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Sample records for health perspective qualitative

  1. Clinical Perspective Qualitative adolescent health research — focus ...

    African Journals Online (AJOL)

    This paper introduces nine steps that are recommended in conducting focus group discussions in rural communities and gives an example of how they can appropriately and fruitfully be employed in adolescent health behavioural research. The paper also reviewed issues related to methods of data collection, data analysis, ...

  2. Social Determinants of Health from the Perspective of Women with Thalassemia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Aboo Torab Talebi

    2016-03-01

    Full Text Available Background and Objective: In recent years, social determinants of health have received much attention from researchers in the social sciences. One of the major problems of the health sector in developing countries is the unequal distribution of health which leads to inequalities in social status and living conditions of people. The purpose of this study was to identify and describe the social determinants of health from the perspective of women with the Thalassemia disease.Materials and Methods: This study is a qualitative and thematic analysis. Participants in the study were 24 women with Thalassemia disease. The sampling method was purposeful. To collect qualitative data observation and participation, semi-structured interviews and study of the documents were used. For data analysis, thematic analysis and Wolcott method were used.Results: Social determinants of health from the perspective of women with thalassemia included economic factors (lack of interest-free banking facilities, health expenditure, social factors (inequality in employment, cultural factors (lack of awareness in society and health factors (inefficient health services.Conclusion: If the needs of disadvantaged people, women, and patients in the design and management of the health system be considered, health system performance would be desirable.

  3. Perspectives of Family Members on Using Technology in Youth Mental Health Care: A Qualitative Study.

    Science.gov (United States)

    Lal, Shalini; Daniel, Winnie; Rivard, Lysanne

    2017-06-23

    Information and communication technologies (ICTs) are increasingly recognized as having an important role in the delivery of mental health services for youth. Recent studies have evaluated young people's access and use of technology, as well as their perspectives on using technology to receive mental health information, services, and support; however, limited attention has been given to the perspectives of family members in this regard. The aim of this study was to explore the perspectives of family members on the use of ICTs to deliver mental health services to youth within the context of specialized early intervention for a first-episode psychosis (FEP). Six focus groups were conducted with family members recruited from an early intervention program for psychosis. Twelve family members participated in the study (target sample was 12-18, and recruitment efforts took place over the duration of 1 year). A 12-item semistructured focus group guide was developed to explore past experiences of technology and recommendations for the use of technology in youth mental health service delivery. A qualitative thematic analysis guided the identification and organization of common themes and patterns identified across the dataset. Findings were organized by the following themes: access and use of technology, potential negative impacts of technology on youth in recovery, potential benefits of using technology to deliver mental health services to youth, and recommendations to use technology for (1) providing quality information in a manner that is accessible to individuals of diverse socioeconomic backgrounds, (2) facilitating communication with health care professionals and services, and (3) increasing access to peer support. To our knowledge, this is among the first (or the first) to explore the perspectives of family members of youth being treated for FEP on the use of technology for mental health care. Our results highlight the importance of considering diverse experiences

  4. MENTAL HEALTH: ISLAMIC PERSPECTIVE

    OpenAIRE

    Muzdalifah M. Rahman

    2015-01-01

    The purpose of this paper was to explain the concept of mental health perspective Contemporary Psychology, describes the mental health of an Islamic perspective and describes how mental health recovery. The theory used is the concept of mental health perspective Contemporary Psychology, and the concept of mental health perspective Islamic Psychology Writing is writing method using qualitative research methods. Mental health is avoiding an Islamic perspective of all symptoms, complaints and...

  5. Improving awareness, accountability, and access through health coaching: qualitative study of patients' perspectives.

    Science.gov (United States)

    Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

    2015-03-01

    To assess patients' experiences with and perceptions of health coaching as part of their ongoing care. A qualitative research design using semistructured interviews that were recorded and transcribed verbatim.Setting Ottawa, Ont. Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Patients' perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability,all factors considered to be precursors to behavioural change.

  6. Adolescent Perspectives on Patient-Provider Sexual Health Communication: A Qualitative Study.

    Science.gov (United States)

    Hoopes, Andrea J; Benson, Samantha K; Howard, Heather B; Morrison, Diane M; Ko, Linda K; Shafii, Taraneh

    2017-10-01

    Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews. Interviews explored participants' past experiences with medical providers and their preferences regarding provider characteristics and communication strategies. Interviews revealed that (1) individual patient dynamics and (2) patient-provider interaction dynamics shape the experience during a sexual health visit. Individual patient dynamics included evolving level of maturity, autonomy, and sexual experience. Patient-provider interaction dynamics were shaped by adolescents' perceptions of providers as sources of health information who distribute valued sexual health supplies like contraception and condoms. Participant concerns about provider judgment, power differential, and lack of confidentiality also emerged as important themes. Adolescents demonstrate diverse and evolving needs for sexual health care and interactions with clinicians as they navigate sexual and emotional development.

  7. Community perspectives on the determinants of maternal health in rural southern Mozambique: a qualitative study.

    Science.gov (United States)

    Firoz, Tabassum; Vidler, Marianne; Makanga, Prestige Tatenda; Boene, Helena; Chiaú, Rogério; Sevene, Esperança; Magee, Laura A; von Dadelszen, Peter; Munguambe, Khátia

    2016-09-30

    Mozambique has one of the highest rates of maternal mortality in sub-Saharan Africa. The main influences on maternal health encompass social, economic, political, environmental and cultural determinants of health. To effectively address maternal mortality in the post-2015 agenda, interventions need to consider the determinants of health so that their delivery is not limited to the health sector. The objective of this exploratory qualitative study was to identify key community groups' perspectives on the perceived determinants of maternal health in rural areas of southern Mozambique. Eleven focus group discussions were conducted with women of reproductive age, pregnant women, matrons, male partners, community leaders and health workers. Participants were recruited using sampling techniques of convenience and snow balling. Focus groups had an average of nine participants each. The heads of 12 administrative posts were also interviewed to understand the local context. Data were coded and analysed thematically using NVivo software. A broad range of political, economic, socio-cultural and environmental determinants of maternal health were identified by community representatives. It was perceived that the civil war has resulted in local unemployment and poverty that had a number of downstream effects including lack of funds for accessing medical care and transport, and influence on socio-cultural determinants, particularly gender relations that disadvantaged women. Socio-cultural determinants included intimate partner violence toward women, and strained relationships with in-laws and co-spouses. Social relationships were complex as there were both negative and positive impacts on maternal health. Environmental determinants included natural disasters and poor access to roads and transport exacerbated by the wet season and subsequent flooding. In rural southern Mozambique, community perceptions of the determinants of maternal health included political, economic, socio

  8. 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

  9. Health professionals' perspectives on children's and young people's participation in health care: a qualitative multihospital study.

    Science.gov (United States)

    Schalkers, Inge; Parsons, Cathleen S; Bunders, Joske F G; Dedding, Christine

    2016-04-01

    To investigate healthcare professionals' perspectives on child participation in paediatric hospital care and their opinions on improving participation practices. Some scholars argue that the decision-making capacities of children largely depend on the attitudes of healthcare professionals rather than on the children's own competences. Healthcare professionals' perspectives on children's participation in hospital care remain largely unexplored. Qualitative descriptive design. Healthcare professionals (n = 32) from 10 paediatric wards in the Netherlands participated in semi-structured interviews. Shier's Pathways to Participation model (2001) was used to guide the interviews. Participation is not a term that is frequently used by professionals; however, they feel familiar with the ideas underlying the term, and it is perceived as being at the core of their work. Professionals believe that high levels of participation are possible in basic care for children. Participation in medical decision-making is considered to be more complex and subject to a number of reservations and restrictions. The participants expressed a strong need to enhance child participation in service evaluation and to increase the respect for and understanding of the rights of children to participate outside of the paediatric unit, including in the surgery and emergency departments. Children do not currently participate in the assessment of hospital services. Creative methods that support the role of children in evaluating and improving the quality of paediatric hospital care and services should be developed. Hospital-wide policies could help to promote understanding of child participation among all professionals caring for children in hospitals. Based on international agreements that the Netherlands has ratified, professionals have the duty to facilitate child participation in hospital care. Concrete opportunities and ideas on how to accomplish this goal in practice are provided, and areas for

  10. 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.

  11. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

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    Candida Graham

    2014-01-01

    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  12. Health-Related Quality of Life after Pediatric Liver Transplantation: A Qualitative Analysis of the Perspectives of Health Care Providers

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    Mar Miserachs

    2017-01-01

    Full Text Available With improved survival outcomes after pediatric liver transplantation (LT, health-related quality of life (HRQoL is an important outcome metric. Understanding the elements contributing to HRQoL after LT in children would enable more targeted strategies towards optimizing best outcomes. This qualitative study aimed to explore health care providers (HCP perceptions about HRQoL after pediatric LT. Thirteen experienced HCP participated in two focus group discussions. Data analysis via a thematic analysis approach revealed 4 major themes: “LT as a facilitator of better HRQoL,” “coping and adapting to LT,” “living with a transplanted liver,” and “the family context.” HCP identified elements that both enhance (improved physical health, peer relationship, and activities of daily living and challenge (need for immunosuppression, transplant follow-up, and restrictions the multidimensional domains of HRQoL. HCP perceived LT to be a stressful life-changing event for children and their families. Patients and their parents’ ability to cope and adjust positively to LT was perceived as a key contributor to better HRQoL. HCP perspective highlights the importance of promoting psychosocial support and a family-centered care delivery model towards the overarching goal of optimizing durable outcomes.

  13. Mental health recovery on care farms and day centres: a qualitative comparative study of users' perspectives

    NARCIS (Netherlands)

    Iancu, Sorana C.; Zweekhorst, Marjolein B. M.; Veltman, Dick J.; van Balkom, Anton J. L. M.; Bunders, Joske F. G.

    2014-01-01

    Mental health services increasingly incorporate the vision of recovery. This qualitative study analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model. Data were collected through

  14. Mental health recovery on care farms and day centres: a qualitative comparative study of users perspectives

    NARCIS (Netherlands)

    Iancu, S.C.; Zweekhorst, M.B.M.; Veltman, D.J.; van Balkom, A.J.L.M.; Bunders-Aelen, J.G.F.

    2014-01-01

    Purpose: Mental health services increasingly incorporate the vision of recovery. This qualitative study analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model. Method: Data were

  15. Positive Mental Health from the perspective of Iranian society: A qualitative study [version 2; referees: 2 approved

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    Arash Mirabzadeh

    2018-02-01

    Full Text Available Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual’s positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community.

  16. Positive Mental Health from the perspective of Iranian society: A qualitative study [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Arash Mirabzadeh

    2018-01-01

    Full Text Available Background: According to the World Health Organization, mental health relates, not only to the absence of mental disorder, but also to Positive Mental Health. Studies have shown that promoting positive mental health, not only reduces the prevalence and incidence of mental disorders, but also affects the process of treatment and reduces related burden. However, this concept has different interpretations in different cultures, and in many societies, mental health is still considered the absence of mental illness. Thus, the present study was conducted to provide an in-depth understanding of Iranian adults` perspective towards the concept of positive mental health. Materials and Methods: In the present qualitative study, eight focus group discussions (6 to 8 adults in each session were held consisting of 30 to 60 year-old men and women from Tehran. Data were analyzed in "DeDoose" qualitative software using content analysis. Results: According to the data obtained, participants found no difference between positive mental health and mental health, mostly equating it to the absence of mental disorders and having positive energy, peace in and satisfaction with life. According to the results, positive mental health has four domains of emotional/psychological, spiritual, social, and life skills. Conclusion: Understanding an individual’s positive mental health concepts culturally and providing appropriate community based programs can significantly promote the mental health of the community.

  17. A qualitative study on malnutrition in children from the perspectives of health workers in tumpat, kelantan.

    Science.gov (United States)

    Cheah, Whye Lian; Wan Manan, Wan Muda; Zabidi-Hussin, Za Mh; Chang, Kam Hock

    2007-03-01

    Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry's framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child's needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.

  18. Characteristics of good supervision: a multi-perspective qualitative exploration of the Masters in Public Health dissertation.

    Science.gov (United States)

    Katikireddi, Srinivasa Vittal; Reilly, Jacqueline

    2017-09-01

    A dissertation is often a core component of the Masters in Public Health (MPH) qualification. This study aims to explore its purpose, from the perspective of both students and supervisors, and identify practices viewed as constituting good supervision. A multi-perspective qualitative study drawing on in-depth one-to-one interviews with MPH supervisors (n = 8) and students (n = 10), with data thematically analysed. The MPH dissertation was viewed as providing generic as well as discipline-specific knowledge and skills. It provided an opportunity for in-depth study on a chosen topic but different perspectives were evident as to whether the project should be grounded in public health practice rather than academia. Good supervision practice was thought to require topic knowledge, generic supervision skills (including clear communication of expectations and timely feedback) and adaptation of supervision to meet student needs. Two ideal types of the MPH dissertation process were identified. Supervisor-led projects focus on achieving a clearly defined output based on a supervisor-identified research question and aspire to harmonize research and teaching practice, but often have a narrower focus. Student-led projects may facilitate greater learning opportunities and better develop skills for public health practice but could be at greater risk of course failure. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health.

  19. Spiritual needs in health care settings: a qualitative meta-synthesis of clients' perspectives.

    Science.gov (United States)

    Hodge, David R; Horvath, Violet E

    2011-10-01

    Spiritual needs often emerge in the context of receiving health or behavioral health services. Yet, despite the prevalence and salience of spiritual needs in service provision, clients often report their spiritual needs are inadequately addressed. In light of research suggesting that most social workers have received minimal training in identifying spiritual needs, this study uses a qualitative meta-synthesis (N=11 studies) to identify and describe clients'perceptions of their spiritual needs in health care settings. The results revealed six interrelated themes: (1) meaning, purpose, and hope; (2) relationship with God; (3) spiritual practices; (4) religious obligations; (5) interpersonal connection; and (6) professional staff interactions. The implications of the findings are discussed as they intersect social work practice and education.

  20. Supporting the Health of Low Socioeconomic Status Employees: Qualitative Perspectives from Employees and Large Companies.

    Science.gov (United States)

    Parrish, Amanda T; Hammerback, Kristen; Hannon, Peggy A; Mason, Caitlin; Wilkie, Michelle N; Harris, Jeffrey R

    2018-03-13

    The aim of this study was to identify alignments between wellness offerings low socioeconomic status (SES) employees need and those large companies can provide. Focus groups (employees); telephone interviews (large companies). Employees were low-SES, insured through their employers, and employed by large Washington State companies. Focus groups covered perceived barriers to healthy behaviors at work and potential support from companies. Interviews focused on priorities for employee health and challenges reaching low-SES employees. Seventy-seven employees participated in eight focus groups; 12 companies completed interviews. Employees identified facilitators and barriers to healthier work environments; companies expressed care for employees, concerns about employee obesity, and reluctance to discuss SES. Our findings combine low-SES employee and large company perspectives and indicate three ways workplaces could most effectively support low-SES employee health: create healthier workplace food environments; prioritize onsite physical activity facilities; use clearer health communications.

  1. Evidence-based health information from the users' perspective--a qualitative analysis.

    Science.gov (United States)

    Hirschberg, Irene; Seidel, Gabriele; Strech, Daniel; Bastian, Hilda; Dierks, Marie-Luise

    2013-10-10

    Evidence-based information is a precondition for informed decision-making and participation in health. There are several recommendations and definitions available on the generation and assessment of so called evidence-based health information for patients and consumers (EBHI). They stress the importance of objectively informing people about benefits and harms and any uncertainties in health-related procedures. There are also studies on the comprehensibility, relevance and user-friendliness of these informational materials. But to date there has been little research on the perceptions and cognitive reactions of users or lay people towards EBHI. The aim of our study is to define the spectrum of consumers' reaction patterns to written EBHI in order to gain a deeper understanding of their comprehension and assumptions, as well as their informational needs and expectations. This study is based on an external user evaluation of EBHI produced by the German Institute for Quality and Efficiency in Health Care (IQWiG), commissioned by the IQWiG. The EBHI were examined within guided group discussions, carried out with lay people. The test readers' first impressions and their appraisal of the informational content, presentation, structure, comprehensibility and effect were gathered. Then a qualitative text analysis of 25 discussion transcripts involving 94 test readers was performed. Based on the qualitative text analysis a framework for reaction patterns was developed, comprising eight main categories: (i) interest, (ii) satisfaction, (iii) reassurance and trust, (iv) activation, (v) disinterest, (vi) dissatisfaction and disappointment, (vii) anxiety and worry, (viii) doubt. Many lay people are unfamiliar with core characteristics of this special information type. Two particularly critical issues are the description of insufficient evidence and the attendant absence of clear-cut recommendations. Further research is needed to examine strategies to explain the specific

  2. Recruitment of Refugees for Health Research: A Qualitative Study to Add Refugees' Perspectives.

    Science.gov (United States)

    Gabriel, Patricia; Kaczorowski, Janusz; Berry, Nicole

    2017-01-29

    Research is needed to understand refugees' health challenges and barriers to accessing health services during settlement. However, there are practical and ethical challenges for engaging refugees as participants. Despite this, there have been no studies to date specifically investigating refugee perspectives on factors affecting engagement in health research. Language-concordant focus groups in British Columbia, Canada, with four government-assisted refugee language groups (Farsi/Dari, Somali, Karen, Arabic) inquired about willingness to participate in health research. Twenty-three variables associated with the willingness of refugees to participate in health research were elicited. Variables related to research design included recruitment strategies, characteristics of the research team members and the nature of the research. Variables related to individual participants included demographic features such as gender and education, attitudes towards research and previous experience with research. This research can be used to increase opportunities for refugees' engagement in research and includes recommendations for subgroups of refugees that may have more difficulties engaging in research.

  3. Experiences of being a young male Sami reindeer herder: a qualitative study in perspective of mental health.

    Science.gov (United States)

    Kaiser, Niclas; Ruong, Terje; Renberg, Ellinor Salander

    2013-01-01

    To explore experiences of what it is to be a young male Sami reindeer herder in Sweden, a group with previously known stigma and specific health issues, and to understand experiences in perspective of mental health. A qualitative content analysis was employed. Data were collected by in-depth interviews with 15 strategically selected reindeer herders aged 18-35 years old. The analysis resulted in 5 sub-themes: (a) being "inside" or "outside" is a question of identity; (b) a paradox between being free/bound; (c) an experience of various threats and a feeling of powerlessness; (d) specific norms for how a "real" reindeer herder should be; and (e) the different impacts and meanings of relations. The overarching theme is summarized thus: being a young reindeer herder means so many (impossible) dreams and conditions. Overall, the experience of the informants was that being a reindeer herder is a privileged position that also implies many impossibilities and unjust adversities they have no control over, and that there is nothing they can do but "bite the bullet or be a failure." Knowledge about this group's experiences can be used to understand difficulties faced by young reindeer herders and its consequences regarding mental health problems. This also implies a need for a broader perspective when discussing future interventions aimed at preventing mental health problems in this group.

  4. Experiences of being a young male Sami reindeer herder: a qualitative study in perspective of mental health

    Directory of Open Access Journals (Sweden)

    Niclas Kaiser

    2013-07-01

    Full Text Available Objectives. To explore experiences of what it is to be a young male Sami reindeer herder in Sweden, a group with previously known stigma and specific health issues, and to understand experiences in perspective of mental health. Methods. A qualitative content analysis was employed. Data were collected by in-depth interviews with 15 strategically selected reindeer herders aged 18–35 years old. Results. The analysis resulted in 5 sub-themes: (a being “inside” or “outside” is a question of identity; (b a paradox between being free/bound; (c an experience of various threats and a feeling of powerlessness; (d specific norms for how a “real” reindeer herder should be; and (e the different impacts and meanings of relations. The overarching theme is summarized thus: being a young reindeer herder means so many (impossible dreams and conditions. Overall, the experience of the informants was that being a reindeer herder is a privileged position that also implies many impossibilities and unjust adversities they have no control over, and that there is nothing they can do but “bite the bullet or be a failure.” Conclusions. Knowledge about this group's experiences can be used to understand difficulties faced by young reindeer herders and its consequences regarding mental health problems. This also implies a need for a broader perspective when discussing future interventions aimed at preventing mental health problems in this group.

  5. Qualitative exploration of stakeholders' perspectives of involuntary admission under the Mental Health Act 2001 in Ireland.

    Science.gov (United States)

    Smyth, Siobhán; Casey, Dympna; Cooney, Adeline; Higgins, Agnes; McGuinness, David; Bainbridge, Emma; Keys, Mary; Georgieva, Irina; Brosnan, Liz; Beecher, Claire; Hallahan, Brian; McDonald, Colm; Murphy, Kathy

    2017-12-01

    There is international interest in, and continued concern about, the potential long-term impact of involuntary admission to psychiatric institutions, and the effect this coercive action has on a person's well-being and human rights. Involuntary detention in hospital remains a controversial process that involves stakeholders with competing concerns and who often describe negative experiences of the process, which can have long-lasting effects on the therapeutic relationship with service users. The aim of the present study was to explore the perspectives of key stakeholders involved in the involuntary admission and detention of people under the Mental Health Act 2001 in Ireland. Focus groups were used to collect data. Stakeholders interviewed were service users, relatives, general practitioners, psychiatrists, mental health nurses, solicitors, tribunal members, and police. Data were analysed using a general inductive approach. Three key categories emerged: (i) getting help; (ii) detention under the Act; and (iii) experiences of the tribunal process. This research highlights gaps in information and uncertainty about the involuntary admission process for stakeholders, but particularly for service users who are most affected by inadequate processes and supports. Mental health law has traditionally focussed on narrower areas of detention and treatment, but human rights law requires a greater refocussing on supporting service users to ensure a truly voluntary approach to care. The recent human rights treaty, the UN Convention on the Rights of Persons with Disabilities, is to guarantee a broad range of fundamental rights, such as liberty and integrity, which can be affected by coercive processes of involuntary admission and treatment. © 2016 Australian College of Mental Health Nurses Inc.

  6. Sex-selective abortion in Nepal: a qualitative study of health workers' perspectives.

    Science.gov (United States)

    Lamichhane, Prabhat; Harken, Tabetha; Puri, Mahesh; Darney, Philip D; Blum, Maya; Harper, Cynthia C; Henderson, Jillian T

    2011-01-01

    Sex-selective abortion is expressly prohibited in Nepal, but limited evidence suggests that it occurs nevertheless. Providers' perspectives on sex-selective abortion were examined as part of a larger study on legal abortion in the public sector in Nepal. In-depth interviews were conducted with health care providers and administrators providing abortion services at four major hospitals (n = 35), two in the Kathmandu Valley and two in outlying rural areas. A grounded theory approach was used to code interview transcripts and to identify themes in the data. Most providers were aware of the ban on sex-selective abortion and, despite overall positive views of abortion legalization, saw sex selection as an increasing problem. Greater availability of abortion and ultrasonography, along with the high value placed on sons, were seen as contributing factors. Providers wanted to perform abortions for legal indications, but described challenges identifying sex-selection cases. Providers also believed that illegal sex-selective procedures contribute to serious abortion complications. Sex-selective abortion complicates the provision of legal abortion services. In addition to the difficulty of determining which patients are seeking abortion for sex selection, health workers are aware of the pressures women face to bear sons and know they may seek unsafe services elsewhere when unable to obtain abortions in public hospitals. Legislative, advocacy, and social efforts aimed at promoting gender equality and women's human rights are needed to reduce the cultural and economic pressures for sex-selective abortion, because providers alone cannot prevent the practice. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. Mental health recovery on care farms and day centres: a qualitative comparative study of users' perspectives.

