using a qualitative interview study approach, involving 22 in-depth interviews, this study first identifies the content of motivation, coping behaviours, performance, and stress in the context of Hong Kong ECPs working on cross-cultural projects in China; it then unveils and explains the associations between the identified variables. Based on the results, stakeholders are recommended to review pre-departure training, so as to ensure that key elements such as personal awareness of stress (cognitive, affective, and physical), expectancies of coping strategies on stress (adaptive or maladaptive), and expectancies of the influence of stress on performance are covered. PMID:29558458

  15. The ambiguity of standing in standing devices: a qualitative interview study concerning children and parents experiences of the use of standing devices.

    Science.gov (United States)

    Nordström, Birgitta; Näslund, Annika; Ekenberg, Lilly; Zingmark, Karin

    2014-10-01

    The aim of this study was to describe children's and parents' experiences of the significance of standing in a standing device. Individual interviews were performed with six children/teenagers (aged 7-19 years) and 14 parents. The interviews were transcribed and analyzed using a qualitative content analysis. The analysis resulted in the major theme, the duality of uprightness and the related themes: (1) the instrumental dimension of standing; (2) the social dimension of standing; and (3) the ambivalent dimension of standing. Each of the themes comprised several subthemes. There is an inherent duality re