    Science.gov (United States)

    Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

    2014-01-01

    Mental health services increasingly incorporate the vision of recovery. This qualitative study analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model. Data were collected through semi-structured interviews with participants on care farms (n = 14), work (n = 7) and creative projects (n = 5). The transition from past to current lives was described as a progressive, non-linear process, with different stages guided by different goals. Participants on creative projects lacked clear goals, presented less interest in peers and high need for emotional support. Participants on work projects aimed for occupational rehabilitation, but struggled with the patient culture of the peer community. Participants on care farms aimed for daytime occupations and closer contact with society. They experienced care farms as open, real-life work settings where they could exercise responsibility and connect with people. Participants progressed towards recovery, as care farms, work- and creative projects empowered them to leave behind inactive, isolated or disorganized living. In day centres, users focused on self-reflection and personal development (creative projects) or on occupational performance (work projects), whereas on care farms, users fulfilled worker roles in a real-life, open community environment. Organized as open communities in real-life settings, care farms facilitate the reflection on personal and social responsibility, and therefore have the potential to help users internalize worker identities and improve their motivation to progress towards recovery. Supervisors on care farms are regarded by users as close contacts within the social networks they develop on the service, a position that allows supervisors to actively engage and promote users' progress towards recovery. Elements of the farm environment (such as the "normal life", presence of family

  8. Health care administrators' perspectives on the role of absorptive capacity for strategic change initiatives: a qualitative study.

    Science.gov (United States)

    Kash, Bita A; Spaulding, Aaron; Gamm, Larry; Johnson, Christopher E

    2013-01-01

    The dimensions of absorptive capacity (ACAP) are defined, and the importance of ACAP is established in the management literature, but the concept has not been applied to health care organizations attempting to implement multiple strategic initiatives. The aim of this study was to test the utility of ACAP by analyzing health care administrators' experiences with multiple strategic initiatives within two health systems. Results are drawn from administrators' assessments of multiple initiatives within two health systems using in-depth personal interviews with a total of 61 health care administrators. Data analysis was performed following deductive qualitative analysis guidelines. Interview transcripts were coded based on the four dimensions of ACAP: acquiring, assimilating, internalizing/transforming, and exploiting knowledge. Furthermore, we link results related to utilization of management resources, including number of key personnel involved and time consumption, to dimensions of ACAP. Participants' description of multiple strategic change initiatives confirmed the importance of the four ACAP dimensions. ACAP can be a useful framework to assess organizational capacity with respect to the organization's ability to concurrently implement multiple strategic initiatives. This capacity specifically revolves around human capital requirements from upper management based on the initiatives' location or stage within the ACAP framework. Strategic change initiatives in health care can be usefully viewed from an ACAP perspective. There is a tendency for those strategic initiatives ranking higher in priority and time consumption to reflect more advanced dimensions of ACAP (assimilate and transform), whereas few initiatives were identified in the ACAP "exploit" dimension. This may suggest that health care leaders tend to no longer identify as strategic initiatives those innovations that have moved to the exploitation stage or that less attention is given to the exploitation

  9. The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies.

    Science.gov (United States)

    Rajah, Retha; Ahmad Hassali, Mohamed Azmi; Jou, Lim Ching; Murugiah, Muthu Kumar

    2018-03-01

    Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers. CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality. A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients. Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.

  10. Stakeholder perspectives on managing the occupational health of UK business drivers: a qualitative approach.

    Science.gov (United States)

    Sang, Katherine J C; Gyi, Diane E; Haslam, Cheryl O

    2011-03-01

    Musculoskeletal disorders are one of the leading causes of work related ill health and sickness absence. Those who drive as part of their job may be at particular risk, with evidence suggesting that prolonged exposure to driving is associated with increased absence from work due to low back pain. Business drivers often work away from a traditional office environment. Such mobile working may pose greater risks to occupational health due to increased ergonomic risks, for example working from the car, longer working hours and a lack of concern amongst drivers about health and safety. It has been suggested that occupational health practices have not adapted to meet the needs of peripatetic workers. The current study explored how occupational health services are delivered to business drivers. Semi-structured interviews were carried out with a sample of 31 stakeholders in 4 organisations. Respondents included, health and safety professionals, occupational health nurses, fleet managers and high mileage business drivers. The interviews were transcribed and analysed using 'Template Analysis'. The data revealed that, within these organisations, the provision of occupational health services was often fragmented and drivers and other key stakeholders were often unaware of the existing systems within their organisations. The peripatetic nature of business drivers meant that they were difficult for occupational health teams to reach. The paper concludes by presenting recommendations for occupational health professionals and researchers engaged with improving the health of peripatetic workers, namely that occupational health policies should be integrated in company strategy and widely disseminated to drivers and those with responsibility for managing their occupational health provision. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  11. African American fathers’ perspectives on their children’s health education: A qualitative, exploratory study

    Directory of Open Access Journals (Sweden)

    Mary eOdum

    2014-12-01

    Full Text Available Purpose: To investigate African American fathers’ perceptions regarding the applicability and need for their involvement as a health connection for their children and describe how participating fathers’ behavior was affected by their attitudes, knowledge, and perceptions of their influence on their children’s health.Methods: This exploratory study gathered data via semi-structured focus groups (n=3 and thematically analyzed it utilizing a grounded theory approach. Participants included African American fathers (n=20 with a mean age of 37 years (SD 11.79, with at least one child between 6-18 years old.Results: Four major themes were revealed: (1 appropriate health education for participants’ children (should first and foremost be delivered by parents; (2 participants’ paternal health-related guidance approach (reactive, rather than proactive; (3 participants’ perceived influences on health-related communication with their children (gender roles, efficacy constraints; and (4 paternal definitions of health (most often associated with diet.Conclusion: Understanding African American fathers’ perceived and desired role in their children’s health edification can inform initiatives that actively engage these men, and nurture their level of involvement, to promote positive health behaviors among their children; this is necessary to realize their potential to actively improve the health of their children, families, and communities.

  12. African-American Fathers' Perspectives on Their Children's Health Education: A Qualitative, Exploratory Study.

    Science.gov (United States)

    Odum, Mary; Smith, Matthew Lee; McKyer, E Lisako J

    2014-01-01

    To investigate African-American fathers' (AAF) perceptions regarding the applicability and need for their involvement as a health connection for their children and describe how participating fathers' behavior was affected by their attitudes, knowledge, and perceptions of their influence on their children's health. This exploratory study gathered data via semi-structured focus groups (n = 3) and thematically analyzed it utilizing a grounded theory approach. Participants included AAF (n = 20) with a mean age of 37 years (SD 11.79), with at least one child between 6 and 18 years old. Four major themes were revealed: (1) appropriate health education for participants' children (should first and foremost be delivered by parents); (2) participants' paternal health-related guidance approach (reactive, rather than proactive); (3) participants' perceived influences on health-related communication with their children (gender roles, efficacy constraints); and (4) paternal definitions of health (most often associated with diet). Understanding AAFs' perceived and desired role in their children's health edification can inform initiatives that actively engage these men, and nurture their level of involvement, to promote positive health behaviors among their children; this is necessary to realize their potential to actively improve the health of their children, families, and communities.

  13. African-American Fathers’ Perspectives on Their Children’s Health Education: A Qualitative, Exploratory Study

    Science.gov (United States)

    Odum, Mary; Smith, Matthew Lee; McKyer, E. Lisako J.

    2014-01-01

    Purpose: To investigate African-American fathers’ (AAF) perceptions regarding the applicability and need for their involvement as a health connection for their children and describe how participating fathers’ behavior was affected by their attitudes, knowledge, and perceptions of their influence on their children’s health. Methods: This exploratory study gathered data via semi-structured focus groups (n = 3) and thematically analyzed it utilizing a grounded theory approach. Participants included AAF (n = 20) with a mean age of 37 years (SD 11.79), with at least one child between 6 and 18 years old. Results: Four major themes were revealed: (1) appropriate health education for participants’ children (should first and foremost be delivered by parents); (2) participants’ paternal health-related guidance approach (reactive, rather than proactive); (3) participants’ perceived influences on health-related communication with their children (gender roles, efficacy constraints); and (4) paternal definitions of health (most often associated with diet). Conclusion: Understanding AAFs’ perceived and desired role in their children’s health edification can inform initiatives that actively engage these men, and nurture their level of involvement, to promote positive health behaviors among their children; this is necessary to realize their potential to actively improve the health of their children, families, and communities. PMID:25538938

  14. Health professional perspectives on lifestyle behaviour change in the paediatric hospital setting: a qualitative study.

    Science.gov (United States)

    Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole

    2014-03-13

    Research exists examining the challenges of delivering lifestyle behaviour change initiatives in practice. However, at present much of this research has been conducted with primary care health professionals, or in acute adult hospital settings. The purpose of this study was to identify barriers and facilitators associated with implementing routine lifestyle behaviour change brief advice into practice in an acute children's hospital. Thirty-three health professionals (nurses, junior doctors, allied health professionals and clinical support staff) from inpatient and outpatient departments at a UK children's hospital were interviewed about their attitudes and beliefs towards supporting lifestyle behaviour change in hospital patients and their families. Responses were analysed using thematic framework analysis. Health professionals identified a range of barriers and facilitators to supporting lifestyle behaviour change in a children's hospital. These included (1) personal experience of effectiveness, (2) constraints associated with the hospital environment, (3) appropriateness of advice delivery given the patient's condition and care pathway and (4) job role priorities, and (5) perceived benefits of the advice given. Delivery of lifestyle behaviour change advice was often seen as an educational activity, rather than a behaviour change activity. Factors underpinning the successful delivery of routine lifestyle behaviour change support must be understood if this is to be implemented effectively in paediatric acute settings. This study reveals key areas where paediatric health professionals may need further support and training to achieve successful implementation.

  15. 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.

  16. Academic Perspectives and Experiences of Knowledge Translation: A Qualitative Study of Public Health Researchers

    Science.gov (United States)

    Collie, Alex; Zardo, Pauline; McKenzie, Donna Margaret; Ellis, Niki

    2016-01-01

    This study explores the views and experiences of knowledge translation of 14 Australian public health academics. Capacity to engage in knowledge translation is influenced by factors within the academic context and the interaction of the academic and policy environments. Early and mid-career researchers reported a different set of experiences and…

  17. MENTAL HEALTH: ISLAMIC PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Muzdalifah M. Rahman

    2015-02-01

    of mental health, especially mental health needs to be developed with an Islamic perspective various studies and research, especially the development of mental health recovery means Islamic perspective.

  18. Physiotherapy students' perspectives of online e-learning for interdisciplinary management of chronic health conditions: a qualitative study.

    Science.gov (United States)

    Gardner, Peter; Slater, Helen; Jordan, Joanne E; Fary, Robyn E; Chua, Jason; Briggs, Andrew M

    2016-02-16

    To qualitatively explore physiotherapy students' perceptions of online e-learning for chronic disease management using a previously developed, innovative and interactive, evidence-based, e-learning package: Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL). Physiotherapy students participated in three focus groups in Perth, Western Australia. Purposive sampling was employed to ensure maximum heterogeneity across age, gender and educational background. To explore students' perspectives on the advantages and disadvantages of online e-learning, ways to enhance e-learning, and information/learning gaps in relation to interdisciplinary management of chronic health conditions, a semi-structured interview schedule was developed. Verbatim transcripts were analysed using inductive methods within a grounded theory approach to derive key themes. Twenty-three students (78 % female; 39 % with previous tertiary qualification) of mean (SD) age 23 (3.6) years participated. Students expressed a preference for a combination of both online e-learning and lecture-style learning formats for chronic disease management, citing flexibility to work at one's own pace and time, and access to comprehensive information as advantages of e-learning learning. Personal interaction and ability to clarify information immediately were considered advantages of lecture-style formats. Perceived knowledge gaps included practical application of interdisciplinary approaches to chronic disease management and developing and implementing physiotherapy management plans for people with chronic health conditions. Physiotherapy students preferred multi-modal and blended formats for learning about chronic disease management. This study highlights the need for further development of practically-oriented knowledge and skills related to interdisciplinary care for people with chronic conditions among physiotherapy students. While RAP-eL focuses on rheumatoid arthritis, the principles of learning apply to

  19. Experiences of early labour management from perspectives of women, labour companions and health professionals: A systematic review of qualitative evidence.

    Science.gov (United States)

    Beake Rm Ma Research Associate, Sarah; Chang Ba MPhil PhD Lecturer, Yan-Shing; Cheyne Rm Rgn MSc PhD Professor Of Midwifery, Helen; Spiby MPhil Rn Rm Professor Of Midwifery, Helen; Sandall Rm MSc PhD Professor Of Social Science And Women's Health, Jane; Bick, Debra

    2018-02-01

    to examine evidence of women's, labour companions' and health professionals' experiences of management of early labour to consider how this could be enhanced to better reflect women's needs. a systematic review of qualitative evidence. women in early labour with term, low risk singleton pregnancies, not booked for a planned caesarean birth or post-dates induction of labour, their labour companions, and health professionals responsible for early labour care (e.g. midwives, nurse-midwives, obstetricians, family doctors). Studies from high and middle income country settings were considered. 21 publications were included from the UK, Ireland, Scandinavia, USA, Italy and New Zealand. Key findings included the impact of communication with health professionals (most usually midwives) on women's decision making; women wanting to be listened to by sympathetic midwives who could reassure that symptoms and signs of early labour were 'normal' and offer clear advice on what to do. Antenatal preparation which included realistic information on what to expect when labour commenced was important and appreciated by women and labour companions. Views of the optimal place for women to remain and allow early labour to progress differed and the perceived benefit of support and help offered by labour companions varied. Some were supportive and helped women to relax, while others were anxious and encouraged women to seek early admission to the planned place of birth. Web-based sources of information are increasingly used by women, with mixed views of the value of information accessed. women, labour companions and health professionals find early labour difficult to manage well, with women unsure of how decisions about admission to their planned place of birth are taken. It is unclear why women are effectively left to manage this aspect of their labour with minimal guidance or support. Tailoring management to meet individual needs, with provision of effective communication could reassure

  20. Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study

    OpenAIRE

    Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

    2015-01-01

    Objectives \\ud \\ud To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. \\ud \\ud Design\\ud \\ud Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. \\ud \\ud \\ud Setting \\ud \\ud Urban disadvantaged communities in the East Midlands of the UK. \\ud \\ud \\ud Participants \\...

  1. Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam.

    Science.gov (United States)

    Graner, Sophie; Mogren, Ingrid; Duong, Le Q; Krantz, Gunilla; Klingberg-Allvin, Marie

    2010-10-14

    High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their

  2. A qualitative exploration of stakeholder perspectives on a school-based multi-component health promotion nutrition programme.

    Science.gov (United States)

    Middleton, G; Keegan, R; Henderson, H

    2012-12-01

    Food for Fitness is an on-going multi-component health promotion programme, delivered in primary and secondary schools by community nutrition assistants. The programme uses nutritional interventions aimed at promoting healthier eating practices for children. This service evaluation investigated the receipt and delivery of the programme, as perceived by local stakeholders who had experienced and administered the service. Semi-structured interviews and focus groups were carried out with three key stakeholder groups: health professionals (n = 9), school teachers (n = 10) and senior health officials (n = 3). Qualitative data were transcribed verbatim and received thematic analysis with deductive and inductive processes. Stakeholders reported that the programme contributed to the development of food education and healthy-eating practices of children in the local area. Stakeholders considered that the main concern was the limited capacity and size of the service. They described problems with long-term sustainability in supporting schools with maintaining nutritional interventions, highlighting issues regarding contact, planning and organisation of several interventions. The findings of the service evaluation inform service management, organisation and ground-level delivery. The use of stakeholder opinion provided contextualised information on the factors that impact on the implementation of the programme. The richness of the qualitative results can guide future planning and provision for similar health promotion nutrition programmes delivered in the school environment. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  3. Unpredictability dictates quality of maternal and newborn care provision in rural Tanzania-A qualitative study of health workers' perspectives.

    Science.gov (United States)

    Baker, Ulrika; Hassan, Farida; Hanson, Claudia; Manzi, Fatuma; Marchant, Tanya; Swartling Peterson, Stefan; Hylander, Ingrid

    2017-02-06

    Health workers are the key to realising the potential of improved quality of care for mothers and newborns in the weak health systems of Sub Saharan Africa. Their perspectives are fundamental to understand the effectiveness of existing improvement programs and to identify ways to strengthen future initiatives. The objective of this study was therefore to examine health worker perspectives of the conditions for maternal and newborn care provision and their perceptions of what constitutes good quality of care in rural Tanzanian health facilities. In February 2014, we conducted 17 in-depth interviews with different cadres of health workers providing maternal and newborn care in 14 rural health facilities in Tandahimba district, south-eastern Tanzania. These facilities included one district hospital, three health centres and ten dispensaries. Interviews were conducted in Swahili, transcribed verbatim and translated into English. A grounded theory approach was used to guide the analysis, the output of which was one core category, four main categories and several sub-categories. 'It is like rain' was identified as the core category, delineating unpredictability as the common denominator for all aspects of maternal and newborn care provision. It implies that conditions such as mothers' access to and utilisation of health care are unreliable; that availability of resources is uncertain and that health workers have to help and try to balance the situation. Quality of care was perceived to vary as a consequence of these conditions. Health workers stressed the importance of predictability, of 'things going as intended', as a sign of good quality care. Unpredictability emerged as a fundamental condition for maternal and newborn care provision, an important determinant and characteristic of quality in this study. We believe that this finding is also relevant for other areas of care in the same setting and may be an important defining factor of a weak health system. Increasing

  4. Adolescents' Perspectives on Personalized E-Feedback in the Context of Health Risk Behavior Screening for Primary Care: Qualitative Study.

    Science.gov (United States)

    Zieve, Garret G; Richardson, Laura P; Katzman, Katherine; Spielvogle, Heather; Whitehouse, Sandy; McCarty, Carolyn A

    2017-07-20

    Electronic health screening tools for primary care present an opportunity to go beyond data collection to provide education and feedback to adolescents in order to motivate behavior change. However, there is limited research to guide feedback message development. The aim of this study was to explore youth perceptions of and preferences for receiving personalized feedback for multiple health risk behaviors and reinforcement for health promoting behaviors from an electronic health screening tool for primary care settings, using qualitative methodology. In total, 31 adolescents aged 13-18 years completed the screening tool, received the electronic feedback, and subsequently participated in individual, semistructured, qualitative interviews lasting approximately 60 min. Participants were queried about their overall impressions of the tool, perceptions regarding various types of feedback messages, and additional features that would help motivate health behavior change. Using thematic analysis, interview transcripts were coded to identify common themes expressed across participants. Overall, the tool was well-received by participants who perceived it as a way to enhance-but not replace-their interactions with providers. They appreciated receiving nonjudgmental feedback from the tool and responded positively to information regarding the consequences of behaviors, comparisons with peer norms and health guidelines, tips for behavior change, and reinforcement of healthy choices. A small but noteworthy minority of participants dismissed the peer norms as not real or relevant and national guidelines as not valid or reasonable. When prompted for possible adaptations to the tool, adolescents expressed interest in receiving follow-up information, setting health-related goals, tracking their behaviors over time, and communicating with providers electronically between appointments. Adolescents in this qualitative study desired feedback that validates their healthy behavior choices

  5. Patient Perspectives on Online Health Information and Communication With Doctors: A Qualitative Study of Patients 50 Years Old and Over

    Science.gov (United States)

    2015-01-01

    Background As health care systems around the world shift toward models that emphasize self-care management, there is increasing pressure for patients to obtain health information online. It is critical that patients are able to identify potential problems with using the Internet to diagnose and treat a health issue and that they feel comfortable communicating with their doctor about the health information they acquire from the Internet. Objective Our aim was to examine patient-identified (1) problems with using the Internet to identify and treat a health issue, (2) barriers to communication with a doctor about online health information seeking, and (3) facilitators of communication with a doctor about patient searches for health information on the Internet. Methods For this qualitative exploratory study, semistructured interviews were conducted with a sample of 56 adults age 50 years old and over. General concerns regarding use of the Internet to diagnose and treat a health issue were examined separately for participants based on whether they had ever discussed health information obtained through the Internet with a doctor. Discussions about barriers to and facilitators of communication about patient searches for health information on the Internet with a doctor were analyzed using thematic analysis. Results Six higher-level general concerns emerged: (1) limitations in own ability, (2) credibility/limitations of online information, (3) anxiety, (4) time consumption, (5) conflict, and (6) non-physical harm. The most prevalent concern raised by participants who communicated with a doctor about their online health information seeking related to the credibility or limitations in online information. Participants who had never communicated with a doctor about their online health information seeking most commonly reported concerns about non-physical harm. Four barriers to communication emerged: (1) concerns about embarrassment, (2) concerns that the doctor doesn’t want

  6. Patient perspectives on online health information and communication with doctors: a qualitative study of patients 50 years old and over.

    Science.gov (United States)

    Silver, Michelle Pannor

    2015-01-13

    As health care systems around the world shift toward models that emphasize self-care management, there is increasing pressure for patients to obtain health information online. It is critical that patients are able to identify potential problems with using the Internet to diagnose and treat a health issue and that they feel comfortable communicating with their doctor about the health information they acquire from the Internet. Our aim was to examine patient-identified (1) problems with using the Internet to identify and treat a health issue, (2) barriers to communication with a doctor about online health information seeking, and (3) facilitators of communication with a doctor about patient searches for health information on the Internet. For this qualitative exploratory study, semistructured interviews were conducted with a sample of 56 adults age 50 years old and over. General concerns regarding use of the Internet to diagnose and treat a health issue were examined separately for participants based on whether they had ever discussed health information obtained through the Internet with a doctor. Discussions about barriers to and facilitators of communication about patient searches for health information on the Internet with a doctor were analyzed using thematic analysis. Six higher-level general concerns emerged: (1) limitations in own ability, (2) credibility/limitations of online information, (3) anxiety, (4) time consumption, (5) conflict, and (6) non-physical harm. The most prevalent concern raised by participants who communicated with a doctor about their online health information seeking related to the credibility or limitations in online information. Participants who had never communicated with a doctor about their online health information seeking most commonly reported concerns about non-physical harm. Four barriers to communication emerged: (1) concerns about embarrassment, (2) concerns that the doctor doesn't want to hear about it, (3) belief that there

  7. A qualitative exploration of the perspectives of mental health professionals on stigma and discrimination of mental illness in Malaysia.

    Science.gov (United States)

    Hanafiah, Ainul Nadhirah; Van Bortel, Tine

    2015-01-01

    Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and 'stigma'. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public attitudes towards mental illness but little to none from the standpoint of mental health professionals. In Malaysia, this research on stigma is particularly limited. Therefore, the state of stigma and discrimination of people with mental illness was investigated from the perspectives of mental health professionals in Malaysia. In-depth, face-to-face, semi-structured interviews were conducted with 15 mental health professionals from both government and private sectors including psychiatrists, psychologists and counsellors. The interviews were approximately 45-minutes long. The data was subsequently analysed using the basic thematic approach. Seven principal themes, each with their own sub-themes, emerged from the analysis of 'stigma of mental illness' from mental health professionals' point of view, including: (1) main perpetrators, (2) types of mental illness carrying stigma, (3) demography and geography of stigma, (4) manifestations of stigma, (5) impacts of stigma, (6) causes of stigma and (7) proposed initiatives to tackle stigma. Stigma of mental illness is widespread in Malaysia. This is most evident amongst people suffering from conditions such as schizophrenia, bipolar disorder and depression. Stigma manifests itself most often in forms of labelling, rejection, social exclusion and in employment. Family, friends and workplace staff are reported to be the main perpetrators of discriminatory conducts. According to the perspectives of the mental health professionals, implications of

  8. Qualitative Assessment of Challenges in Tuberculosis Control in West Gojjam Zone, Northwest Ethiopia: Health Workers’ and Tuberculosis Control Program Coordinators’ Perspectives

    Directory of Open Access Journals (Sweden)

    Senedu B. Gebreegziabher

    2016-01-01

    Full Text Available Background. Weak health systems pose many barriers to effective tuberculosis (TB control. This study aimed at exploring health worker’s and TB control program coordinator’s perspectives on health systems challenges facing TB control in West Gojjam Zone, Amhara Region, Ethiopia. Methods. This was a qualitative descriptive study. Eight in-depth interviews with TB control program coordinators and two focus group discussions among 16 health workers were conducted. Purposive sampling was used to recruit study participants. Thematic analysis was used to identify and analyse main themes. Results. We found that intermittent interruptions of laboratory reagents and anti-TB drugs supplies, absence of trained and motivated health workers, poor TB data documentation, lack of adherence to TB treatment guideline, and lack of access to TB diagnostic tools at peripheral health institutions were challenges facing the TB control program performance in the study zone. Conclusions. Ensuring uninterrupted supply of anti-TB drugs and laboratory reagents to all health institutions is essential. Continuous refresher training of health workers on standard TB care and data handling and developing and implementing a sound retention strategy to attract and motivate health professionals to work in rural areas are necessary interventions to improve the TB control program performance in the study zone.

  9. Smartphone log data in a qualitative perspective

    DEFF Research Database (Denmark)

    Ørmen, Jacob; Thorhauge, Anne Mette

    2015-01-01

    into studies of smartphones in everyday life. Through an illustrative study, we explore a more nuanced perspective on what can be considered “log data” and how these types of data can be collected and analysed. A qualitative approach to log data analysis offers researchers new opportunities to situate......Log data from smartphones have primarily been used in large-scale research designs to draw statistical inferences from hundreds or even thousands of participants. In this article, we argue that more qualitatively oriented designs can also benefit greatly from integrating these rich data sources...... serve as cues to instigate discussion and reflection as well as act as resources for contextualizing and organizing related empirical material. In the discussion, the advantages of a qualitative perspective for research designs are assessed in relation to issues of validity. Further perspectives...

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

    Science.gov (United States)

    McGraw, Caroline; Abbott, Stephen; Brook, Judy

    2018-02-19

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

  11. [Qualitative research methodology in health care].

    Science.gov (United States)

    Bedregal, Paula; Besoain, Carolina; Reinoso, Alejandro; Zubarew, Tamara

    2017-03-01

    Health care research requires different methodological approaches such as qualitative and quantitative analyzes to understand the phenomena under study. Qualitative research is usually the least considered. Central elements of the qualitative method are that the object of study is constituted by perceptions, emotions and beliefs, non-random sampling by purpose, circular process of knowledge construction, and methodological rigor throughout the research process, from quality design to the consistency of results. The objective of this work is to contribute to the methodological knowledge about qualitative research in health services, based on the implementation of the study, “The transition process from pediatric to adult services: perspectives from adolescents with chronic diseases, caregivers and health professionals”. The information gathered through the qualitative methodology facilitated the understanding of critical points, barriers and facilitators of the transition process of adolescents with chronic diseases, considering the perspective of users and the health team. This study allowed the design of a transition services model from pediatric to adult health services based on the needs of adolescents with chronic diseases, their caregivers and the health team.

  12. Stakeholders' Perspectives on Strategies for the Recruitment and Retention of Primary Health Care Employees in Qatar: A Qualitative Approach.

    Science.gov (United States)

    Alameddine, Mohamad; Yassoub, Rami; Mourad, Yara; Khodr, Hiba

    2017-01-01

    This study explores the recruitment and retention conditions influencing primary health care (PHC) human resources for health (HRH) in Qatar and suggests strategies for their improvement. A qualitative design employing semistructured key informant interviews with PHC stakeholders in Qatar was utilized. Key interviewees were originally recognized, and snowball sampling was used to identify additional interviewees until reaching saturation point. Interview scripts were transcribed and then analyzed thematically using the Nvivo software package. Thematic analysis precipitated a number of themes. Under recruitment, the centrality of enhancing collaboration with academic institutions, enhancing extrinsic benefits, and strengthening human resources recruitment and management practices. Dedicated support needs to be provided to expatriate HRH especially in regard to housing services, children schooling, and streamlining administrative processes for relocation. Findings revealed that job security, continuous professional development, objective performance appraisal systems, enhanced job transparency, and remuneration are key retention concerns. The study provides a number of recommendations for the proper recruitment and retention of HRH. Health planners and decision makers must take these recommendations into consideration to ensure the presence of a competent and sustainable HRH in the PHC sector in the future.

  13. HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study.

    Science.gov (United States)

    Dombrowski, Julia C; Carey, James W; Pitts, Nicole; Craw, Jason; Freeman, Arin; Golden, Matthew R; Bertolli, Jeanne

    2016-06-10

    U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing "Data to Care" programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009-2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV

  14. Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam

    Directory of Open Access Journals (Sweden)

    Krantz Gunilla

    2010-10-01

    Full Text Available Abstract Background High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and

  15. Stakeholder perspectives on workplace health promotion: a qualitative study of midsized employers in low-wage industries.

    Science.gov (United States)

    Hannon, Peggy A; Hammerback, Kristen; Garson, Gayle; Harris, Jeffrey R; Sopher, Carrie J

    2012-01-01

    Study goals were to (1) describe stakeholder perceptions of workplace health promotion (WHP) appropriateness, (2) describe barriers and facilitators to implementing WHP, (3) learn the extent to which WHP programs are offered to workers' spouses and partners and assess attitudes toward including partners in WHP programs, and (4) describe willingness to collaborate with nonprofit agencies to offer WHP. Five 1.5-hour focus groups. The focus groups were conducted with representatives of midsized (100-999 workers) workplaces in the Seattle metropolitan area, Washington state. Thirty-four human resources professionals in charge of WHP programs and policies from five low-wage industries: accommodation/food services, manufacturing, health care/social assistance, education, and retail trade. A semistructured discussion guide. Qualitative analysis of focus group transcripts using grounded theory to identify themes. Most participants viewed WHP as appropriate, but many expressed reservations about intruding in workers' personal lives. Barriers to implementing WHP included cost, time, logistical challenges, and unsupportive culture. Participants saw value in extending WHP programs to workers' partners, but were unsure how to do so. Most were willing to work with nonprofit agencies to offer WHP. Midsized, low-wage employers face significant barriers to implementing WHP; to reach these employers and their workers, nonprofit agencies and WHP vendors need to offer WHP programs that are inexpensive, turnkey, and easy to adapt.

  16. 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

  17. Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: a qualitative study

    Directory of Open Access Journals (Sweden)

    Saw PS

    2015-03-01

    information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs’ reluctance were perceived as barriers to integration. Conclusion: This study provides insights into consumers’ perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed. Keywords: pharmacist integration, private clinic, general practitioners, health care consumer, Malaysia

  18. Perspectives on enhancing international practical training of students in health and social care study programs - A qualitative descriptive case study.

    Science.gov (United States)

    Hvalič-Touzery, Simona; Hopia, Hanna; Sihvonen, Sanna; Diwan, Sadhna; Sen, Soma; Skela-Savič, Brigita

    2017-01-01

    Internationalization of practical training in health and social care study programs is an important aspect of higher education. However, field mentors' and classroom teachers' competence in guiding culturally diverse students varies widely in European countries, and the majority does not have enough training in guiding foreign students. This study aimed to examine which factors enhance the efficacy of international practical placement experiences in health and social care study programs. A qualitative descriptive case study design was used. The study was conducted at six higher education institutions-two in Finland and one in Croatia, Estonia, the Netherlands and Slovenia. A convenience sample of 14 mentors, 15 teachers and 14 students with international experiences from six higher education institutions which are part of the Bologna Process was recruited. The data were collected from six focus groups using a semi-structured questionnaire based on a literature review. Each higher education institution conducted one group interview that was tape-recorded, transcribed and analysed for themes. Participants made several recommendations for enhancing the practical placement experience of students, teachers, and mentors. Most recommendations dealt with practical supervision of students. Three major themes noted were: 'Attitudes towards internationalization of practical placements', 'Factors impacting the international placement experience', and 'Pedagogical methods used and structural support available for internationalization.' The study highlights the need for strengthening the multicultural knowledge and skills of mentors and teachers. The findings provide practical guidelines for improving the international placement experience across health and social care fields. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Represented Speech in Qualitative Health Research

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2017-01-01

    Represented speech refers to speech where we reference somebody. Represented speech is an important phenomenon in everyday conversation, health care communication, and qualitative research. This case will draw first from a case study on physicians’ workplace learning and second from a case study...... on nurses’ apprenticeship learning. The aim of the case is to guide the qualitative researcher to use own and others’ voices in the interview and to be sensitive to represented speech in everyday conversation. Moreover, reported speech matters to health professionals who aim to represent the voice...... of their patients. Qualitative researchers and students might learn to encourage interviewees to elaborate different voices or perspectives. Qualitative researchers working with natural speech might pay attention to how people talk and use represented speech. Finally, represented speech might be relevant...

  20. Stakeholders' perspectives on facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea: a qualitative study.

    Science.gov (United States)

    Chol, Chol; Hunter, Cynthia; Debru, Berhane; Haile, Berhana; Negin, Joel; Cumming, Robert G

    2018-01-19

    Wars affect maternal health services by destroying health systems. Eritrea experienced two wars with neighbouring Ethiopia. Despite this, the maternal mortality ratio (MMR) in Eritrea fell by 69% from 1590 per 100,000 live births in 1990 to 501 in 2015. This study aimed to examine facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea. Using in-depth interviews and field observations for data collection, this qualitative study was conducted in five healthcare facilities in Asmara, the capital of Eritrea, in February and March 2016. The participants were: women (n = 40), husbands (n = 5), healthcare providers (n = 10), and decision makers (n = 5). There were two perceived facilitators of utilisation of and access to maternal health services: health education (related to the WHO health service delivery building blocks) and improvement in gender equality driven by the role played by Eritrean women as combatants during the War of Independence (1961-1991). The only perceived barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and shortage of healthcare workers (related to the WHO health workforce building block). This study assessed women and their husbands/partners' perceptions and the possible effects of contemporary Eritrean culture and the history of war on the utilisation of and access to maternal health services in the country. As well, we examined healthcare providers' and decision makers' perspectives. The two key facilitators of women's utilisation of and access to maternal health services were health education and women's empowerment driven by their role as combatants during the War of Independence. One main barrier was poor quality of care due to lack of ultrasound machines, short clinic opening hours, and a shortage of healthcare workers. As only a limited number of qualitative studies have been published about maternal health services in war

  1. Strategic leadership will be essential for dietitian eHealth readiness: A qualitative study exploring dietitian perspectives of eHealth readiness.

    Science.gov (United States)

    Maunder, Kirsty; Walton, Karen; Williams, Peter; Ferguson, Maree; Beck, Eleanor

    2018-05-16

    To explore dietitians' perspectives on the eHealth readiness of Australian dietitians, and to identify strategies to improve eHealth readiness of the profession. Dietitians who met the criteria for nutrition informatics experts participated in semi-structured interviews between June 2016 and March 2017. The interviews were recorded and transcribed verbatim. Thematic analysis using coding was undertaken until consensus was reached by the researchers regarding key themes, topics and exemplar quotes. Interviews with 10 nutrition informatics experts revealed 25 discussion topics grouped into four main themes: benefits of eHealth for dietitians; risks of dietitians not being involved in eHealth; dietitians are not ready for eHealth; and strategies to improve eHealth readiness. The strategies identified for improving eHealth readiness included: collaboration and representation, education, offering of incentives and mentoring, as well as development of a national strategy, organisational leaders, nutrition informatics champions and a supportive environment. These findings suggest that dietitians may not be ready for eHealth. Strategic leadership and the actioning of other identified strategies will be imperative to preparing dietitians for eHealth to ensure the profession can practice effectively in the digital age, optimise nutrition care and support research for eHealth. If dietitians do not engage in eHealth, others may take their place, or dietitians may be forced to use eHealth in ways that are not the most effective for practice or maximising patient outcomes. © 2018 Dietitians Association of Australia.

  2. Content validation of the international classification of functioning, disability and health core set for stroke from gender perspective using a qualitative approach.

    Science.gov (United States)

    Glässel, A; Coenen, M; Kollerits, B; Cieza, A

    2014-06-01

    The extended ICF Core Set for stroke is an application of the International Classification of Functioning, Disability and Health (ICF) of the World Health Organisation (WHO) with the purpose to represent the typical spectrum of functioning of persons with stroke. The objective of the study is to add evidence to the content validity of the extended ICF Core Set for stroke from persons after stroke taking into account gender perspective. A qualitative study design was conducted by using individual interviews with women and men after stroke in an in- and outpatient rehabilitation setting. The sampling followed the maximum variation strategy. Sample size was determined by saturation. Concepts from qualitative data analysis were linked to ICF categories and compared to the extended ICF Core Set for stroke. Twelve women and 12 men participated in 24 individual interviews. In total, 143 out of 166 ICF categories included in the extended ICF Core Set for stroke were confirmed (women: N.=13; men: N.=17; both genders: N.=113). Thirty-eight additional categories that are not yet included in the extended ICF Core Set for stroke were raised by women and men. This study confirms that the experience of functioning and disability after stroke shows communalities and differences for women and men. The validity of the extended ICF Core Set for stroke could be mostly confirmed, since it does not only include those areas of functioning and disability relevant to both genders but also those exclusively relevant to either women or men. Further research is needed on ICF categories not yet included in the extended ICF Core Set for stroke.

  3. Perspectives on reasons for non-adherence to medication in persons with schizophrenia in Ethiopia: a qualitative study of patients, caregivers and health workers.

    Science.gov (United States)

    Teferra, Solomon; Hanlon, Charlotte; Beyero, Teferra; Jacobsson, Lars; Shibre, Teshome

    2013-06-17

    Levels of non-adherence to antipsychotic medication in persons with schizophrenia in rural African settings have been shown to be comparable to those found in high-income countries. Improved understanding of the underlying reasons will help to inform intervention strategies relevant to the context. A qualitative study was conducted among persons with schizophrenia (n = 24), their caregivers (n = 19), research field workers (n = 7) and health workers (n = 1) involved in the ongoing population-based cohort study, 'The Butajira Study on Course and Outcome of Schizophrenia and Bipolar Disorder', based in rural Ethiopia. Six focus group discussions and 9 in-depth interviews were conducted to elicit perspectives on non-adherence to antipsychotic medication. Thematic analysis was used to identify prominent perspectives. Predominant reasons for non-adherence specific to a low-income country setting included inadequate availability of food to counter appetite stimulation and the perceived strength of antipsychotic medications. The vital role of the family or other social support in the absence of a statutory social safety net was emphasised. Expectations of cure, rather than need for continuing care, were reported to contribute to non-adherence in the longer-term. Many of the factors associated with non-adherence in high-income countries were also considered important in Ethiopia, including lack of insight, failure to improve with treatment, medication side effects, substance abuse, stigma and dissatisfaction with the attitude of the care provider. This study identifies additional barriers to medication adherence faced by persons with schizophrenia in Ethiopia compared to those in high-income countries. In this era of scaling up of mental health care, greater attention to provision of social and financial assistance will potentially improve adherence and thereby enable patients to benefit more fully from medication.

  4. Indigenous perspectives on active living in remote Australia: a qualitative exploration of the socio-cultural link between health, the environment and economics.

    Science.gov (United States)

    Thompson, Sharon L; Chenhall, Richard D; Brimblecombe, Julie K

    2013-05-15

    The burden of chronic disease in Indigenous Australia is more than double that of non-Indigenous populations and even higher in remote Northern Territory (NT) communities. Sufficient levels of physical activity are known to reduce the risk of chronic disease and improve the health of those already suffering from chronic disease. It has been identified that effective promotion of physical activity in Indigenous settings requires the diverse cultural perspectives and participation of Indigenous people. However, Indigenous concepts of physical activity are not represented in the public health literature and examples of Indigenous involvement in physical activity promotion are scarce. This study aimed to explore and describe local perspectives, experiences and meanings of physical activity in two remote NT Indigenous communities. Qualitative research methods guided by ethnographic and participatory action research principles were used. Semi-structured interviews conducted with 23 purposively selected community members were the main source of data, augmented by five commissioned paintings by community-based artists and observations recorded in a journal by the first author. The findings reveal that in this cultural context the meaning of physical activity is embedded in socially significant and economically necessary physical engagement with the environment. Participants described physical activities associated with Indigenous natural and cultural resource management, customary spaces, seasonal timing and traditional education as creating and protecting health. These activities were viewed not only as culturally appropriate physical activities that contribute to health but as legitimate, physically active forms of social organisation, education and employment that help to build and maintain relationships, wealth, resources and the environment. This different construction of physical activity in remote Indigenous communities highlights the importance of involving

  5. Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study.

    Science.gov (United States)

    Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

    2015-02-27

    To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. Urban disadvantaged communities in the East Midlands of the UK. 45 respondents, including 34 people of South Asian origin (16 at-risk individuals, six family groups involving 18 relatives), of mainly Pakistani and Indian origin, including 16 non-English speakers; and 11 health professionals working locally with communities of concern. South Asian participants underlined the challenges of requiring family members across generations to engage in modifying dietary behaviours, and the central role of communal eating of traditional 'Asian' food in their cultural lives. Barriers to increasing physical activity included cost, personal safety and lack of time outside of long working hours and carer commitments. However, increasing walking activity was regarded as feasible by both community and health professional participants. Respondents emphasised using a social approach for potential interventions, undertaking activity with family or friends and with bilingual community peers to facilitate engagement, motivation and support. Spoken content and delivery of interventions was favoured, including personal stories and multilingual audio-visual information; within local informal rather than provider settings, including the home; and aided by pedometers for self-monitoring. Focusing on physical activity by increasing walking may hold promise as health promotion in this deprived South Asian community context. Further intervention development, with exploration of feasibility and acceptability of the social approach and elements suggested, is merited. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  6. Exploring the perspectives of allied health practitioners toward the use of journal clubs as a medium for promoting evidence-based practice: a qualitative study.

    Science.gov (United States)

    Lizarondo, Lucylynn M; Grimmer-Somers, Karen; Kumar, Saravana

    2011-09-23

    Research evidence suggests that journal clubs (JCs) are one approach which can be used to bridge the gap between research and clinical practice. However, there are issues which potentially threaten their viability such as on-going participation or compliance with attendance, which require further exploration. The objectives of this study are: to explore the views and perspectives of allied health practitioners (AHPs) regarding the use of any type of JC in promoting evidence-based practice (EBP); to identify ways in which an innovative model of JC developed by the International Centre for Allied Health Evidence (iCAHE) might be refined. A qualitative descriptive study utilising focus group interviews with various groups of AHP was undertaken-- those who have been exposed to the iCAHE JC model and those who have no experience of the iCAHE model (although they may have had exposure to other forms of JC). Maximum variation sampling was used to recruit participants for the study. Transcripts of focus groups were coded and distilled into content-related categories. Six focus groups with 39 AHPs were facilitated. Allied health practitioners perspectives' on JCs were classified in five broad categories: utility and benefits of a JC, elements of an effective and sustainable JC, barriers to participation, incentives for participation, and opportunities for improvement in the current iCAHE JC model. Overall, JCs were seen as a forum for reflective practice and keeping up-to-date with research evidence, and a venue for learning the processes involved in critical appraisal. Limited knowledge of statistics and heavy clinical workload were reported as barriers to participation in a JC. Strategies such as mentoring, strong support from managers, and providing CPD (continuing professional development) points can potentially address these barriers. Opportunities for refinement of the current iCAHE model were raised. This study suggests that a structured model of JC such as i

  7. School Nurses' perspectives on the role of the school nurse in health education and health promotion in England: a qualitative study.

    Science.gov (United States)

    Hoekstra, Beverley A; Young, Vicki L; Eley, Charlotte V; Hawking, Meredith K D; McNulty, Cliodna A M

    2016-01-01

    The role of the school nurse is complex with many possible elements identified by previous research. The aim of this study is to understand perceptions of the role of the school nurse in order to support school nurses in the delivery of health education. The study used an inductive, qualitative research design involving semi-structured interviews and focus groups. Participants were recruited from four NHS trusts across England and final sample size was thirty one school nurses. Three focus groups and two interviews took place in person, and three interviews were over the phone. Data was thematically analysed. School nurses described six main themes. Four themes directly related to the school nurse role: the main roles of a school nurse, school nurses' role in health education, prioritisation of workload and activities, and community work. A further two other themes related to the delivery of health education: the school nursing system and educational resources. The role of the school nurse in England is very diverse and the school nurse role in health education is primarily to advise and support schools, rather than to directly deliver education. The study identified that tailored public health educational resources are needed to support school nurses.

  8. Employing a Qualitative Description Approach in Health Care Research

    Science.gov (United States)

    Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

    2017-01-01

    A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage. PMID:29204457

  9. Employing a Qualitative Description Approach in Health Care Research.

    Science.gov (United States)

    Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

    2017-01-01

    A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage.

  10. Qualitative research and dental public health

    Directory of Open Access Journals (Sweden)

    Roslind Preethi George

    2012-01-01

    Full Text Available The use of Qualitative Research (QR methods are now getting common in various aspects of health and healthcare research and they can be used to interpret, explore, or obtain a deeper understanding of certain aspects of human beliefs, attitudes, or behavior through personal experiences and perspectives. The potential scope of QR in the field of dental public health is immense, but unfortunately, it has remained underutilized. However, there are a number of studies which have used this type of research to probe into some unanswered questions in the field of public health dentistry ranging from workforce issues to attitudes of patients. In recent health research, evidence gathered through QR methods provide understanding to the social, cultural, and economic factors affecting the health status and healthcare of an individual and the population as a whole. This study will provide an overview of what QR is and discuss its contributions to dental public health research.

  11. Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

    Directory of Open Access Journals (Sweden)

    Rhonda C. Boyd

    2011-01-01

    Full Text Available Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1 screening and referral, (2 facilitators to referral, (3 barriers to referral, (4 culture and language, (5 life events, and (6 support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

  12. Family members and health professionals' perspectives on future life planning of ageing people with Down syndrome: a qualitative study.

    Science.gov (United States)

    Covelli, Venusia; Raggi, Alberto; Paganelli, Chiara; Leonardi, Matilde

    2017-08-08

    To address the way in which primary caregivers of people over 45 with Down syndrome describe daily life activities and context and foresee their future. Thirteen family members and 15 health professionals participated to four focus groups. Meaningful concepts were identified and linked to the International Classification of Functioning, Disability and Health using established linking rules. A total of 258 relevant concepts were identified and linked to 75 categories of the classification: 38 were from activity and participation and 17 from environmental factors domains. The most commonly reported issues were mental functions (b117-intellectual functions and b152-emotional functions), community life activities (d910-community life and d920-recreation and leisure) and environmental factors (e310-support of immediate family, e355-support from health professionals and e555-associations and organizational services). Information on the daily life and health of ageing people with Down syndrome is important to plan social and health care interventions tailored to deal with problems that they may encounter in older age. Considering the interaction between health and environment and maintaining a continuity of daily routines were reported as the most relevant topics for managing daily lives of persons with Down syndrome in older ages. Implications for rehabilitation Pay more attention to the interaction between environmental factors and health condition in ageing people with Down syndrome. Information about the life contest are important in order to plan present and future social-health care interventions. Future planning for people with Down syndrome is a great concern for family members.

  13. Qualitative Methods in Mental Health Services Research

    Science.gov (United States)

    Palinkas, Lawrence A.

    2014-01-01

    Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research. PMID:25350675

  14. Employees' Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study.

    Science.gov (United States)

    Carolan, Stephany; de Visser, Richard O

    2018-01-19

    Prevalence rates of work-related stress, depression, and anxiety are high, resulting in reduced productivity and increased absenteeism. There is evidence that these conditions can be successfully treated in the workplace, but take-up of psychological treatments among workers is low. Digital mental health interventions delivered in the workplace may be one way to address this imbalance, but although there is evidence that digital mental health is effective at treating stress, depression, and anxiety in the workplace, uptake of and engagement with these interventions remains a concern. Additionally, there is little research on the appropriateness of the workplace for delivering these interventions or on what the facilitators and barriers to engagement with digital mental health interventions in an occupational setting might be. The aim of this research was to get a better understanding of the facilitators and barriers to engaging with digital mental health interventions in the workplace. Semistructured interviews were held with 18 participants who had access to an occupational digital mental health intervention as part of a randomized controlled trial. The interviews were transcribed, and thematic analysis was used to develop an understanding of the data. Digital mental health interventions were described by interviewees as convenient, flexible, and anonymous; these attributes were seen as being both facilitators and barriers to engagement in a workplace setting. Convenience and flexibility could increase the opportunities to engage with digital mental health, but in a workplace setting they could also result in difficulty in prioritizing time and ensuring a temporal and spatial separation between work and therapy. The anonymity of the Internet could encourage use, but that benefit may be lost for people who work in open-plan offices. Other facilitators to engagement included interactive and interesting content and design features such as progress trackers and

  15. Qualitative description of dental hygiene practices within oral health and dental care perspectives of Mexican-American adults and teenagers.

    Science.gov (United States)

    Maupome, Gerardo; Aguirre-Zero, Odette; Westerhold, Chi

    2015-01-01

    The objectives of this study were to identify dental hygiene themes voiced by adults and teenagers of Mexican origin [or Mexican Americans (MAs)] and place these themes within the larger landscape of oral health and dental care perceptions. Interviews with urban-based MAs were analyzed to identify barriers, beliefs, and behaviors influencing engagement in dental hygiene practices. Adult (n = 16, ages 33-52) and teenage (n = 17, ages 14-19) MAs reported themes pertaining to structural factors (financial and economic-related barriers, the dual challenges of reduced access to care vis-à-vis successfully navigating the dental care system, and the effects of reduced social support derived from migration) and to individual factors (different agendas between MAs and health systems for dental care utilization and indications for oral self-care, including limited dental hygiene instruction from professionals and larger impacts from school-based and mass media). Also, prior experiences with dental hygiene, prevention, and associated themes were characterized by a range of attitudes from fatalistic to highly determined agency. Good family upbringing was instrumental for appropriate dental hygiene, anteceding good oral health; and outlining a loose structure of factors affecting oral health such as diet, having "weak" teeth, or personal habits. Themes from adults and teenagers in the Midwest United States were generally similar to other groups of MA parents and younger children. Dental hygiene was not salient relative to other oral health and dental care matters. Several opportunities for improvement of knowledge and enhancing motivation for dental hygiene practices were identified, both within and outside professional resources. © 2014 American Association of Public Health Dentistry.

  16. Paraprofessional Home Visitors' Perspectives on Addressing Poor Mental Health, Substance Abuse, and Domestic Violence: A Qualitative Study

    Science.gov (United States)

    Tandon, S. Darius; Mercer, Constance D.; Saylor, Elizabeth L.; Duggan, Anne K.

    2008-01-01

    This research was conducted to understand paraprofessional home visitors' perceptions of their training in addressing poor mental health, substance abuse, and domestic violence, and their actions in working with families in addressing these issues. Five focus groups were conducted with a total of 28 paraprofessional home visitors. Three main…

  17. Digital Health Interventions for Adults With Type 2 Diabetes: Qualitative Study of Patient Perspectives on Diabetes Self-Management Education and Support.

    Science.gov (United States)

    Pal, Kingshuk; Dack, Charlotte; Ross, Jamie; Michie, Susan; May, Carl; Stevenson, Fiona; Farmer, Andrew; Yardley, Lucy; Barnard, Maria; Murray, Elizabeth

    2018-01-29

    The prevalence of type 2 diabetes is increasing globally, and health services in many countries are struggling with the morbidity, mortality, and costs associated with the complications of this long-term condition. Diabetes self-management education (DSME) and behavioral support can reduce the risks of developing diabetes-related complications and improve glycemic control. However, their uptake is low. Digital health interventions (DHI) can provide sustained support and may overcome challenges associated with attending diabetes self-management sessions. They have the potential for delivery at multiple locations at convenient times, anonymity, and presentation of content in attractive and tailored formats. This study investigates the needs and wants of patients with type 2 diabetes to inform the development of digital self-management education and support. The objective of this study was to explore patient perspectives on unmet needs for self-management and support and the role of DHI in adults living with type 2 diabetes. This study used a qualitative approach based on data generated from 4 focus groups with 20 patients. The data generated by the focus groups illustrated the significant burden that the diagnosis of diabetes places on many patients and the negative impacts on their emotional well-being, work, social life, and physical health. Although patients' experiences of the health care services varied, there was agreement that even the best services were unable to meet all users' needs to support the emotional regulation, psychological adjustment, and behavioral changes needed for successful self-management. By focusing on medical management and information provision, existing health care services and education programs may not be adequately meeting all the needs of patients with type 2 diabetes. DHIs have the potential to improve access to DSME and behavioral support and extend the range of content offered by health services to fit with a wider range of

  18. A qualitative exploration of the perspectives of mental health professionals on stigma and discrimination of mental illness in Malaysia

    OpenAIRE

    Hanafiah, Ainul Nadhirah; Van Bortel, Tine

    2015-01-01

    Background Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and ?stigma?. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public a...

  19. Meaning and barriers to quality care service provision in Child and Adolescent Mental Health Services: Qualitative study of stakeholder perspectives.

    Science.gov (United States)

    Svirydzenka, Nadzeya; Ronzoni, Pablo; Dogra, Nisha

    2017-02-20

    Defining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders" understanding of the meaning of quality in the context of CAMHS. The study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24). Semi-structured interviews were used to collect data and thematic analysis was applied to explore participant's views on the meaning and measurement of quality and how these might reflect the IOM indicators and their relevance in CAMHS. An initial barrier to implementing quality care in CAMHS was the difficulty and limited agreement in defining the meaning of quality care, its measurement and implementation for all participants. Clinical staff defined quality as personal values, a set of practical rules, or clinical discharge rates; while patients suggested being more involved in the decision-making process. Commissioners, while supportive of adequate safeguarding and patient satisfaction procedures, did not explicitly link their view on quality to commissioning guidelines. Identifying practical barriers to implementing quality care was easier for all interviewees and common themes included: lack of meaningful measures, recourses, accountability, and training. All interviewees considered the IOM six markers as comprehensive and relevant to CAMHS. No respondent individually or within one stakeholder group identified more than a few of the indicators or barriers of a quality CAMHS service. However, the composite responses of the respondents enable us to develop a more complete picture of how to improve quality care in practice and guide future research in the area.

  20. Women's perspectives on the ethical implications of non-invasive prenatal testing: a qualitative analysis to inform health policy decisions.

    Science.gov (United States)

    Vanstone, Meredith; Cernat, Alexandra; Nisker, Jeff; Schwartz, Lisa

    2018-04-16

    Non-Invasive Prenatal Testing (NIPT) is a technology which provides information about fetal genetic characteristics (including sex) very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women's social and ethical values. We approach the need for ethical policy-making by studying the use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area.

  1. Patient Perspectives on Sharing Anonymized Personal Health Data Using a Digital System for Dynamic Consent and Research Feedback: A Qualitative Study

    Science.gov (United States)

    Whitley, Edgar A; Lund, David; Kaye, Jane

    2016-01-01

    Background Electronic health records are widely acknowledged to provide an important opportunity to anonymize patient-level health care data and collate across populations to support research. Nonetheless, in the wake of public and policy concerns about security and inappropriate use of data, conventional approaches toward data governance may no longer be sufficient to respect and protect individual privacy. One proposed solution to improve transparency and public trust is known as Dynamic Consent, which uses information technology to facilitate a more explicit and accessible opportunity to opt out. In this case, patients can tailor preferences about whom they share their data with and can change their preferences reliably at any time. Furthermore, electronic systems provide opportunities for informing patients about data recipients and the results of research to which their data have contributed. Objective To explore patient perspectives on the use of anonymized health care data for research purposes. To evaluate patient perceptions of a Dynamic Consent model and electronic system to enable and implement ongoing communication and collaboration between patients and researchers. Methods A total of 26 qualitative interviews and three focus groups were conducted that included a video presentation explaining the reuse of anonymized electronic patient records for research. Slides and tablet devices were used to introduce the Dynamic Consent system for discussion. A total of 35 patients with chronic rheumatic disease with varying levels of illness and social deprivation were recruited from a rheumatology outpatient clinic; 5 participants were recruited from a patient and public involvement health research network. Results Patients were supportive of sharing their anonymized electronic patient record for research, but noted a lack of transparency and awareness around the use of data, making it difficult to secure public trust. While there were general concerns about

  2. Patient Perspectives on Sharing Anonymized Personal Health Data Using a Digital System for Dynamic Consent and Research Feedback: A Qualitative Study.

    Science.gov (United States)

    Spencer, Karen; Sanders, Caroline; Whitley, Edgar A; Lund, David; Kaye, Jane; Dixon, William Gregory

    2016-04-15

    Electronic health records are widely acknowledged to provide an important opportunity to anonymize patient-level health care data and collate across populations to support research. Nonetheless, in the wake of public and policy concerns about security and inappropriate use of data, conventional approaches toward data governance may no longer be sufficient to respect and protect individual privacy. One proposed solution to improve transparency and public trust is known as Dynamic Consent, which uses information technology to facilitate a more explicit and accessible opportunity to opt out. In this case, patients can tailor preferences about whom they share their data with and can change their preferences reliably at any time. Furthermore, electronic systems provide opportunities for informing patients about data recipients and the results of research to which their data have contributed. To explore patient perspectives on the use of anonymized health care data for research purposes. To evaluate patient perceptions of a Dynamic Consent model and electronic system to enable and implement ongoing communication and collaboration between patients and researchers. A total of 26 qualitative interviews and three focus groups were conducted that included a video presentation explaining the reuse of anonymized electronic patient records for research. Slides and tablet devices were used to introduce the Dynamic Consent system for discussion. A total of 35 patients with chronic rheumatic disease with varying levels of illness and social deprivation were recruited from a rheumatology outpatient clinic; 5 participants were recruited from a patient and public involvement health research network. Patients were supportive of sharing their anonymized electronic patient record for research, but noted a lack of transparency and awareness around the use of data, making it difficult to secure public trust. While there were general concerns about detrimental consequences of data falling

  3. Forest health from different perspectives

    Science.gov (United States)

    T. E. Kolb; M. R. Wagner; W. W. Covington

    1995-01-01

    Forest health is an increasingly important concept in natural resource management. However, definition of forest health is difficult and dependent on human perspective. From a utilitarian perspective, forest health has been defined by the production of forest conditions which directly satisfy human needs. From an ecosystem-centered perspective, forest health has been...

  4. Influence of qualitative research on women's health screening guidelines.

    Science.gov (United States)

    Abadir, Anna Maria; Lang, Ariella; Klein, Talia; Abenhaim, Haim Arie

    2014-01-01

    Considerable time and resources are allocated to carry out qualitative research. The purpose of our study was to evaluate the availability of qualitative research on women's health screening and assess its influence on screening practice guidelines in the United States, Canada, and the United Kingdom. Medline, CINHAL, and WEB of Science databases were used to identify the availability of qualitative research conducted in the past 15 years on 3 different women's health screening topics: cervical cancer screening, breast cancer screening, and prenatal first-trimester screening. Key national practice guidelines on women's health screening were selected using the National Guideline Clearinghouse web site. Bibliometric analysis was used to determine the frequency of qualitative references cited in the guidelines. A total of 272 qualitative research papers on women's health screening was identified: 109 on cervical cancer screening, 104 on breast cancer screening, and 59 on prenatal first-trimester screening. The qualitative studies focused on health care provider perspectives as well as ethical, ethnographic, psychological, and social issues surrounding screening. Fifteen national clinical practice guidelines on women's health screening were identified. A total of 943 references was cited, only 2 of which comprised of qualitative research cited by only 1 clinical practice guideline. Although there is considerable qualitative research that has been carried out on women's health screening, its incorporation into clinical practice guidelines is minimal. Further exploration of the disconnect between the two is important for enhancing knowledge translation of qualitative research within clinical practice. Copyright © 2014 Mosby, Inc. All rights reserved.

  5. Health care professionals' perspectives on the requirements ...

    African Journals Online (AJOL)

    Wilma ten Ham

    Purpose: of the research: To explore and describe the perspectives of health .... promoting skin-to-skin contact, and exclusive breastfeeding .... ducted telephonically except for one face-to-face interview. ... tape recorded and field notes were kept of each interview. ... Data were analysed using qualitative content analysis.

  6. Perspectives on reasons for non-adherence to medication in persons with schizophrenia in Ethiopia: a qualitative study of patients, caregivers and health workers

    OpenAIRE

    Teferra, Solomon; Hanlon, Charlotte; Beyero, Teferra; Jacobsson, Lars; Shibre, Teshome

    2013-01-01

    Background: Levels of non-adherence to antipsychotic medication in persons with schizophrenia in rural African settings have been shown to be comparable to those found in high-income countries. Improved understanding of the underlying reasons will help to inform intervention strategies relevant to the context. Methods: A qualitative study was conducted among persons with schizophrenia (n = 24), their caregivers (n = 19), research field workers (n = 7) and health workers (n = 1) involved in th...

  7. Perspectives on reflexology: A qualitative approach.

    Science.gov (United States)

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2017-07-01

    Reflexology is the systematic practice of applying some pressure to particular points on the feet and hands to impact on health of related parts of the body. To explore the practitioners' perspectives of reflexology in Malaysia. Data was collected using face-to-face semi-structured interviews with practitioners in Malaysia. The interviews were conducted in the Malay language and recorded. Interview conversations were translated and transcribed verbatim. Responses relating to different themes were identified in each of the interviews and a coding frame was developed. For each theme, the relevant data enabled a description of the range of views and experiences. Data collection and analysis were conducted concurrently and recruitment was stopped when saturation had been reached. All respondents gave written consent for their participation. The findings show that reflexology treatment nowadays has been accepted as one of the ways to maintain general health. Practitioners believe that reflexology is able to detect some problems in to the body, which can make patients aware of a health condition and seek further treatment. However, if reflexology is not performed correctly, it may cause negative effects such as pain and bruises. Some practitioners voiced concern that illegal activities are taking place in unethical reflexology centers. Empowering the practitioner as a professional would help gain the public's trust and confidence in their treatment. Strict enforcement of regulation related to illegal conduct in reflexology centers will improve people's perception of the practice.

  8. Perspectives on health.

    Science.gov (United States)

    Huch, M H

    1991-01-01

    On May 12, 1989, in Pittsburgh, six nurse leaders participated in a panel discussion on health at Discovery International, Inc.'s Nurse Theorist Conference. The participants were Imogene King, Nola Pender, Betty Neuman, Martha E. Rogers, Afaf Meleis and Rosemarie Rizzo Parse. The goal of the conferences was to present views on the meaning of health from different perspectives. The panel discussion provided the nurse leaders with an opportunity to engage in a dialogue about health. Five of the participants answered the questions posed and the conference keynote speaker Afaf Meleis responded. Four questions were posed to the panel relating to the meaning of health, the uniqueness of nursing, and nurse-person relationships. The dialogue of the panel discussion follows.

  9. The other 23 hours: a qualitative study of fitness provider perspectives on social support for health promotion for adults with mental illness.

    Science.gov (United States)

    Aschbrenner, Kelly; Mueser, Kim; Bartels, Stephen; Carpenter-Song, Elizabeth; Pratt, Sarah; Barre, Laura; Naslund, John; Kinney, Allison

    2015-05-01

    Current efforts to reduce the increased risk of premature death from preventable cardiovascular disease among adults with serious mental illness (SMI) through lifestyle change have had limited success. Engaging informal support systems to promote healthy behaviors in everyday life may increase the effectiveness of health promotion interventions targeting this at-risk population. In-depth semistructured interviews were conducted with 10 fitness trainers serving adults with SMI in a health promotion program at community mental health centers to explore their perspectives on the potential of enlisting support from significant others for health behavior change. Trainers reported that the majority of participants had a relative or significant other who influenced their health behaviors, and they saw potential value in involving them in efforts to improve health outcomes by extending support into participants' daily lives. They did not feel qualified to work with families of individuals with mental illness, but they were willing to partner with providers who had experience in this area. Social workers who practice with families could play a critical role on health promotion teams addressing cardiovascular risk in adults with SMI by using their skills and experiences to engage families in supporting a relative through the process of health behavior change.

  10. Qualitative and mixed methods in public health

    National Research Council Canada - National Science Library

    Padgett, Deborah

    2012-01-01

    "This text has a large emphasis on mixed methods, examples relating to health research, new exercises pertaining to health research, and an introduction on qualitative and mixed methods in public health...

  11. Moving Beyond a Deficit Perspective with Qualitative Research Methods.

    Science.gov (United States)

    Anzul, Margaret; Evans, Judith F.; King, Rita; Tellier-Robinson, Dora

    2001-01-01

    Four researchers argue the merits of qualitative methodology and its particular relevance to those in special education who seek to move beyond a deficit perspective. Unconstrained by defined variables and decontextualized settings, qualitative methods allowed the researchers to extend the scope of their studies beyond originally stated research…

  12. Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives.

    Science.gov (United States)

    DiGiacomo, Michelle; Green, Anna; Rodrigues, Emma; Mulligan, Kathryn; Davidson, Patricia M

    2015-11-21

    Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.

  13. Stigma, HIV and health: a qualitative synthesis

    OpenAIRE

    Chambers, Lori A.; Rueda, Sergio; Baker, D. Nico; Wilson, Michael G.; Deutsch, Rachel; Raeifar, Elmira; Rourke, Sean B.; Team, The Stigma Review

    2015-01-01

    Background HIV-related stigma continues to negatively impact the health and well-being of people living with HIV, with deleterious effects on their care, treatment and quality of life. A growing body of qualitative research has documented the relationship between HIV-related stigma and health. This review aims to synthesize qualitative evidence that explored the intersections of stigma and health for people with HIV. Methods A thematic summary was conducted that was guided by the qualitative ...

  14. Experiences and barriers to Health-Related Quality of Life following liver transplantation: a qualitative analysis of the perspectives of pediatric patients and their parents

    Directory of Open Access Journals (Sweden)

    Taylor Rachel

    2010-12-01

    Full Text Available Abstract This paper examines health-related quality of life (HRQOL experiences and barriers facing young people who have received a liver transplant (LT. Semi-structured qualitative interviews were conducted with children and adolescents who have undergone LT and their parents. Findings indicate that LT fosters substantially improved child and adolescent HRQOL; however, young people also experience challenges such as difficulties with medication compliance, self-management of care routines, physical activity restrictions, and undesirable medical procedures. Implications and recommendations for clinical practice and research are discussed.

  15. Challenges in conducting qualitative research in health: A conceptual paper

    Science.gov (United States)

    Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

    2015-01-01

    Background: Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. Materials and Methods: This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. Results: One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. Conclusions: The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others. PMID:26793245

  16. [Requirements for and expectations of health technology assessment in Galicia (Spain). A qualitative study from the perspective of decision-makers and clinicians].

    Science.gov (United States)

    Varela-Lema, Leonor; Merino, Gerardo Atienza; García, Marisa López; Martínez, María Vidal; Triana, Elena Gervas; Mota, Teresa Cerdá

    2011-01-01

    To explore perceptions of the use of health technology assessment (HTA) in the Galician public health system, identify opinions on the usefulness of the products and services developed by the Galician Health Technology Assessment Agency (avalia-t), and determine the barriers and facilitators to the transfer of results to clinical practice. We performed a qualitative study based on in-depth semi-structured interviews of 20 intentionally selected experts (10 health care professionals and 10 hospital decision makers). The interviews were tape recorded and transcribed for inductive thematic analysis. Interest in HTA activities was high, but most informants considered these activities to be underused as a tool to aid decision making in clinical practice. A series of key factors was identified to guarantee HTA use: greater dissemination of HTA activities and availability of the results, increased involvement and communication among health care professionals in the selection and prioritization of relevant research, contextualization and adaptation of results to the local context, increased organizational support and greater financial resources. The present study allows end-userś opinions on the utility of the various products/services offered by HTA agencies to be contrasted in order to adapt HTA activity to their needs and requirements. The involvement of health care professionals in all HTA fields is perceived as one of the main lines of action for HTA agencies. Such involvement could be achieved by reinforcing personal contact and increasing feedback to collaborators. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Understanding Qualitative Research: A School Nurse Perspective

    Science.gov (United States)

    Broussard, Lisa

    2006-01-01

    More school nurses are engaging in the generation of research, and their studies increasingly are using qualitative methods to describe various areas of practice. This article provides an overview of 4 major qualitative methods: ethnography, phenomenology, grounded theory, and historical research. Examples of school nursing research studies that…

  18. Can smartphones and tablets improve the management of childhood illness in Tanzania? A qualitative study from a primary health care worker's perspective.

    Science.gov (United States)

    Shao, Amani Flexson; Rambaud-Althaus, Clotilde; Swai, Ndeniria; Kahama-Maro, Judith; Genton, Blaise; D'Acremont, Valerie; Pfeiffer, Constanze

    2015-04-02

    The impact of the Integrated Management of Childhood Illness (IMCI) strategy has been less than anticipated because of poor uptake. Electronic algorithms have the potential to improve quality of health care in children. However, feasibility studies about the use of electronic protocols on mobile devices over time are limited. This study investigated constraining as well as facilitating factors that influence the uptake of a new electronic Algorithm for Management of Childhood Illness (ALMANACH) among primary health workers in Dar es Salaam, Tanzania. A qualitative approach was applied using in-depth interviews and focus group discussions with altogether 40 primary health care workers from 6 public primary health facilities in the three municipalities of Dar es Salaam, Tanzania. Health worker's perceptions related to factors facilitating or constraining the uptake of the electronic ALMANACH were identified. In general, the ALMANACH was assessed positively. The majority of the respondents felt comfortable to use the devices and stated that patient's trust was not affected. Most health workers said that the ALMANACH simplified their work, reduced antibiotic prescription and gave correct classification and treatment for common causes of childhood illnesses. Few HWs reported technical challenges using the devices and complained about having had difficulties in typing. Majority of the respondents stated that the devices increased the consultation duration compared to routine practice. In addition, health system barriers such as lack of staff, lack of medicine and lack of financial motivation were identified as key reasons for the low uptake of the devices. The ALMANACH built on electronic devices was perceived to be a powerful and useful tool. However, health system challenges influenced the uptake of the devices in the selected health facilities.

  19. Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors.

    Directory of Open Access Journals (Sweden)

    Fung Kuen Koo

    Full Text Available This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1 participants' attitudes towards NSPs, (2 participants' opinions on the effectiveness and barriers of NSPs, and (3 suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division. Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34 regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24 questioned the legitimacy of NSPs and concerned about the poor management of drug users' risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users' addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation.

  20. Reporting Qualitative Research: Standards, Challenges, and Implications for Health Design.

    Science.gov (United States)

    Peditto, Kathryn

    2018-04-01

    This Methods column describes the existing reporting standards for qualitative research, their application to health design research, and the challenges to implementation. Intended for both researchers and practitioners, this article provides multiple perspectives on both reporting and evaluating high-quality qualitative research. Two popular reporting standards exist for reporting qualitative research-the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Though compiled using similar procedures, they differ in their criteria and the methods to which they apply. Creating and applying reporting criteria is inherently difficult due to the undefined and fluctuating nature of qualitative research when compared to quantitative studies. Qualitative research is expansive and occasionally controversial, spanning many different methods of inquiry and epistemological approaches. A "one-size-fits-all" standard for reporting qualitative research can be restrictive, but COREQ and SRQR both serve as valuable tools for developing responsible qualitative research proposals, effectively communicating research decisions, and evaluating submissions. Ultimately, tailoring a set of standards specific to health design research and its frequently used methods would ensure quality research and aid reviewers in their evaluations.

  1. A philosophical analysis of the general methodology of qualitative research: a critical rationalist perspective.

    Science.gov (United States)

    Rudnick, Abraham

    2014-09-01

    Philosophical discussion of the general methodology of qualitative research, such as that used in some health research, has been inductivist or relativist to date, ignoring critical rationalism as a philosophical approach with which to discuss the general methodology of qualitative research. This paper presents a discussion of the general methodology of qualitative research from a critical rationalist perspective (inspired by Popper), using as an example mental health research. The widespread endorsement of induction in qualitative research is positivist and is suspect, if not false, particularly in relation to the context of justification (or rather theory testing) as compared to the context of discovery (or rather theory generation). Relativism is riddled with philosophical weaknesses and hence it is suspect if not false too. Theory testing is compatible with qualitative research, contrary to much writing about and in qualitative research, as theory testing involves learning from trial and error, which is part of qualitative research, and which may be the form of learning most conducive to generalization. Generalization involves comparison, which is a fundamental methodological requirement of any type of research (qualitative or other); hence the traditional grounding of quantitative and experimental research in generalization. Comparison--rather than generalization--is necessary for, and hence compatible with, qualitative research; hence, the common opposition to generalization in qualitative research is misdirected, disregarding whether this opposition's claims are true or false. In conclusion, qualitative research, similar to quantitative and experimental research, assumes comparison as a general methodological requirement, which is necessary for health research.

  2. Models of care for musculoskeletal health: a cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation.

    Science.gov (United States)

    Briggs, Andrew M; Jordan, Joanne E; Speerin, Robyn; Jennings, Matthew; Bragge, Peter; Chua, Jason; Slater, Helen

    2015-11-16

    The prevalence and impact of musculoskeletal conditions are predicted to rapidly escalate in the coming decades. Effective strategies are required to minimise 'evidence-practice', 'burden-policy' and 'burden-service' gaps and optimise health system responsiveness for sustainable, best-practice healthcare. One mechanism by which evidence can be translated into practice and policy is through Models of Care (MoCs), which provide a blueprint for health services planning and delivery. While evidence supports the effectiveness of musculoskeletal MoCs for improving health outcomes and system efficiencies, no standardised national approach to evaluation in terms of their 'readiness' for implementation and 'success' after implementation, is yet available. Further, the value assigned to MoCs by end users is uncertain. This qualitative study aimed to explore end users' views on the relevance of musculoskeletal MoCs to their work and value of a standardised evaluation approach. A cross-sectional qualitative study was undertaken. Subject matter experts (SMEs) with health, policy and administration and consumer backgrounds were drawn from three Australian states. A semi-structured interview schedule was developed and piloted to explore perceptions about musculoskeletal MoCs including: i) aspects important to their work (or life, for consumers) ii) usefulness of standardised evaluation frameworks to judge 'readiness' and 'success' and iii) challenges associated with standardised evaluation. Verbatim transcripts were analysed by two researchers using a grounded theory approach to derive key themes. Twenty-seven SMEs (n = 19; 70.4 % female) including five (18.5 %) consumers participated in the study. MoCs were perceived as critical for influencing and initiating changes to best-practice healthcare planning and delivery and providing practical guidance on how to implement and evaluate services. A 'readiness' evaluation framework assessing whether critical components across the

  3. Challenges and strategies for sustaining youth-friendly health services - a qualitative study from the perspective of professionals at youth clinics in northern Sweden.

    Science.gov (United States)

    Thomée, Suzanne; Malm, Desiré; Christianson, Monica; Hurtig, Anna-Karin; Wiklund, Maria; Waenerlund, Anna-Karin; Goicolea, Isabel

    2016-12-21

    Youth-friendly health-care services - those that are accessible, acceptable, equitable, appropriate and effective for different youth subpopulations - are beneficial for youth health, but not easy to implement and sustain. Sweden is among the few countries where youth-friendly health-care services have been integrated within the public health system and sustained for a long time. This study explores the challenges and strategies in providing sustainable youth-friendly health-care services, from the perspective of professionals working in youth clinics in northern Sweden. Eleven semi-structured interviews with various health-care professionals working in youth clinics in northern Sweden were conducted. The interviews were transcribed verbatim, and analysed using thematic analysis in relation to the World Health Organization domains of youth friendliness. Four themes emerged from the analysis of the data: 1) 'Meeting youths on their own terms - the key to ensuring a holistic and youth-centred care' was related to the acceptability and appropriateness of the services; 2) 'Organizational challenges and strategies in keeping professionals' expertise on youth updated' referred to the domain of effectiveness; 3) 'Youth clinics are accessible for those who know and can reach them' was related to the domains of accessibility and equity, and 4) 'The challenge of combining strong directions and flexibility in diverse local realities' focused on the struggle to sustain the youth clinics organization and their goals within the broader health system. Professionals working in youth clinics are perceived as motivated, interested and knowledgeable about youth, and the clinics ensure confidentiality and a youth-centred and holistic approach. Challenges remain, especially in terms of ensuring equitable access to different youth subpopulations, improving monitoring routines and ensuring training and competence for all professionals, independently of the location and characteristics of

  4. HIV provider and patient perspectives on the Development of a Health Department “Data to Care” Program: a qualitative study

    Directory of Open Access Journals (Sweden)

    Julia C. Dombrowski

    2016-06-01

    Full Text Available Abstract Background U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing “Data to Care” programs to assists persons living with HIV (PLWH with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Methods Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009–2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. Results PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care

  5. a qualitative study of providers' perspectives

    African Journals Online (AJOL)

    Background: Glaucoma management is challenging to patients as well as to the eye care providers.The study is aimed at describing the challenges faced by providers using qualitative methods. Methods: In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres ...

  6. Service user and family member perspectives on services for mental health, substance use/addiction, and violence: a qualitative study of their goals, experiences and recommendations.

    Science.gov (United States)

    Haskell, Rebecca; Graham, Kathryn; Bernards, Sharon; Flynn, Andrea; Wells, Samantha

    2016-01-01

    Mental health and substance use disorders (MSD) are significant public health concerns that often co-occur with violence. To improve services that address MSD and violence [MSD(V)], it is critical to understand the perspectives of those most affected, people who have sought help for MSD(V) (i.e., "service users"), especially those with co-occurring issues, as well as their family members. We conducted structured interviews with 73 service users and 41 family members of service users in two Ontario communities (one urban, one rural) regarding their goals related to help-seeking, positive and negative experiences, and recommendations for improving systems of care. Overall, participants expressed a need for services that: (1) are respectful, nonjudgmental, and supportive, help service users to feel more 'normal' and include education to reduce stigma; (2) are accessible, varied and publicly funded, thereby meeting individual needs and addressing equity concerns at a systems level; and (3) are coordinated, holistic and inclusive of family members who often support service users. The findings provide a rich understanding of how service users and their families perceive services for MSD(V) issues and identify key ways to better meet their needs.

  7. Qualitative Descriptive Methods in Health Science Research.

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    Colorafi, Karen Jiggins; Evans, Bronwynne

    2016-07-01

    The purpose of this methodology paper is to describe an approach to qualitative design known as qualitative descriptive that is well suited to junior health sciences researchers because it can be used with a variety of theoretical approaches, sampling techniques, and data collection strategies. It is often difficult for junior qualitative researchers to pull together the tools and resources they need to embark on a high-quality qualitative research study and to manage the volumes of data they collect during qualitative studies. This paper seeks to pull together much needed resources and provide an overview of methods. A step-by-step guide to planning a qualitative descriptive study and analyzing the data is provided, utilizing exemplars from the authors' research. This paper presents steps to conducting a qualitative descriptive study under the following headings: describing the qualitative descriptive approach, designing a qualitative descriptive study, steps to data analysis, and ensuring rigor of findings. The qualitative descriptive approach results in a summary in everyday, factual language that facilitates understanding of a selected phenomenon across disciplines of health science researchers. © The Author(s) 2016.

  8. Mental health service user and staff perspectives on tobacco addiction and smoking cessation: A meta-synthesis of published qualitative studies.

    Science.gov (United States)

    Malone, V; Harrison, R; Daker-White, G

    2018-05-01

    reduce the smoking rates in people living with serve mental illness. A meta-synthesis was undertaken to summarize the data from multiple studies to inform the development of future smoking cessation intervention studies. Methods MEDLINE, PsycINFO, Embase and CINAHL were searched in March 2017. A total of 965 titles and abstracts were screened for inclusion with 29 papers reviewed in full and 15 studies that met inclusion criteria. Included studies were assessed for quality using the Critical Appraisal Skills Programme tool. Key data across studies were examined and compared, and a thematic analysis was conducted. Results Analysis and synthesis developed five analytical themes: environmental and social context, living with a mental health illness, health awareness, financial awareness and provision of smoking cessation support. Themes generated the interpretive construct: "Whose role is it anyway?" which highlights tensions between staff perspectives on their role and responsibilities to providing smoking cessation support and support service users would like to receive. Relevance to mental health nursing Routine smoking cessation training for mental health professionals and research on innovative smoking cessation interventions to support people living with mental illness are needed. The Cochrane tobacco group has not found sufficient direct evidence of existing evidence-based interventions that have beneficial effect on smoking in people living with mental illness. With this in mind, mental health professionals should be encouraged to engage in future research into the development of new interventions and consider innovative harm reduction strategies for smoking into their practice, to reduce the morbidity and mortality many people living with mental illness experience from tobacco smoking. © 2018 John Wiley & Sons Ltd.

  9. Homeless health needs: shelter and health service provider perspective.

    Science.gov (United States)

    Hauff, Alicia J; Secor-Turner, Molly

    2014-01-01

    The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.

  10. Exploring Perceptions of the Mental Health of Youth in Mexico: A Qualitative Study

    Science.gov (United States)

    Wells, Lisa; Varjas, Kris; Cadenhead, Catherine; Morillas, Catalina; Morris, Ashley

    2012-01-01

    Limited information is available regarding the mental health of children and adolescents in Mexico (Paula, Duarte, & Bordin, 2007). The purpose of this exploratory qualitative study was to examine the construct of mental health of children and adolescents from the emic perspective of key informants in Mexico. Utilizing qualitative methods of…

  11. Australian consumer perspectives, attitudes and behaviours on antibiotic use and antibiotic resistance: a qualitative study with implications for public health policy and practice.

    Science.gov (United States)

    Lum, Elaine P M; Page, Katie; Nissen, Lisa; Doust, Jenny; Graves, Nicholas

    2017-10-10

    Consumers receive over 27 million antibiotic prescriptions annually in Australian primary healthcare. Hence, consumers are a key group to engage in the fight against antibiotic resistance. There is a paucity of research pertaining to consumers in the Australian healthcare environment. This study aimed to investigate the perspectives, attitudes and behaviours of Australian consumers on antibiotic use and antibiotic resistance, to inform national programs for reducing inappropriate antibiotic consumption. Semi-structured interviews with 32 consumers recruited via convenience and snowball sampling from a university population in South East Queensland. Interview transcripts were deductively and inductively coded. Main themes were identified using iterative thematic analysis. Three themes emerged from the analysis, to elucidate factors affecting antibiotic use: (a) prescription type; (b) consumer attitudes, behaviours, skills and knowledge; and (c) consumer engagement with antibiotic resistance. Consumers held mixed views regarding the use of delayed antibiotic prescriptions, and were often not made aware of the use of repeat antibiotic prescriptions. Consumers with regular general practitioners were more likely to have shared expectations regarding minimising the use of antibiotics. Even so, advice or information mediated by general practitioners was influential with all consumers; and helped to prevent inappropriate antibiotic use behaviours. Consumers were not aware of the free Return of Unwanted Medicines service offered by pharmacies and disposed of leftover antibiotics through household waste. To engage with mitigating antibiotic resistance, consumers required specific information. Previous public health campaigns raising awareness of antibiotics were largely not seen by this sample of consumers. Australian consumers have specific information needs regarding prescribed antibiotics to enable appropriate antibiotic use behaviours. Consumers also have expectations

  12. Australian consumer perspectives, attitudes and behaviours on antibiotic use and antibiotic resistance: a qualitative study with implications for public health policy and practice

    Directory of Open Access Journals (Sweden)

    Elaine P. M. Lum

    2017-10-01

    Full Text Available Abstract Background Consumers receive over 27 million antibiotic prescriptions annually in Australian primary healthcare. Hence, consumers are a key group to engage in the fight against antibiotic resistance. There is a paucity of research pertaining to consumers in the Australian healthcare environment. This study aimed to investigate the perspectives, attitudes and behaviours of Australian consumers on antibiotic use and antibiotic resistance, to inform national programs for reducing inappropriate antibiotic consumption. Method Semi-structured interviews with 32 consumers recruited via convenience and snowball sampling from a university population in South East Queensland. Interview transcripts were deductively and inductively coded. Main themes were identified using iterative thematic analysis. Results Three themes emerged from the analysis, to elucidate factors affecting antibiotic use: (a prescription type; (b consumer attitudes, behaviours, skills and knowledge; and (c consumer engagement with antibiotic resistance. Consumers held mixed views regarding the use of delayed antibiotic prescriptions, and were often not made aware of the use of repeat antibiotic prescriptions. Consumers with regular general practitioners were more likely to have shared expectations regarding minimising the use of antibiotics. Even so, advice or information mediated by general practitioners was influential with all consumers; and helped to prevent inappropriate antibiotic use behaviours. Consumers were not aware of the free Return of Unwanted Medicines service offered by pharmacies and disposed of leftover antibiotics through household waste. To engage with mitigating antibiotic resistance, consumers required specific information. Previous public health campaigns raising awareness of antibiotics were largely not seen by this sample of consumers. Conclusions Australian consumers have specific information needs regarding prescribed antibiotics to enable

  13. Involving people with early-stage dementia in qualitative research about their lifeworld perspectives

    DEFF Research Database (Denmark)

    Thoft, Diana Schack

    Involving people with early-stage dementia in qualitative research about their lifeworld perspectives......Involving people with early-stage dementia in qualitative research about their lifeworld perspectives...

  14. Leveraging the private sector for child health: a qualitative examination of caregiver and provider perspectives on private sector care for childhood pneumonia in Uttar Pradesh, India.

    Science.gov (United States)

    Brunie, Aurélie; Lenzi, Rachel; Lahiri, Anamika; Izadnegahdar, Rasa

    2017-02-22

    The private health sector is a primary source of curative care for childhood illnesses in many low- and middle-income countries. Therefore ensuring appropriate private sector care is an important step towards improving outcomes from illnesses like pneumonia, which is the leading infectious cause of childhood mortality worldwide. This study aimed to provide evidence on private sector care for childhood pneumonia in Uttar Pradesh, India, by simultaneously exploring providers' knowledge and practices and caregivers' experiences. We conducted in-depth interviews with a purposive sample of 36 practitioners and 34 caregivers in two districts. Practitioners included allopathic doctors, AYUSH providers, and drug sellers. Caregivers were mothers of children under the age of five with symptoms consistent with pneumonia who had seen one of those practitioners. Interview transcripts were analyzed thematically. Caregivers were generally prompt in seeking care outside the home, but many initially favored local informal providers based on access and cost. Drug sellers were not commonly consulted for treatment. Formal providers had imperfect, but reasonable, knowledge of pneumonia and followed appropriate steps for diagnosis, though some gaps were noticed that were primarily related to lack of (or failure to use) diagnostic tools. Most practitioners prescribed antibiotics and supportive symptomatic treatment. Relational and structural factors encouraged overuse of antibiotics and treatment interruption. Caregivers often had a limited understanding of treatment but wanted rapid symptomatic improvements, frequently leading to sequentially consulting multiple providers and interrupting treatment when symptoms improved. Providers were confronted with these expectations and care-seeking patterns. This study contributes in-depth evidence on private sector care for childhood pneumonia in UP. Achieving appropriate care requires an enriched perspective that simultaneously considers the

  15. Reliability assessments in qualitative health promotion research.

    Science.gov (United States)

    Cook, Kay E

    2012-03-01

    This article contributes to the debate about the use of reliability assessments in qualitative research in general, and health promotion research in particular. In this article, I examine the use of reliability assessments in qualitative health promotion research in response to health promotion researchers' commonly held misconception that reliability assessments improve the rigor of qualitative research. All qualitative articles published in the journal Health Promotion International from 2003 to 2009 employing reliability assessments were examined. In total, 31.3% (20/64) articles employed some form of reliability assessment. The use of reliability assessments increased over the study period, ranging from qualitative articles decreased. The articles were then classified into four types of reliability assessments, including the verification of thematic codes, the use of inter-rater reliability statistics, congruence in team coding and congruence in coding across sites. The merits of each type were discussed, with the subsequent discussion focusing on the deductive nature of reliable thematic coding, the limited depth of immediately verifiable data and the usefulness of such studies to health promotion and the advancement of the qualitative paradigm.

  16. Qualitative and quantitative methods in health research

    OpenAIRE

    V?zquez Navarrete, M. Luisa

    2009-01-01

    Introduction Research in the area of health has been traditionally dominated by quantitative research. However, the complexity of ill-health, which is socially constructed by individuals, health personnel and health authorities have motivated the search for other forms to approach knowledge. Aim To discuss the complementarities of qualitative and quantitative research methods in the generation of knowledge. Contents The purpose of quantitative research is to measure the magnitude of an event,...

  17. The professional perspective on patient involvement in the development of quality indicators: a qualitative analysis using the example of chronic heart failure in the German health care setting

    Directory of Open Access Journals (Sweden)

    Pohontsch NJ

    2015-01-01

    Full Text Available Nadine Janis Pohontsch,1 Heidrun Herzberg,2 Stefanie Joos,3 Felix Welti,4 Martin Scherer,1 Eva Blozik1 1Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamberg, Germany; 2Faculty of Health, Nursing, Management, Neubrandenburg University of Applied Sciences, Neubrandenburg, Germany; 3Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany; 4Faculty of Human Sciences, University of Kassel, Kassel, Germany Purpose: There is an international consensus that quality indicators (QIs of health care ought to represent patient-relevant aspects. Therefore, patient involvement in the development process is essential. However, there is no methodological gold standard for involving patients in QI development. The aim of this study is to explore experts’ views on the representation of patient-relevant aspects in the QI development process using the QIs developed in the context of the German National Disease Management Guideline for Heart Failure as an example. Methods: Semi-structured, open telephone interviews were conducted with 15 German experts (patient representatives, physicians, researchers, and methodologists involved in guideline development or quality assessment. Interview themes were the relevance of the exemplary set of QIs for patients, as well as the legitimacy of, competence of, and collaboration with the patient representative who participated in the development process. Interviews were fully transcribed and content analyzed. Deductive categories derived from the research questions were supplemented by inductively formed categories during the review of the interview material.Results: The qualitative analysis suggests a discrepancy between the guidelines’ QIs and those relevant to patients from an expert’s point of view, such as physician-patient communication and quality of counseling. Experts reported only minor communication and cooperation

  18. Women's mental health during pregnancy: A participatory qualitative study.

    Science.gov (United States)

    Franks, Wendy L M; Crozier, Kenda E; Penhale, Bridget L M

    2017-08-01

    British public health and academic policy and guidance promotes service user involvement in health care and research, however collaborative research remains underrepresented in literature relating to pregnant women's mental health. The aim of this participatory research was to explore mothers' and professionals' perspectives on the factors that influence pregnant women's mental health. This qualitative research was undertaken in England with the involvement of three community members who had firsthand experience of mental health problems during pregnancy. All members of the team were involved in study design, recruitment, data generation and different stages of thematic analysis. Data were transcribed for individual and group discussions with 17 women who self-identified as experiencing mental health problems during pregnancy and 15 professionals who work with this group. Means of establishing trustworthiness included triangulation, researcher reflexivity, peer debriefing and comprehensive data analysis. Significant areas of commonality were identified between mothers' and professionals' perspectives on factors that undermine women's mental health during pregnancy and what is needed to support women's mental health. Analysis of data is provided with particular reference to contexts of relational, systemic and ecological conditions in women's lives. Women's mental health is predominantly undermined or supported by relational, experiential and material factors. The local context of socio-economic deprivation is a significant influence on women's mental health and service requirements. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  19. A qualitative study of user perceptions of mobile health apps.

    Science.gov (United States)

    Peng, Wei; Kanthawala, Shaheen; Yuan, Shupei; Hussain, Syed Ali

    2016-11-14

    Mobile apps for health exist in large numbers today, but oftentimes, consumers do not continue to use them after a brief period of initial usage, are averse toward using them at all, or are unaware that such apps even exist. The purpose of our study was to examine and qualitatively determine the design and content elements of health apps that facilitate or impede usage from the users' perceptive. In 2014, six focus groups and five individual interviews were conducted in the Midwest region of the U.S. with a mixture of 44 smartphone owners of various social economic status. The participants were asked about their general and health specific mobile app usage. They were then shown specific features of exemplar health apps and prompted to discuss their perceptions. The focus groups and interviews were audio recorded, transcribed verbatim, and coded using the software NVivo. Inductive thematic analysis was adopted to analyze the data and nine themes were identified: 1) barriers to adoption of health apps, 2) barriers to continued use of health apps, 3) motivators, 4) information and personalized guidance, 5) tracking for awareness and progress, 6) credibility, 7) goal setting, 8) reminders, and 9) sharing personal information. The themes were mapped to theories for interpretation of the results. This qualitative research with a diverse pool of participants extended previous research on challenges and opportunities of health apps. The findings provide researchers, app designers, and health care providers insights on how to develop and evaluate health apps from the users' perspective.

  20. A public health perspective

    African Journals Online (AJOL)

    user

    EDITORIAL. Enabling local health departments to save more lives: A public ... promoting health through the organized efforts of society” (1) ... and synergistic with achieving the sustainable development goals because its furtherance brings a ...

  1. What are the experiences of seeking, receiving and providing FGM-related healthcare? Perspectives of health professionals and women/girls who have undergone FGM: protocol for a systematic review of qualitative evidence.

    Science.gov (United States)

    Evans, Catrin; Tweheyo, Ritah; McGarry, Julie; Eldridge, Jeanette; McCormick, Carol; Nkoyo, Valentine; Higginbottom, Gina Marie Awoko

    2017-12-14

    Female genital mutilation (FGM) is an issue of global concern. High levels of migration mean that healthcare systems in higher-income western countries are increasingly being challenged to respond to the care needs of affected communities. Research has identified significant challenges in the provision of, and access to, FGM-related healthcare. There is a lack of confidence and competence among health professionals in providing appropriate care, suggesting an urgent need for evidence-based service development in this area. This study will involve two systematic reviews of qualitative evidence to explore the experiences, needs, barriers and facilitators to seeking and providing FGM-related healthcare in high-income (Organisation for Economic Cooperation and Development) countries, from the perspectives of: (1) women and girls who have undergone FGM and (2) health professionals. Twelve databases including MEDLINE, EMBASE, PsycINFO, ASSIA, Web of Science, ERIC, CINAHL, and POPLINE will be searched with no limits on publication year. Relevant grey literature will be identified from digital sources and professional networks.Two reviewers will independently screen, select and critically appraise the studies. Study quality will be assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument appraisal tool. Findings will be extracted into NVivo software. Synthesis will involve inductive thematic analysis, including in-depth reading, line by line coding of the findings, development of descriptive themes and re-coding to higher level analytical themes. Confidence in the review findings will be assessed using the CERQual approach. Findings will be integrated into a comprehensive set of recommendations for research, policy and practice. The syntheses will be reported as per the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Two reviews will be published in peer-reviewed journals and an integrated report

  2. Beauty and health: anthropological perspectives

    NARCIS (Netherlands)

    Edmonds, A.

    2008-01-01

    This essay, written as a 'teaser' for an up-coming symposium, reflects on how human beauty can be understood from an anthropological and medical anthropological perspective. First, it considers how aesthetic and healing rationales can conflict or merge in a variety of medical technologies and health

  3. Ethical and legal implications of the risks of medical tourism for patients: a qualitative study of Canadian health and safety representatives’ perspectives

    Science.gov (United States)

    Crooks, Valorie A; Turner, Leigh; Cohen, I Glenn; Bristeir, Janet; Snyder, Jeremy; Casey, Victoria; Whitmore, Rebecca

    2013-01-01

    Objectives Medical tourism involves patients’ intentional travel to privately obtain medical care in another country. Empirical evidence regarding health and safety risks facing medical tourists is limited. Consideration of this issue is dominated by speculation and lacks meaningful input from people with specific expertise in patient health and safety. We consulted with patient health and safety experts in the Canadian province of British Columbia to explore their views concerning risks that medical tourists may be exposed to. Herein, we report on the findings, linking them to existing ethical and legal issues associated with medical tourism. Design We held a focus group in September 2011 in Vancouver, British Columbia with professionals representing different domains of patient health and safety expertise. The focus group was transcribed verbatim and analysed thematically. Participants Seven professionals representing the domains of tissue banking, blood safety, health records, organ transplantation, dental care, clinical ethics and infection control participated. Results Five dominant health and safety risks for outbound medical tourists were identified by participants: (1) complications; (2) specific concerns regarding organ transplantation; (3) transmission of antibiotic-resistant organisms; (4) (dis)continuity of medical documentation and (5) (un)informed decision-making. Conclusions Concern was expressed that medical tourism might have unintended and undesired effects upon patients’ home healthcare systems. The individual choices of medical tourists could have significant public consequences if healthcare facilities in their home countries must expend resources treating postoperative complications. Participants also expressed concern that medical tourists returning home with infections, particularly antibiotic-resistant infections, could place others at risk of exposure to infections that are refractory to standard treatment regimens and thereby pose

  4. Gatekeepers of health: A qualitative assessment of child care centre staff's perspectives, practices and challenges to enteric illness prevention and management in child care centres

    Directory of Open Access Journals (Sweden)

    Adams Cindy L

    2008-06-01

    Full Text Available Abstract Background Enteric outbreaks associated with child care centres (CCC have been well documented internationally and in Canada. The current literature focuses on identifying potential risk factors for introduction and transmission of enteric disease, but does not examine why these risk factors happen, how the risk is understood and managed by the staff of CCCs, or what challenges they experience responding to enteric illness. The purpose of this study was to explore the understanding, knowledge and actions of CCC staff regarding enteric illness and outbreaks, and to identify challenges that staff encounter while managing them. Methods Focus groups were conducted with staff of regulated CCCs in Southern Ontario. Five focus groups were held with 40 participants. An open ended style of interviewing was used. Data were analyzed using content analysis. Results CCC staff play an important role in preventing and managing enteric illness. Staff used in-depth knowledge of the children, the centre and their personal experiences to assist in making decisions related to enteric illness. The decisions and actions may differ from guidance provided by public health officials, particularly when faced with challenges related to time, money, staffing and parents. Conclusion CCC staff relied on experience and judgment in coordination with public health information to assist decision-making in the management of enteric illness and outbreaks. Advice and guidance from public health officials to CCC staff needs to be consistent yet flexible so that it may be adapted in a variety of situations and meet regulatory and public health requirements.

  5. Design, Implementation and Evaluation of School-Based Sexual Health Education in Sub-Saharan Africa: A Qualitative Study of Researchers' Perspectives

    Science.gov (United States)

    Sani, A. Sadiq; Abraham, Charles; Denford, Sarah; Mathews, Catherine

    2018-01-01

    This study investigated facilitators and challenges to designing, implementing and evaluating school-based sexual health education in sub-Saharan Africa, using interviews with intervention designers and researchers. At the pre-planning and planning stages, participants reported that facilitating factors included addressing the reproductive health…

  6. Perspectives of key stakeholders regarding task shifting of care for HIV patients in Mozambique: a qualitative interview-based study with Ministry of Health leaders, clinicians, and donors.

    Science.gov (United States)

    Rustagi, Alison S; Manjate, Rosa Marlene; Gloyd, Stephen; John-Stewart, Grace; Micek, Mark; Gimbel, Sarah; Sherr, Kenneth

    2015-04-01

    Task shifting is a common strategy to deliver antiretroviral therapy (ART) in resource-limited settings and is safe and effective if implemented appropriately. Consensus among stakeholders is necessary to formulate clear national policies that maintain high-quality care. We sought to understand key stakeholders' opinions regarding task shifting of HIV care in Mozambique and to characterize which specific tasks stakeholders considered appropriate for specific cadres of health workers. National and provincial Ministry of Health leaders, representatives from donor and non-governmental organizations (NGOs), and clinicians providing HIV care were intentionally selected to represent diverse viewpoints. Using open- and closed-ended questions, interviewees were asked about their general support of task shifting, its potential advantages and disadvantages, and whether each of seven cadres of non-physician health workers should perform each of eight tasks related to ART provision. Responses were tallied overall and stratified by current job category. Interviews were conducted between November 2007 and June 2008. Of 62 stakeholders interviewed, 44% held leadership positions in the Ministry of Health, 44% were clinicians providing HIV care, and 13% were donors or employed by NGOs; 89% held a medical degree. Stakeholders were highly supportive of physician assistants performing simple ART-related tasks and unanimous in opposing community health workers providing any ART-related services. The most commonly cited motives to implement task shifting were to increase ART access, decrease physician workload, and decrease patient wait time, whereas chief concerns included reduced quality of care and poor training and supervision. Support for task shifting was higher among clinicians than policy and programme leaders for three specific task/cadre combinations: general mid-level nurses to initiate ART in adults (supported by 75% of clinicians vs. 41% of non-clinicians) and in pregnant

  7. Barriers and facilitators of evidence-based practice in pediatric behavioral sleep care: qualitative analysis of the perspectives of health professionals.

    Science.gov (United States)

    Boerner, Katelynn E; Coulombe, J Aimée; Corkum, Penny

    2015-01-01

    Behavioral sleep problems are highly prevalent among young and school-aged children. Despite strong evidence for effective interventions, few children receive evidence-based care. In this study, 124 Canadian health professionals answered open-ended questions regarding barriers and facilitators of their provision of evidence-based behavioral sleep-related care, and responses were analyzed for content. Responses represented issues at an individual practice level, as well as broader systemic issues. The most frequently reported barrier and facilitator related to knowledge, training, and education. Other barriers included lack of time and institutional support, and facilitators included supportive sleep attitudes and beliefs. This study may inform the design of education programs for health professionals, and provides support for broader systems-level initiatives targeted at increasing evidence-based practice.

  8. The Malnourished University Student: Health from the Student Perspective

    OpenAIRE

    Jones, Sandra Beth

    2015-01-01

    Over the first four years of college, students’ self-ratings on writing ability and motivation to perform well increase, while self-reports of physical and emotional health decrease during that same period (Astin, 1997). This qualitative investigation identifies and explains the environmental and cultural forces that shape and are shaped by health and wellness perspectives of students. Research questions for this investigation addressed students’ understandings of health and wellness and th...

  9. Health inequalities--gender perspective.

    Science.gov (United States)

    Ostrowska, Antonina

    2012-01-01

    Health inequalities have become recently one of the major concerns of European health policy. Observed differences in health status of men and women are also frequently discussed within this framework, and are becoming a subject of growing interest of researchers. Clinical and epidemiological researches document male-female health differences, trying to explain them within bio-medical model. However, apart of biological (sex) divergence, health inequalities reflect differences in social roles, social status and culturally established patterns and stereotypes of femininity and masculinity (gender differences). The article, using sociological perspective, attempts to show that observed differences in man's and women's health may be attributable to the differing sociocultural and structural arrangements, social support and lifestyle factors of both genders. As a result, many of these differences are of inequality character. Another dimension of inequality discussed in this article is the way man and women are treated by the institution of medicine.

  10. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study

    NARCIS (Netherlands)

    Smeulers, Marian; Onderwater, Astrid T.; van Zwieten, Myra C. B.; Vermeulen, Hester

    2014-01-01

    To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative

  11. Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.

    Science.gov (United States)

    Marques, Luana; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi M; Wiltsey Stirman, Shannon

    2016-08-01

    This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Las enfermedades crónicas desde la mirada de los enfermos y los profesionales de la salud: un estudio cualitativo en México Chronic illness from the perspective of patients and health professionals: a qualitative study in Mexico

    Directory of Open Access Journals (Sweden)

    Francisco J. Mercado-Martínez

    2007-09-01

    Full Text Available Las enfermedades crónicas constituyen las primeras causas de morbi-mortalidad e implican costos crecientes para los servicios sanitarios en numerosos países. Sin embargo, poco se conoce la forma como diversos grupos las perciben y enfrentan. Este trabajo compara las perspectivas de dos tipos de profesionales sanitarios y población enferma sobre tales enfermedades y sobre las relaciones existentes entre los actores involucrados. Un estudio cualitativo, multicéntrico, se realizó en tres ciudades de México: Guadalajara, San Luis Potosí y México DF. Participaron sujetos con enfermedades crónicas, médicos y profesionales sanitarios no médicos. La información se obtuvo mediante grupos focales y entrevistas individuales, analizándose mediante análisis del discurso. La perspectiva de los participantes sobre tales enfermedades varía entre la mirada medicalizada de los médicos, frente a la de los sujetos enfermos centrada en los padecimientos y la vida diaria. Los participantes coinciden en la existencia de relaciones desiguales entre los trabajadores de la salud, la familia y las personas enfermas, así como en relaciones más igualitarias entre los enfermos. Se discuten múltiples implicaciones de los resultados.Chronic diseases are leading causes of morbidity, mortality, and increasing expenditures in numerous countries. However, little is known about how chronic diseases are perceived and managed by social actors. This article aims to compare the perspectives of health professionals and patients towards chronic diseases, besides analyzing the relationship between these two groups. A qualitative, multi-center study was conducted in three Mexican cities: Guadalajara, San Luis Potosí, and Mexico City. Participants included chronically ill individuals, physicians, and other health professionals from primary and secondary health care centers. Data collection used focus groups and interviews. The data were analyzed using discourse analysis

  13. Health insurance reform: labor versus health perspectives.

    Science.gov (United States)

    Ammar, Walid; Awar, May

    2012-01-01

    The Ministry of Labor (MOL) has submitted to the Council of Ministers a social security reform plan. The Ministry of Public Health (MOPH) considers that health financing should be dealt with as part of a more comprehensive health reform plan that falls under its prerogatives. While a virulent political discussion is taking place, major stakeholders' inputs are very limited and civil society is totally put away from the whole policy making process. The role of the media is restricted to reproducing political disputes, without meaningful substantive debate. This paper discusses health insurance reform from labor market as well as public health perspectives, and aims at launching a serious public debate on this crucial issue that touches the life of every citizen.

  14. Qualitative data analysis for health services research: developing taxonomy, themes, and theory.

    Science.gov (United States)

    Bradley, Elizabeth H; Curry, Leslie A; Devers, Kelly J

    2007-08-01

    To provide practical strategies for conducting and evaluating analyses of qualitative data applicable for health services researchers. DATA SOURCES AND DESIGN: We draw on extant qualitative methodological literature to describe practical approaches to qualitative data analysis. Approaches to data analysis vary by discipline and analytic tradition; however, we focus on qualitative data analysis that has as a goal the generation of taxonomy, themes, and theory germane to health services research. We describe an approach to qualitative data analysis that applies the principles of inductive reasoning while also employing predetermined code types to guide data analysis and interpretation. These code types (conceptual, relationship, perspective, participant characteristics, and setting codes) define a structure that is appropriate for generation of taxonomy, themes, and theory. Conceptual codes and subcodes facilitate the development of taxonomies. Relationship and perspective codes facilitate the development of themes and theory. Intersectional analyses with data coded for participant characteristics and setting codes can facilitate comparative analyses. Qualitative inquiry can improve the description and explanation of complex, real-world phenomena pertinent to health services research. Greater understanding of the processes of qualitative data analysis can be helpful for health services researchers as they use these methods themselves or collaborate with qualitative researchers from a wide range of disciplines.

  15. A qualitative study of user perceptions of mobile health apps

    Directory of Open Access Journals (Sweden)

    Wei Peng

    2016-11-01

    Full Text Available Abstract Background Mobile apps for health exist in large numbers today, but oftentimes, consumers do not continue to use them after a brief period of initial usage, are averse toward using them at all, or are unaware that such apps even exist. The purpose of our study was to examine and qualitatively determine the design and content elements of health apps that facilitate or impede usage from the users’ perceptive. Methods In 2014, six focus groups and five individual interviews were conducted in the Midwest region of the U.S. with a mixture of 44 smartphone owners of various social economic status. The participants were asked about their general and health specific mobile app usage. They were then shown specific features of exemplar health apps and prompted to discuss their perceptions. The focus groups and interviews were audio recorded, transcribed verbatim, and coded using the software NVivo. Results Inductive thematic analysis was adopted to analyze the data and nine themes were identified: 1 barriers to adoption of health apps, 2 barriers to continued use of health apps, 3 motivators, 4 information and personalized guidance, 5 tracking for awareness and progress, 6 credibility, 7 goal setting, 8 reminders, and 9 sharing personal information. The themes were mapped to theories for interpretation of the results. Conclusions This qualitative research with a diverse pool of participants extended previous research on challenges and opportunities of health apps. The findings provide researchers, app designers, and health care providers insights on how to develop and evaluate health apps from the users’ perspective.

  16. Health Promoting Pocket Parks in a Landscape Architectural Perspective

    DEFF Research Database (Denmark)

    Peschardt, Karin Kragsig

    This thesis presents how the health potential of pocket parks can be improved through design from a landscape architectural perspective. In developed countries, the densification of cities is a wide-spread tendency which often results in a compact city planning structure. People who live in dense...... promoting potential of nine pocket parks in Copenhagen. From a landscape architectural perspective the health potential is investigated based on both qualitative and quantitative methods. The study elucidates use, the restorative potential as well as how physical content within the pocket parks can...

  17. Optimizing Tailored Health Promotion for Older Adults : Understanding Their Perspectives on Healthy Living

    NARCIS (Netherlands)

    Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L S; Seidell, Jacob C; Slaets, Joris P J; Smits, Carolien H M

    2017-01-01

    Objective: This study explores older adults' perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative

  18. Transition into the workplace: comparing health graduates' and organisational perspectives.

    Science.gov (United States)

    Walker, Arlene; Costa, Beth M

    2017-02-01

    Health graduates face personal and work-related stressors during the graduate year. The extent to which employers and health graduates have a shared understanding of graduate stressors is unclear but may impact graduate support and transition into the health profession. Aim and design: The aim of this exploratory qualitative study was to identify factors that impact health graduates' transition and integration into the workplace, comparing the perspectives of health graduates and organisational representatives. Individual and small group semi-structured interviews were conducted with 15 medical and 26 nursing graduates and five organisational representatives from a regional health organisation in Victoria, Australia. A thematic analysis was undertaken on the data. Five main categories were identified: dealing with change, dealing with conflict, workload, taking responsibility and factors that influence performance. Similarities and differences in the perspectives of health graduates and organisational representatives were identified. These findings have implications for current graduate support programs.

  19. Qualitative description – the poor cousin of health research?

    OpenAIRE

    Sondergaard Jens; Andersen Rikke; Olesen Frede; Neergaard Mette

    2009-01-01

    Abstract Background The knowledge and use of qualitative description as a qualitative research approach in health services research is limited. The aim of this article is to discuss the potential benefits of a qualitative descriptive approach, to identify its strengths and weaknesses and to provide examples of use. Discussion Qualitative description is a useful qualitative method in much medical research if you keep the limitations of the approach in mind. It is especially relevant in mixed m...

  20. How will we know "good" qualitative research when we see it? Beginning the dialogue in health services research.

    Science.gov (United States)

    Devers, K J

    1999-12-01

    To lay the foundation for an explicit review and dialogue concerning the criteria that should be used to evaluate qualitative health services research. Clear criteria are critical for the discipline because they provide a benchmark against which research can be assessed. Existing literature in the social sciences and health services research, particularly in primary care and medicine. Traditional criteria for evaluating qualitative research are rooted in the philosophical perspective (positivism) most closely associated with quantitative research and methods. As a result, qualitative research and methods may not be used as frequently as they can be and research results generated from qualitative studies may not be disseminated as widely as possible. However, alternative criteria for evaluating qualitative research have been proposed that reflect a different philosophical perspective (post-positivism). Moreover, these criteria are tailored to the unique purposes for which qualitative research is used and the research designs traditionally employed. While criteria based on these two different philosophical perspectives have much in common, some important differences exist. The field of health services research must engage in a collective, "qualitative" process to determine which criteria to adopt (positivist or post-positivist), or whether some combination of the two is most appropriate. Greater clarity about the criteria used to evaluate qualitative research will strengthen the discipline by fostering a more appropriate and improved use of qualitative methods, a greater willingness to fund and publish "good" qualitative research, and the development of more informed consumers of qualitative research results.

  1. Advancing the Science of Qualitative Research to Promote Health Equity.

    Science.gov (United States)

    Griffith, Derek M; Shelton, Rachel C; Kegler, Michelle

    2017-10-01

    Qualitative methods have long been a part of health education research, but how qualitative approaches advance health equity has not been well described. Qualitative research is an increasingly important methodologic tool to use in efforts to understand, inform, and advance health equity. Qualitative research provides critical insight into the subjective meaning and context of health that can be essential for understanding where and how to intervene to inform health equity research and practice. We describe the larger context for this special theme issue of Health Education & Behavior, provide brief overviews of the 15 articles that comprise the issue, and discuss the promise of qualitative research that seeks to contextualize and illuminate answers to research questions in efforts to promote health equity. We highlight the critical role that qualitative research can play in considering and incorporating a diverse array of contextual information that is difficult to capture in quantitative research.

  2. Motivation of health surveillance assistants in Malawi: A qualitative study.

    Science.gov (United States)

    Chikaphupha, Kingsley R; Kok, Maryse C; Nyirenda, Lot; Namakhoma, Ireen; Theobald, Sally

    2016-06-01

    Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of HSAs. A qualitative study capturing the perspectives of purposively selected participants was conducted in two districts: Salima and Mchinji. Participants included HSAs, health managers, and various community members. Data were collected through focus group discussions (n = 16) and in-depth interviews (n = 44). The study sample was comprised of 112 women and 65 men. Qualitative data analysis was informed by existing frameworks on factors influencing health worker motivation. Our analysis identified five key themes shaping HSA motivation: salary, accommodation, human resource management, supplies and logistics, and community links. Each of these played out at different levels-individual, family, community, and organisational-with either positive or negative effects. Demotivating factors related primarily to the organisational level, while motivating factors were more often related to individual, family, and community levels. A lack of financial incentives and shortages of basic supplies and materials were key factors demotivating HSAs. Supervision was generally perceived as unsupportive, uncoordinated, and top-down. Most HSAs complained of heavy workload. Many HSAs felt further recognition and support from the Ministry of Health, and the development of a clear career pathway would improve their motivation. Factors shaping motivation of HSAs are complex and multilayered; experiences at one level will impact other levels. Interventions are required to enhance HSA motivation, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. HSAs have unique experiences, and there is need to hear

  3. Qualitative Examination of African American Women's Perspectives about Depression

    Directory of Open Access Journals (Sweden)

    K. B. Holden

    2015-07-01

    Full Text Available Gaining greater understanding about the various psychosocial, socio-cultural, and environmental factors that may influence experiences of depression among African American women (AAW helps elucidate how this mental illness impacts the lives of this population. Sixty-three adult AAW comprised the study’s convenience sample.  Specifically, focus group cohorts inclusive of women from an academic institution, a primary healthcare clinic, and an urban community setting were conducted.  Results indicated six (6 dominant common themes as issues that may increase risk for depression among diverse AAW.  Similarities and differences about perspectives that contributed to depression were delineated among the three cohorts of AAW.  These results are important for mental/behavioral health researchers, practitioners, and public health professionals that are engaged in the design and implementation of culturally centered and gender-specific prevention and intervention strategies targeted to AAW at risk for depression.  

  4. Health literacy and the social determinants of health: a qualitative model from adult learners.

    Science.gov (United States)

    Rowlands, Gillian; Shaw, Adrienne; Jaswal, Sabrena; Smith, Sian; Harpham, Trudy

    2017-02-01

    Health literacy, ‘the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health’, is key to improving peoples’ control over modifiable social determinants of health (SDH). This study listened to adult learners to understand their perspectives on gathering, understanding and using information for health. This qualitative project recruited participants from community skills courses to identify relevant ‘health information’ factors. Subsequently different learners put these together to develop a model of their ‘Journey to health’. Twenty-seven participants were recruited; twenty from community health literacy courses and seven from an adult basic literacy and numeracy course. Participants described health as a ‘journey’ starting from an individual's family, ethnicity and culture. Basic (functional) health literacy skills were needed to gather and understand information. More complex interactive health literacy skills were needed to evaluate the importance and relevance of information in context, and make health decisions. Critical health literacy skills could be used to adapt negative external factors that might inhibit health-promotion. Our model is an iterative linear one moving from ethnicity, community and culture, through lifestyle, to health, with learning revisited in the context of different sources of support. It builds on existing models by highlighting the importance of SDH in the translation of new health knowledge into healthy behaviours, and the importance of health literacy in enabling people to overcome barriers to health.

  5. Electronic portfolio motivational factors from students’ perspective: A qualitative study

    Directory of Open Access Journals (Sweden)

    Rokhsareh Mobarhan

    2015-06-01

    Full Text Available Electronic portfolio (e-Portfolio is known as an electronic learning record which collects the learning evidences, reflections and accomplishments. In fact, it tells the story of learning achievements. It is an important tool for students, lecturers, administrators and faculties to monitor the learning outcomes. Similarly to other technologies, e-Portfolio is also considered successful, if it is used by students continuously. Previous researches showed the importance of intrinsic and extrinsic motivations in using any technologies. However, lack of motivation has been a major concern for developing any successful online learning environments. The aim of this paper is to explain the e-Portfolio motivational factors from students’ perspective. Interviews are conducted with students from one university in Malaysia in order to get better understanding of the phenomena. The target interviewees are bachelor students chosen from different faculties. Based on the qualitative content analysis of the interviews, the motivational factors affecting the continuous use of e-portfolio are coded in eight themes and then they categorized in four main groups of individual, system, social and environmental characteristics. Finally they are classified into intrinsic or extrinsic motivations.

  6. [Teaching and learning the science of qualitative research in the health area].

    Science.gov (United States)

    Calderón, Carlos

    2012-03-01

    Qualitative research constitutes a necessary perspective of knowledge within the field of health services. Healthcare always occurs in complex contexts and its enhancement requires research methodologies that address this complexity. Nevertheless, the knowledge and use of qualitative research in health services is still very limited. Among the different factors that affect its development, the teaching and learning of qualitative research proves to be fundamental, even beyond undergraduate education. Healthcare professionals and health services present certain specific aspects that must be considered in the design and development of the teaching and learning of qualitative research. Based on an eight-year online training experience with Primary Healthcare professionals, the main challenges are indentified and discussed.

  7. Self-knowledge of health teachers: A qualitative exploratory study.

    Science.gov (United States)

    Canever, Bruna Pedroso; do Prado, Marta Lenise; Gomes, Diana Coelho; Backes, Vânia Marli Schubert; de Jesus, Bruna Helena

    2018-06-01

    Specific pedagogical training for teaching in the area of health emerges with the goal of creating critical and reflective professionals and as a necessary challenge to university teaching, where there is reflection on self-awareness, consciousness, and the incompleteness of being. This study aims to understand how Freire's critical consciousness is expressed in the pedagogical practice of health teachers. This study is a qualitative study that is descriptive, exploratory, and analytical. Twenty-one teachers from a public university in southern Brazil participated. Data were collected using open-ended, in-person interviews held from May to December 2013. Data systematization was based on Minayo's operative proposal. The analysis yielded 2 main categories, including the naïve critical consciousness of health teachers, i.e., education as a practice of oppression, and the epistemological critical consciousness of health teachers, i.e., education as a practice of freedom. The results revealed the teachers' self-knowledge, including the reasoning and motivations that made them become teachers, the characteristics considered necessary to be a teacher, the teachers' feelings in their teaching practice, and the teaching preparation required for being in the classroom from the perspective of naïve and epistemological critical consciousness. The study shows that the self-knowledge that emerged from the teachers' reports encourages new perspectives in the construction of the teacher, raising the challenge of development and transformation from naïve consciousness to epistemological consciousness, and thus contributing to a breakthrough with respect to critical and creative teacher training. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Biocultural perspectives on women's health.

    Science.gov (United States)

    1997-04-01

    During the 1997 meeting of the American Association for the Advancement of Science, a session was devoted to biocultural perspectives on women's health in developing countries. The topics covered included female circumcision conducted as part of the traditional wedding ceremony of the Rendille people of Kenya and the deleterious effect of sociocultural factors such as acceptance of premarital sexual intercourse and early child-bearing on the health of adolescent girls in West Africa. A study in Bangladesh sought information on women's health during pregnancy and lactation. Using 19,000 paired questionnaires and urine samples from 493 women representing all reproductive states, pregnancy-related sickness (such as nausea and vomiting) was correlated to hormone levels, maternal age, and fetal loss. Preliminary results contradict a popular belief that incidence of pregnancy-related sickness is associated with a lowered risk of early fetal loss. Another study in Bangladesh revealed that previous research indicating that women in Bangladesh experience menopause eight years sooner than US women was inaccurate. The two-year earlier onset of menopause found in Bangladesh is likely caused by stress-related anovulation. A preliminary literature review has also shown that Bangladeshi women lack significant amounts of phytoestrogens in their diet. Improved knowledge of biocultural factors is sought as a prerequisite for improving medical treatment in developed and developing countries.

  9. General Practitioners' Perspective on eHealth and Lifestyle Change

    DEFF Research Database (Denmark)

    Brandt, Carl Joakim; Søgaard, Gabrielle Isidora; Clemensen, Jane

    2018-01-01

    BACKGROUND: 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. OBJECTIVE: This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior...... 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...

  10. Treatment of hemophilia: A qualitative study of mothers' perspectives.

    Science.gov (United States)

    von der Lippe, Charlotte; Frich, Jan C; Harris, Anna; Solbraekke, Kari Nyheim

    2017-01-01

    In Norway, boys with hemophilia usually begin treatment after their first bleeding episode. Boys with severe hemophilia usually start prophylactic treatment around 18-24 months. Health professionals administer factor concentrate initially, but when boys are around 4 years old most parents start treating their children at home. There is a lack of research on how parents, and especially how carrier mothers, experience the medical treatment for their sons' hemophilia. Our aim was to investigate how carrier mothers experience this treatment in the hospital setting and at home. In this qualitative study, we interviewed 16 mothers of boys or men with hemophilia A or B. Data were collected via semistructured interviews and analyzed using an inductive thematic analytical approach. Mothers experienced both practical and emotional challenges in relation to their sons' treatment, and repeated venipuncture was especially difficult emotionally. Parents preferred home treatment to hospital treatment because it was less time-consuming, less disruptive to family life, and provided a greater sense of control. Encountering healthcare professionals who were unfamiliar with hemophilia was a second major stress factor, especially when parents felt that health professionals lacked competence and were unwilling to seek advice. While home treatment for hemophilia enables freedom, flexibility, and autonomy for the boys as well as for the family, mothers may experience treatment of hemophilia as a burden. Health professionals should provide tailored practical and emotional support to parents by probing into their experiences with treating their sons' hemophilia. © 2016 Wiley Periodicals, Inc.

  11. Perspectives about family meals from single-headed and dual-headed households: a qualitative analysis.

    Science.gov (United States)

    Berge, Jerica M; Hoppmann, Caroline; Hanson, Carrie; Neumark-Sztainer, Dianne

    2013-12-01

    Cross-sectional and longitudinal research has shown that family meals are protective for adolescent healthful eating behaviors. However, little is known about what parents think of these findings and whether parents from single- vs dual-headed households have differing perspectives about the findings. In addition, parents' perspectives regarding barriers to applying the findings on family meals in their own homes and suggestions for more widespread adoption of the findings are unknown. The current study aimed to identify single- and dual-headed household parents' perspectives regarding the research findings on family meals, barriers to applying the findings in their own homes, and suggestions for helping families have more family meals. The current qualitative study included 59 parents who participated in substudy of two linked multilevel studies-EAT 2010 (Eating and Activity in Teens) and Families and Eating and Activity in Teens (F-EAT). Parents (91.5% female) were racially/ethnically and socioeconomically diverse. Data were analyzed using a grounded theory approach. Results from the current study suggest that parents from both single- and dual-headed households have similar perspectives regarding why family meals are protective for healthful eating habits for adolescents (eg, provides structure/routine, opportunities for communication, connection), but provide similar and different reasons for barriers to family meals (eg, single-headed=cost vs dual-headed=lack of creativity) and ideas and suggestions for how to increase the frequency of family meals (eg, single-headed=give fewer options vs dual-headed=include children in the meal preparation). Findings can help inform public health intervention researchers and providers who work with adolescents and their families to understand how to approach discussions regarding reasons for having family meals, barriers to carrying out family meals, and ways to increase family meals depending on family structure. Copyright

  12. Obesity in primary care: a qualitative synthesis of patient and practitioner perspectives on roles and responsibilities.

    Science.gov (United States)

    Henderson, Emily

    2015-04-01

    Obesity is a top-priority global health issue; however, a clear way to address obesity in primary care is not yet in view. To conduct a meta-ethnography of patient and primary care practitioner perspectives of roles and responsibilities in how to address obesity in the UK, to inform evidence-based services that are acceptable to, and appropriate for, patients and practitioners. Qualitative synthesis applying meta-ethnographic methods according to the Noblit and Hare monograph. Database searches in MEDLINE(®), Social Sciences Citation Index(®), CINAHL, and Health Management Information Consortium were limited to 1997-2012 to examine recent perspectives. Full articles of practitioner and/or patient perspectives on obesity services in primary care were reviewed, and included semi-structured or unstructured interviews and focus groups, and participant observations. Nine studies were synthesised with perspectives from patients (n = 105) and practitioners (n = 144). Practitioners believe that patients are responsible for obesity, and that primary care should not help, or is poorly equipped to do so. Patients 'take responsibility' by 'blaming' themselves, but feel that practitioners should demonstrate more leadership. The empowerment of patients to access health services is reliant on the empowerment of practitioners to take an unambiguous position. Primary care has the potential either to perpetuate or counter obesity-related stigma. There needs to be a firm decision as to what role primary care will take in the prevention and treatment of obesity. To remain ambiguous runs the risk of losing patients' confidence and adding to a growing sense of futility. © British Journal of General Practice 2015.

  13. Truck Drivers' Experiences and Perspectives Regarding Factors Influencing Traffic Accidents: A Qualitative Study.

    Science.gov (United States)

    Karimi Moonaghi, Hossein; Ranjbar, Hossein; Heydari, Abbas; Scurlock-Evans, Laura

    2015-08-01

    Traffic accidents are a major public health problem, leading to death and disability. Although pertinent studies have been conducted, little data are available in Iran. This study explored the experiences of truck drivers and their perspectives regarding factors contributing to traffic accidents. Eighteen truck drivers, purposively sampled, participated in semi-structured interviews. Data were analyzed using qualitative content analysis. A main theme, lack of ability to control stress, emerged as a factor influencing the incidence of traffic accidents. This main theme was found to have three subthemes: poor organization of the job, lack of workplace facilities and proper equipment, and unsupportive environment. Although several factors were found to contribute to traffic accidents, their effects were not independent, and all were considered significant. Identifying factors that contribute to traffic accidents requires a systematic and holistic approach. Findings could be used by the transportation industry and community health centers to prevent traffic accidents. © 2015 The Author(s).

  14. Impact of environmental factors in home rehabilitation--a qualitative study from the perspective of older persons using the International Classification of Functioning, Disability and Health to describe facilitators and barriers.

    Science.gov (United States)

    Randström, Kerstin Björkman; Asplund, Kenneth; Svedlund, Marianne

    2012-01-01

    The aim of this study was to explore older people's experience of environmental factors that impact on their activity and participation in home rehabilitation. Older people aged between 68 and 93 years and receiving home rehabilitation were interviewed. A qualitative content analysis was performed on the interview text using the predetermined structure of the International Classification of Functioning, Disability and Health (ICF) environmental domain. The text was linked to the closest ICF category. The results identified environmental facilitators and barriers that influenced activity and participation among older people receiving home rehabilitation. Approaches that provided a facilitative environment were access to assistive products and technologies, alterations to the physical environment, social support and relationships, and adjusted health and social care services. A qualitative study using ICF-listed environmental factors contributed a holistic view of facilitators and barriers in home rehabilitation for older people. Awareness of the importance of the impact of the social environment on activities and participation could improve home rehabilitation services for older people. The study represents an important step towards a holistic approach using the ICF, which aims to enable all health care professionals to describe, plan and evaluate rehabilitation services together with older people across the health and social care sectors.

  15. Perspectives on healthy aging among Thai elderly: a qualitative study.

    Science.gov (United States)

    Thanakwang, Kattika; Soonthorndhada, Kusol; Mongkolprasoet, Jiraporn

    2012-12-01

    In this qualitative study, we provide an in-depth understanding of the views of healthy aging among Thai elderly and explore the ways that contribute to healthy aging. Data were collected using focus groups and in-depth interviews in four selected provinces of Thailand, and were analyzed using content analysis. The results revealed that Thai elderly described being healthy as the result of multiple components involving physical, mental, and social well-being. Healthy aging was viewed as an absence of serious diseases, having functional independence, a positive psycho-emotional outlook, and making a social contribution. The factors considered to contribute to healthy aging included activities promoting physical and psychological health, as well as active engagement in social activities. Understanding how the elderly define healthy aging and identifying the most important components and factors that contribute to being healthy provides insight into possible policy implications and interventions to promote health and well-being among Thai elderly. © 2012 Wiley Publishing Asia Pty Ltd.

  16. Northern perspectives on medical elective tourism: a qualitative study

    Science.gov (United States)

    Coke, Sarah; Kuper, Ayelet; Richardson, Lisa; Cameron, Anita

    2016-01-01

    Background: The Royal College of Physicians and Surgeons of Canada recognizes education to be necessary for doctors to provide culturally safe care. Communities in northern Canada have large populations of Aboriginal people and other marginalized groups. Our goal was to identify the elements of appropriate predeparture curricula for these medical trainees. Methods: We conducted our study in Kenora, Ontario. With the help of a core collaborative group and the support of the local Aboriginal Health Access Centre, we interviewed a purposive sample of community members about their interactions with trainees from southern Canada. Aboriginal and non-Aboriginal researchers with roots in northern and southern Canada brought perspectives to the inductive analysis. Results: We conducted 17 semistructured interviews between February and March 2014. Participants felt that southern trainees were inadequately educated in northern politics, society and history. They identified 2 more themes: determinants of health affecting the local Aboriginal population, and provider and patient factors affecting delivery of culturally competent care. Participants also shared ideas on how best to implement this content into curricula. Interpretation: Providing culturally competent care to northern communities is a complex process requiring education. Using a collaborative method, we were able to delineate the experiences of members of a northern community and identify knowledge gaps of southern trainees travelling there. Our results provide a foundation for the content and structure of formal predeparture curricula to enable such trainees to provide culturally safe care. PMID:27398374

  17. Northern perspectives on medical elective tourism: a qualitative study.

    Science.gov (United States)

    Coke, Sarah; Kuper, Ayelet; Richardson, Lisa; Cameron, Anita

    2016-01-01

    The Royal College of Physicians and Surgeons of Canada recognizes education to be necessary for doctors to provide culturally safe care. Communities in northern Canada have large populations of Aboriginal people and other marginalized groups. Our goal was to identify the elements of appropriate predeparture curricula for these medical trainees. We conducted our study in Kenora, Ontario. With the help of a core collaborative group and the support of the local Aboriginal Health Access Centre, we interviewed a purposive sample of community members about their interactions with trainees from southern Canada. Aboriginal and non-Aboriginal researchers with roots in northern and southern Canada brought perspectives to the inductive analysis. We conducted 17 semistructured interviews between February and March 2014. Participants felt that southern trainees were inadequately educated in northern politics, society and history. They identified 2 more themes: determinants of health affecting the local Aboriginal population, and provider and patient factors affecting delivery of culturally competent care. Participants also shared ideas on how best to implement this content into curricula. Providing culturally competent care to northern communities is a complex process requiring education. Using a collaborative method, we were able to delineate the experiences of members of a northern community and identify knowledge gaps of southern trainees travelling there. Our results provide a foundation for the content and structure of formal predeparture curricula to enable such trainees to provide culturally safe care.

  18. Achieving trustworthiness in qualitative research: a pan-paradigmatic perspective.

    Science.gov (United States)

    Williams, Elizabeth Nutt; Morrow, Susan L

    2009-07-01

    In this article, as two researchers from different traditions in qualitative research (consensual qualitative research and grounded theory), the authors present their shared views on the critical elements of trustworthiness in qualitative data. In addition to making specific recommendations about the integrity of data, the balance between participant meaning and researcher interpretation, and clear communication and application of the findings, they identify ways in which these issues are difficult to negotiate within and across different qualitative approaches. The authors present examples from various qualitative studies, emphasize the need for a shared language to reduce confusion between qualitative traditions and with researchers from a more strictly quantitative orientation, and recommend particular approaches to establishing trustworthiness in qualitative research.

  19. Community perceptions of tuberculosis: A qualitative exploration from a gender perspective.

    Science.gov (United States)

    Karim, F; Johansson, E; Diwan, V K; Kulane, A

    2011-02-01

    To explore community laypersons' perspective on tuberculosis (TB)-related illness experiences, meanings, behaviours and impact with reference to gender. Qualitative, conducted in rural Bangladesh. Eleven focus group discussions (FGDs) were conducted (six female and five male) in five subdistricts where the non-governmental organization BRAC operates. On average, seven purposively chosen poor, illiterate, non-TB patients participated in each FGD. Discussions were audiotaped, translated verbatim into English and analysed using MAXQDA software for qualitative data analysis, used it to assign codes to text segments to identify themes from participants' narratives. TB was recognized as a deadly disease that could affect anyone. The discussants were fairly aware of the psychological, financial and social impacts of TB. Women faced with adverse consequences more often than men, such as trouble in ongoing and prospective marital affairs. Coughing up sputum in public by women is culturally frowned upon, resulting in enormous suffering. Women tended to describe the clinical features more vaguely than men, and often specified fewer characteristic symptoms such as blood in sputum. The gender differences in the health and socio-economic impact of TB included perceived causality, curability, stigma, family and community support, fear of disclosure, and use of self-help or home remedies. Interactive health education covering various consequences of TB could be indispensable to changing negative beliefs. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. [Qualitative Research in Health Services Research - Discussion Paper, Part 3: Quality of Qualitative Research].

    Science.gov (United States)

    Stamer, M; Güthlin, C; Holmberg, C; Karbach, U; Patzelt, C; Meyer, T

    2015-12-01

    The third and final discussion paper of the German Network of Health Services Research's (DNVF) "Qualitative Methods Working Group" demonstrates methods for the evaluation and quality of qualitative research in health services research. In this paper we discuss approaches described in evaluating qualitative studies, including: an orientation to the general principles of empirical research, an approach-specific course of action, as well as procedures based on the research-process and criteria-oriented approaches. Divided into general and specific aspects to be considered in a qualitative study quality evaluation, the central focus of the discussion paper undertakes an extensive examination of the process and criteria-oriented approaches. The general aspects include the participation of relevant groups in the research process as well as ethical aspects of the research and data protection issues. The more specific aspects in evaluating the quality of qualitative research include considerations about the research interest, research questions, and the selection of data collection methods and types of analyses. The formulated questions are intended to guide reviewers and researchers to evaluate and to develop qualitative research projects appropriately. The intention of this discussion paper is to ensure a transparent research culture, and to reflect on and discuss the methodological and research approach of qualitative studies in health services research. With this paper we aim to initiate a discussion on high quality evaluation of qualitative health services research. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Type 2 diabetes patients' and providers' differing perspectives on medication nonadherence: a qualitative meta-synthesis.

    Science.gov (United States)

    Brundisini, Francesca; Vanstone, Meredith; Hulan, Danielle; DeJean, Deirdre; Giacomini, Mita

    2015-11-23

    Poor adherence to medication regimens increases adverse outcomes for patients with Type 2 diabetes. Improving medication adherence is a growing priority for clinicians and health care systems. We examine the differences between patient and provider understandings of barriers to medication adherence for Type 2 diabetes patients. We searched systematically for empirical qualitative studies on the topic of barriers to medication adherence among Type 2 diabetes patients published between 2002-2013; 86 empirical qualitative studies qualified for inclusion. Following qualitative meta-synthesis methods, we coded and analyzed thematically the findings from studies, integrating and comparing findings across studies to yield a synthetic interpretation and new insights from this body of research. We identify 7 categories of barriers: (1) emotional experiences as positive and negative motivators to adherence, (2) intentional non-compliance, (3) patient-provider relationship and communication, (4) information and knowledge, (5) medication administration, (6) social and cultural beliefs, and (7) financial issues. Patients and providers express different understandings of what patients require to improve adherence. Health beliefs, life context and lay understandings all inform patients' accounts. They describe barriers in terms of difficulties adapting medication regimens to their lifestyles and daily routines. In contrast, providers' understandings of patients poor medication adherence behaviors focus on patients' presumed needs for more information about the physiological and biomedical aspect of diabetes. This study highlights key discrepancies between patients' and providers' understandings of barriers to medication adherence. These misunderstandings span the many cultural and care contexts represented by 86 qualitative studies. Counseling and interventions aimed at improving medication adherence among Type 2 diabetes might become more effective through better integration of

  2. Methodology series module 10: Qualitative health research

    Directory of Open Access Journals (Sweden)

    Maninder Singh Setia

    2017-01-01

    Full Text Available Although quantitative designs are commonly used in clinical research, some studies require qualitative methods. These designs are different from quantitative methods; thus, researchers should be aware of data collection methods and analyses for qualitative research. Qualitative methods are particularly useful to understand patient experiences with the treatment or new methods of management or to explore issues in detail. These methods are useful in social and behavioral research. In qualitative research, often, the main focus is to understand the issue in detail rather than generalizability; thus, the sampling methods commonly used are purposive sampling; quota sampling; and snowball sampling (for hard to reach groups. Data can be collected using in-depth interviews (IDIs or focus group discussions (FGDs. IDI is a one-to-one interview with the participant. FGD is a method of group interview or discussion, in which more than one participant is interviewed at the same time and is usually led by a facilitator. The commonly used methods for data analysis are: thematic analysis; grounded theory analysis; and framework analysis. Qualitative data collection and analysis require special expertise. Hence, if the reader plans to conduct qualitative research, they should team up with a qualitative researcher.

  3. Methodology Series Module 10: Qualitative Health Research.

    Science.gov (United States)

    Setia, Maninder Singh

    2017-01-01

    Although quantitative designs are commonly used in clinical research, some studies require qualitative methods. These designs are different from quantitative methods; thus, researchers should be aware of data collection methods and analyses for qualitative research. Qualitative methods are particularly useful to understand patient experiences with the treatment or new methods of management or to explore issues in detail. These methods are useful in social and behavioral research. In qualitative research, often, the main focus is to understand the issue in detail rather than generalizability; thus, the sampling methods commonly used are purposive sampling; quota sampling; and snowball sampling (for hard to reach groups). Data can be collected using in-depth interviews (IDIs) or focus group discussions (FGDs). IDI is a one-to-one interview with the participant. FGD is a method of group interview or discussion, in which more than one participant is interviewed at the same time and is usually led by a facilitator. The commonly used methods for data analysis are: thematic analysis; grounded theory analysis; and framework analysis. Qualitative data collection and analysis require special expertise. Hence, if the reader plans to conduct qualitative research, they should team up with a qualitative researcher.

  4. [Qualitative research in health services research - discussion paper, Part 2: Qualitative research in health services research in Germany - an overview].

    Science.gov (United States)

    Karbach, U; Stamer, M; Holmberg, C; Güthlin, C; Patzelt, C; Meyer, T

    2012-08-01

    This is the second part of a 3-part discussion paper by the working group on "Qualitative Methods" in the German network of health services research (DNVF) that shall contribute to the development of a memorandum concerning qualitative health services research. It aims to depict the different types of qualitative research that are conducted in health services research in Germany. In addition, the authors present a specific set of qualitative data collection and analysis tools to demonstrate the potential of qualitative research for health services research. QUALITATIVE RESEARCH IN HEALTH SERVICES RESEARCH - AN OVERVIEW: To give an overview of the types of qualitative research conducted in German health services research, the abstracts of the 8th German Conference on Health Services Research were filtered to identify qualitative or mixed-methods studies. These were then analysed by looking at the context which was studied, who was studied, the aims of the studies, and what type of methods were used. Those methods that were mentioned most often for data collection and analysis are described in detail. QUALITATIVE RESEARCH AT THE CONFERENCE FOR HEALTH SERVICES RESEARCH 2009: Approximately a fifth of all abstracts (n=74) had a qualitative (n=47) or a mixed-methods approach combining quantitative and qualitative methods (n=27). Research aims included needs assessment (41%), survey development (36%), evaluation (22%), and theorizing (1%). Data collection mostly consisted of one-on-one interviews (n=45) and group discussions (n=29). Qualitative content analysis was named in 35 abstracts, 30 abstracts did not reference their method of analysis. In addition to a quantitative summary of the abstract findings, the diversity of fields addressed by qualitative methods is highlighted. Although drawing conclusions on the use of qualitative methods in German health services research from the analysis of conference abstracts is not possible, the overview we present demonstrates the

  5. Patient perspectives on care received at community acupuncture clinics: a qualitative thematic analysis.

    Science.gov (United States)

    Tippens, Kimberly M; Chao, Maria T; Connelly, Erin; Locke, Adrianna

    2013-10-29

    Community acupuncture is a recent innovation in acupuncture service delivery in the U.S. that aims to improve access to care through low-cost treatments in group-based settings. Patients at community acupuncture clinics represent a broader socioeconomic spectrum and receive more frequent treatments compared to acupuncture users nationwide. As a relatively new model of acupuncture in the U.S., little is known about the experiences of patients at community acupuncture clinics and whether quality of care is compromised through this high-volume model. The aim of this study was to assess patients' perspectives on the care received through community acupuncture clinics. The investigators conducted qualitative, thematic analysis of written comments from an observational, cross-sectional survey of clients of the Working Class Acupuncture clinics in Portland, Oregon. The survey included an open-ended question for respondents to share comments about their experiences with community acupuncture. Comments were received from 265 community acupuncture patients. Qualitative analysis of written comments identified two primary themes that elucidate patients' perspectives on quality of care: 1) aspects of health care delivery unique to community acupuncture, and 2) patient engagement in health care. Patients identified unique aspects of community acupuncture, including structures that facilitate access, processes that make treatments more comfortable and effective and holistic outcomes including physical improvements, enhanced quality of life, and empowerment. The group setting, community-based locations, and low cost were highlighted as aspects of this model that allow patients to access acupuncture. Patients' perspectives on the values and experiences unique to community acupuncture offer insights on the quality of care received in these settings. The group setting, community-based locations, and low cost of this model potentially reduce access barriers for those who might not

  6. Qualitative and mixed methods in mental health services and implementation research.

    Science.gov (United States)

    Palinkas, Lawrence A

    2014-01-01

    Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This article reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the articles included in this special series along with representative examples from the literature. Qualitative methods are used to provide a "thick description" or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods but often differ with respect to study design, data collection, and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semistructured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed-method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research.

  7. Qualitative description - the poor cousin of health research?

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Andersen, Rikke Sand

    2009-01-01

    ', relatives' or professionals' experiences with a particular topic. Another great advantage of the method is that it is suitable if time or resources are limited. SUMMARY: As a consequence of the growth in qualitative research in the health sciences, researchers sometimes feel obliged to designate their work......BACKGROUND: The knowledge and use of qualitative description as a qualitative research approach in health services research is limited.The aim of this article is to discuss the potential benefits of a qualitative descriptive approach, to identify its strengths and weaknesses and to provide examples...... of use. DISCUSSION: Qualitative description is a useful qualitative method in much medical research if you keep the limitations of the approach in mind. It is especially relevant in mixed method research, in questionnaire development and in research projects aiming to gain firsthand knowledge of patients...

  8. Women's experiences of Takotsubo cardiomyopathy in a short-term perspective--a qualitative content analysis.

    Science.gov (United States)

    Dahlviken, Rønnaug M; Fridlund, Bengt; Mathisen, Lars

    2015-06-01

    Takotsubo cardiomyopathy is a reversible condition mimicking acute myocardial infarction. The phenomenon is associated with emotional and physical stressful trigger events. Evidence-based patient counselling should be based on disease-specific knowledge of patient experiences. The aim of the study was to describe women's experiences of Takotsubo cardiomyopathy in a short-term perspective. The study design was explorative and descriptive. Semi-structured interviews were conducted with 14 women diagnosed with Takotsubo cardiomyopathy, 1 day to 9 months after hospitalisation. The transcriptions underwent qualitative content analysis. The main theme that emerged was Takotsubo cardiomyopathy as a continuous process of making sense and adapting. To begin with, understanding and coping with signs and symptoms were described as having a diversity of signs and symptoms, taking actions towards signs and symptoms, receiving treatment for suspected ST/non ST-elevation myocardial infarction diagnosis and finally being diagnosed with Takotsubo cardiomyopathy. Understanding the context of illness was expressed as getting treated for Takotsubo cardiomyopathy diagnosis and having previous stressful conditions of life. The changing perspective that emanated was a combination of having prospects and expectations and experiencing limitations. Finally, managing to live with Takotsubo cardiomyopathy was manifested as returning home with the illness and receiving follow-up health care. Information on regaining prior health status and capacity within a short-term perspective may not be accurate. These women struggle and require education and counselling from healthcare professionals to comprehend and manage having a Takotsubo cardiomyopathy diagnosis. Women experiencing Takotsubo cardiomyopathy may be a target group for holistic and individual health care with a longer duration of follow-up. © 2014 Nordic College of Caring Science.

  9. Ethical Perspectives on Qualitative Research in Applied Psychology

    Science.gov (United States)

    Haverkamp, Beth E.

    2005-01-01

    The present article explores ethical issues that emerge in qualitative research conducted by applied psychologists. The utility and relevance of the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2002) for qualitative research are examined. The importance of psychology's fiduciary relationship with…

  10. The failure of suicide prevention in primary care: family and GP perspectives - a qualitative study.

    Science.gov (United States)

    Leavey, Gerard; Mallon, Sharon; Rondon-Sulbaran, Janeet; Galway, Karen; Rosato, Michael; Hughes, Lynette

    2017-11-21

    Although Primary care is crucial for suicide prevention, clinicians tend to report completed suicides in their care as non-preventable. We aimed to examine systemic inadequacies in suicide prevention from the perspectives of bereaved family members and GPs. Qualitative study of 72 relatives or close friends bereaved by suicide and 19 General Practitioners who have experienced the suicide of patients. Relatives highlight failures in detecting symptoms and behavioral changes and the inability of GPs to understand the needs of patients and their social contexts. A perceived overreliance on anti-depressant treatment is a major source of criticism by family members. GPs tend to lack confidence in the recognition and management of suicidal patients, and report structural inadequacies in service provision. Mental health and primary care services must find innovative and ethical ways to involve families in the decision-making process for patients at risk of suicide.

  11. Qualitative Research in PBL in Health Sciences Education: A Review

    Science.gov (United States)

    Jin, Jun; Bridges, Susan

    2016-01-01

    Context: Qualitative methodologies are relatively new in health sciences education research, especially in the area of problem-based learning (PBL). A key advantage of qualitative approaches is the ability to gain in-depth, textured insights into educational phenomena. Key methodological issues arise, however, in terms of the strategies of…

  12. A Call for Critical Perspectives in Qualitative Research

    Directory of Open Access Journals (Sweden)

    Rainer Winter

    2010-11-01

    Full Text Available The formation of critical poststructuralism in the United States has fundamentally transformed qualitative research. The crisis of representation first discussed in anthropology has had the effect of rethinking the foundations of qualitative research by putting ethical questions on the agenda and stimulating a search for new forms of validity. Against this backdrop, this study will analyze different methods and research strategies in critical qualitative inquiry, such as interpretive interactionism, autoethnography, and performance ethnography. The call to action inherent in these strategies and further contributions to cultural and social change will be discussed. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs110171

  13. Determinants of Early Marriage from Married Girls’ Perspectives in Iranian Setting: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Simin Montazeri

    2016-01-01

    Full Text Available Early marriage is a worldwide problem associated with a range of health and social consequences for teenage girls. Designing effective health interventions for managing early marriage needs to apply the community-based approaches. However, it has received less attention from policymakers and health researchers in Iran. Therefore, the current study aimed to explore determinants of early marriage from married girls’ perspectives. The study was conducted from May 2013 to January 2015 in Ahvaz, Iran. A purposeful sampling method was used to select fifteen eligible participants. Data were collected through face-to-face, semistructured interviews and were analyzed using the conventional content analysis approach. Three categories emerged from the qualitative data including “family structure,” “Low autonomy in decision-making,” and “response to needs.” According to the results, although the participants were not ready to get married and intended to postpone their marriage, multiple factors such as individual and contextual factors propelled them to early marriage. Given that early marriage is a multifactorial problem, health care providers should consider a multidimensional approach to support and empower these vulnerable girls.

  14. Patients' perspectives on statin therapy for treatment of hypercholesterolaemia: a qualitative study.

    Science.gov (United States)

    Tolmie, Elizabeth P; Lindsay, Grace M; Kerr, Susan M; Brown, Malcom R; Ford, Ian; Gaw, Allan

    2003-07-01

    Health Care Practitioners' attempts to implement secondary prevention targets for coronary heart disease (CHD) may be restricted by low rates of persistence with statin therapy. There is a need to understand why some patients, despite having established CHD and elevated cholesterol, do not comply with their prescribed statin regimen. To explore patients' perspectives on compliance with statin therapy. Primary care, West of Scotland. The research approach was qualitative. Thirty-three patients prescribed statin therapy and identified as having different patterns of compliance (poor moderate and good) were interviewed. The in-depth interviews were conducted on a one to one basis. Patients prescribed statin therapy for less than three months were excluded. Data were analysed thematically with the assistance of QSR Nudist. From analysis of the narrative data, two broad categories, i.e. 'Patient-health care provider communication' and 'Health beliefs' were identified. These categories encompassed six main themes: 'Initiation of therapy'; 'Subsequent feedback'; 'Sources of misconceptions'; 'Unconditional acceptance'; 'Conditional acceptance'; 'Deferment and Rejection'. Acceptance of and compliance with statin therapy appeared to be associated with the provision, interpretation and feedback of information during patient-practitioner consultations, and patients' beliefs about personal health status, cholesterol, and recommended cholesterol-lowering strategies. Patients' beliefs and understanding about cholesterol, and the role of cholesterol modifying strategies should be determined prior to the initiation of therapy and at appropriate intervals thereafter.

  15. Determinants of Early Marriage from Married Girls' Perspectives in Iranian Setting: A Qualitative Study.

    Science.gov (United States)

    Montazeri, Simin; Gharacheh, Maryam; Mohammadi, Nooredin; Alaghband Rad, Javad; Eftekhar Ardabili, Hassan

    2016-01-01

    Early marriage is a worldwide problem associated with a range of health and social consequences for teenage girls. Designing effective health interventions for managing early marriage needs to apply the community-based approaches. However, it has received less attention from policymakers and health researchers in Iran. Therefore, the current study aimed to explore determinants of early marriage from married girls' perspectives. The study was conducted from May 2013 to January 2015 in Ahvaz, Iran. A purposeful sampling method was used to select fifteen eligible participants. Data were collected through face-to-face, semistructured interviews and were analyzed using the conventional content analysis approach. Three categories emerged from the qualitative data including "family structure," "Low autonomy in decision-making," and "response to needs." According to the results, although the participants were not ready to get married and intended to postpone their marriage, multiple factors such as individual and contextual factors propelled them to early marriage. Given that early marriage is a multifactorial problem, health care providers should consider a multidimensional approach to support and empower these vulnerable girls.

  16. ‘You try to play a role in her pregnancy’ - a qualitative study on recent fathers’ perspectives about childbearing and encounter with the maternal health system in Kigali, Rwanda

    Directory of Open Access Journals (Sweden)

    Jessica Påfs

    2016-08-01

    Full Text Available Background: Rwanda has raised gender equality on the political agenda and is, among other things, striving for involving men in reproductive health matters. With these structural changes taking place, traditional gender norms in this setting are challenged. Deeper understanding is needed of men's perceptions about their gendered roles in the maternal health system. Objective: To explore recent fathers’ perspectives about their roles during childbearing and maternal care-seeking within the context of Rwanda's political agenda for gender equality. Design: Semi-structured interviews were conducted with 32 men in Kigali, Rwanda, between March 2013 and April 2014. A framework of naturalistic inquiry guided the overall study design and analysis. In order to conceptualize male involvement and understand any gendered social mechanisms, the analysis is inspired by the central principles from relational gender theory. Results: The participants in this study appeared to disrupt traditional masculinities and presented ideals of an engaged and caring partner during pregnancy and maternal care-seeking. They wished to carry responsibilities beyond the traditional aspects of being the financial provider. They also demonstrated willingness to negotiate their involvement according to their partners’ wishes, external expectations, and perceived cultural norms. While the men perceived themselves as obliged to accompany their partner at first antenatal care (ANC visit, they experienced several points of resistance from the maternal health system for becoming further engaged. Conclusions: These men perceived both maternal health system policy and care providers as resistant toward their increased engagement in childbearing. Importantly, perceiving themselves as estranged may consequently limit their engagement with the expectant partner. Our findings therefore recommend maternity care to be more responsive to male partners. Given the number of men already taking

  17. Recovery in Psychosis from a Service User Perspective: A Systematic Review and Thematic Synthesis of Current Qualitative Evidence.

    Science.gov (United States)

    Wood, L; Alsawy, S

    2017-11-29

    There is a growing number of qualitative accounts regarding recovery from psychosis from a service user perspective. The aim of this study was to conduct a systematic review of these qualitative accounts. A thematic synthesis was utilised to synthesise and analyse seventeen studies included in the review. Studies were included if they used a qualitative methodology to explore service users' experiences of recovery from psychosis as a primary research question. All included studies were subjected to a quality assessment. The analysis outlined three subordinate themes: the recovery journey, facilitators of recovery (e.g. faith and spirituality, personal agency and hope), and barriers to recovery (e.g. stigma and discrimination, negative effects of mental health services and medication). Recovery is an idiosyncratic process but includes key components which are important to people who experience psychosis. These should be explored within clinical practice.

  18. Perspectives of unemployed workers with mental health problems: barriers to and solutions for return to work

    NARCIS (Netherlands)

    Audhoe, Selwin S.; Nieuwenhuijsen, Karen; Hoving, Jan L.; Sluiter, Judith K.; Frings-Dresen, Monique H. W.

    2018-01-01

    To evaluate the barriers to and solutions for return to work (RTW) from the perspective of unemployed workers who were sick-listed due to mental health problems. We conducted semi-structured interviews with 25 sick-listed unemployed workers with mental health problems. Qualitative data analysis was

  19. Improving employee well-being through worksite health promotion? The employees' perspective

    OpenAIRE

    Nöhammer , Elisabeth; Stummer , Harald; Schusterschitz , Claudia

    2010-01-01

    Abstract Aim The aim of the present study was to investigate the potential of worksite health promotion to improve individual well-being from the employees? perspective, analyze benefit categories and develop suggestions for future worksite health promotion program designs. Subjects and methods A questionnaire based on a qualitative study was distributed in four Austrian organizations to cover state-owned,...

  20. The Reviews Are in: A Qualitative Content Analysis of Consumer Perspectives on Apps for Bipolar Disorder

    Science.gov (United States)

    Fogarty, Andrea S; Boydell, Katherine; Christensen, Helen

    2017-01-01

    Background The delivery of mobile health (mHealth) services is acceptable to mental health consumers. However, despite the benefits of accessibility, cost-effectiveness, anonymity, and ability to tailor content to individual needs, consumer engagement remains a hurdle for uptake and continued use. This may be unsurprising as few studies have examined app content from the consumer perspective or assessed consumer preferences for the content of apps for mental health management. An opportunity to examine consumer perspectives exists in using naturally generated data that is publically available in the Google Play and Apple app stores. Whereas commercial developers routinely use this data, to date there has been no in-depth evaluation within scientific research. Objective The aim of our study was to explore what consumers consider useful content for mental health management apps, identify unmet needs, and understand user expectations of mental health apps within the context of apps for bipolar disorder. Methods Publically available English language consumer reviews of 48 apps for bipolar disorder were used as data, providing a total of 2173 reviews. Review text was coded and analyzed using a team approach to qualitative content analysis. Results were presented in 2 forms: (1) a quantitative summary of the 9 major and minor themes and (2) a qualitative synthesis of key thematic findings. Results The majority of reviews were for symptom monitoring apps (87.94%, 1911/2173). The qualitative content analysis revealed 5 main themes: (1) laudatory talk, comments regarding the app’s benefits including helpfulness and successful design features (74.00% of reviews, 1608/2173); (2) unfavorable feedback, negative reviews largely concerning unmet needs, privacy and technical issues, and potential dangers of app use (25.54%, 555/2173); (3) conceptions of community, referring to both communities of users with mental ill-health accessed via the app and a community created among app

  1. The Reviews Are in: A Qualitative Content Analysis of Consumer Perspectives on Apps for Bipolar Disorder.

    Science.gov (United States)

    Nicholas, Jennifer; Fogarty, Andrea S; Boydell, Katherine; Christensen, Helen

    2017-04-07

    The delivery of mobile health (mHealth) services is acceptable to mental health consumers. However, despite the benefits of accessibility, cost-effectiveness, anonymity, and ability to tailor content to individual needs, consumer engagement remains a hurdle for uptake and continued use. This may be unsurprising as few studies have examined app content from the consumer perspective or assessed consumer preferences for the content of apps for mental health management. An opportunity to examine consumer perspectives exists in using naturally generated data that is publically available in the Google Play and Apple app stores. Whereas commercial developers routinely use this data, to date there has been no in-depth evaluation within scientific research. The aim of our study was to explore what consumers consider useful content for mental health management apps, identify unmet needs, and understand user expectations of mental health apps within the context of apps for bipolar disorder. Publically available English language consumer reviews of 48 apps for bipolar disorder were used as data, providing a total of 2173 reviews. Review text was coded and analyzed using a team approach to qualitative content analysis. Results were presented in 2 forms: (1) a quantitative summary of the 9 major and minor themes and (2) a qualitative synthesis of key thematic findings. The majority of reviews were for symptom monitoring apps (87.94%, 1911/2173). The qualitative content analysis revealed 5 main themes: (1) laudatory talk, comments regarding the app's benefits including helpfulness and successful design features (74.00% of reviews, 1608/2173); (2) unfavorable feedback, negative reviews largely concerning unmet needs, privacy and technical issues, and potential dangers of app use (25.54%, 555/2173); (3) conceptions of community, referring to both communities of users with mental ill-health accessed via the app and a community created among app users and developers (24.25%, 527

  2. Health and environment: social science perspectives

    NARCIS (Netherlands)

    Kopnina, H.; Keune, H.

    2010-01-01

    In this new book the authors examine the contribution of social scientists to the topics of health and environment. They present diverse perspectives on classical and contemporary debates by focusing on social scientific framing of environment and health, as well as on the potential contribution of

  3. Ethical issues in the reuse of qualitative data: perspectives from literature, practice, and participants.

    Science.gov (United States)

    Yardley, Sarah J; Watts, Kate M; Pearson, Jennifer; Richardson, Jane C

    2014-01-01

    In this article, we explore ethical issues in qualitative secondary analysis through a comparison of the literature with practitioner and participant perspectives. To achieve this, we integrated critical narrative review findings with data from two discussion groups: qualitative researchers and research users/consumers. In the literature, we found that theoretical debate ran parallel to practical action rather than being integrated with it. We identified an important and novel theme of relationships that was emerging from the perspectives of researchers and users. Relationships were significant with respect to trust, sharing data, transparency and clarity, anonymity, permissions, and responsibility. We provide an example of practice development that we hope will prompt researchers to re-examine the issues in their own setting. Informing the research community of research practitioner and user perspectives on ethical issues in the reuse of qualitative data is the first step toward developing mechanisms to better integrate theoretical and empirical work.

  4. Where does good quality qualitative health care research get published?

    Science.gov (United States)

    Richardson, Jane C; Liddle, Jennifer

    2017-09-01

    This short report aims to give some insight into current publication patterns for high-quality qualitative health research, using the Research Excellence Framework (REF) 2014 database. We explored patterns of publication by range and type of journal, by date and by methodological focus. We also looked at variations between the publications submitted to different Units of Assessment, focussing particularly on the one most closely aligned with our own research area of primary care. Our brief analysis demonstrates that general medical/health journals with high impact factors are the dominant routes of publication, but there is variation according to the methodological approach adopted by articles. The number of qualitative health articles submitted to REF 2014 overall was small, and even more so for articles based on mixed methods research, qualitative methodology or reviews/syntheses that included qualitative articles.

  5. Judicialization of Health: A Perspective of Effectiveness

    Directory of Open Access Journals (Sweden)

    Claudia Mota Estabel

    2015-12-01

    Full Text Available This work is scoped to synthesize the legalization of the right to health, and offer a perspective for shaping effectiveness. Using the inductive method and based on research literature and case law, at first a brief history of the right to health will be presented as well as some of the principles relating to fundamental precept. Per second, from a normative and jurisprudential approach, the right will be presented to health in the judiciary perspective, focused on the instruments already used (court decisions, the number of demands that concern the health issue, and public policies adopted by the judiciary both in its own sphere as administratively. Finally, emphasis shall be the various issues in the legal health procedure regarding the joint responsibility of federal entities and guidelines for proper conformation of the right to health, the effect of promoting citizenship and social justice.

  6. Understanding Preschool Teachers' Perspectives on Empathy: A Qualitative Inquiry

    Science.gov (United States)

    Peck, Nancy Farstad; Maude, Susan P.; Brotherson, Mary Jane

    2015-01-01

    Empathy is a trait and skill necessary for teachers working with children and for partnering with families. This qualitative study focused on how teachers expressed empathy in the context of early childhood education. Diversity has increased in the United States and as diversity increases, the need for teachers to be able to empathize with…

  7. Accelerating transition dynamics in city regions: A qualitative modeling perspective

    NARCIS (Netherlands)

    P.J. Valkering (Pieter); Yücel, G. (Gönenç); Gebetsroither-Geringer, E. (Ernst); Markvica, K. (Karin); Meynaerts, E. (Erika); N. Frantzeskaki (Niki)

    2017-01-01

    textabstractIn this article, we take stock of the findings from conceptual and empirical work on the role of transition initiatives for accelerating transitions as input for modeling acceleration dynamics. We applied the qualitative modeling approach of causal loop diagrams to capture the dynamics

  8. Disadvantaged Former Miners' Perspectives on Smoking Cessation: A Qualitative Study

    Science.gov (United States)

    White, Simon; Baird, Wendy

    2013-01-01

    Objective: To explore disadvantaged former miners' perspectives in north Derbyshire, United Kingdom (UK) on smoking and smoking cessation. Methods: In-depth, audiotaped interviews with 16 disadvantaged former miners who smoked or had stopped smoking within six months. Results: Perceptions of being able to stop smoking with minimal difficulty and…

  9. Perspectives on cervical cancer screening among educated Muslim women in Dubai (the UAE): a qualitative study.

    Science.gov (United States)

    Khan, Sarah; Woolhead, Gillian

    2015-10-24

    Cervical cancer (CC) is the seventh leading cause of death among women in the United Arab Emirates (UAE), with most deaths attributed to late detection of this cancer. The UAE lacks a national CC screening programme. Thus, cervical screening is only performed opportunistically during women's visits to health facilities. CC screening rates in the UAE are as low as 16.9 %, and little is known about the perspectives of the nation's educated Muslim women regarding screening. Consequently, the aim of this study is to explore Muslim women's perspectives towards cervical screening in Dubai to promote strategies for increasing its uptake, thereby leading to a decrease in morbidity and mortality associated with CC. Interpretivist and social constructivist epistemological approaches were applied for this qualitative study. Data were obtained through 13 in-depth interviews. Purposive and snowballing methods were used to recruit six South Asian women and seven Emirati women living in Dubai. Thematic content analysis was concurrently applied with comparative analysis to the data. Four themes regarding women's perceptions of CC emerged from the data. First, CC was considered a 'silent disease' that could be detected with early screening. However, it was also associated with extramarital sexual relations, which negatively influenced screening uptake. Second, women's fear, pain and embarrassment, along with cultural influences, deterred them from undergoing screening. Third, a growing mistrust of allopathic medicine and impersonal healthcare promoted a negative view of screening. Last, women became aware of screening mainly when they were pregnant or receiving fertility treatment. The study highlighted a number of important factors relating to cultural, religious and sexual behaviour that shaped educated Muslim women's perspectives on CC screening. Evidently, the current opportunistic approach to screening is flawed. A national awareness programme on CC screening should be

  10. Mexico: perspectives in school health.

    Science.gov (United States)

    Allensworth, D M; Greene, A G

    1990-09-01

    The school health program in Mexico, directed by the Office of School Hygiene (la Unidad de Higiene Escolar), is in a state of flux. The program will change substantially if an initiative between the national offices of health and education is enacted. The initiative would establish a national commission to be replicated at state, county, and district levels. Commissions would oversee integration of the health services component, social participation, and research into the school health program which currently only focuses on health instruction and a healthy school environment. The initiative would restore and improve a former model that incorporated health services as a part of the school health program. The history of the school health program, which can trace its roots to 1861 and President Benito Juarez, is provided.

  11. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    .... What contributes to this deterioration, and how can its effects be mitigated? Engendering Migrant Health brings together researchers from across Canada to address the intersections of gender, immigration, and health in the lives of new Canadians...

  12. Public Health Perspectives on Aquaculture.

    Science.gov (United States)

    Gormaz, Juan G; Fry, Jillian P; Erazo, Marcia; Love, David C

    2014-01-01

    Nearly half of all seafood consumed globally comes from aquaculture, a method of food production that has expanded rapidly in recent years. Increasing seafood consumption has been proposed as part of a strategy to combat the current non-communicable disease (NCD) pandemic, but public health, environmental, social, and production challenges related to certain types of aquaculture production must be addressed. Resolving these complicated human health and ecologic trade-offs requires systems thinking and collaboration across many fields; the One Health concept is an integrative approach that brings veterinary and human health experts together to combat zoonotic disease. We propose applying and expanding the One Health approach to facilitate collaboration among stakeholders focused on increasing consumption of seafood and expanding aquaculture production, using methods that minimize risks to public health, animal health, and ecology. This expanded application of One Health may also have relevance to other complex systems with similar trade-offs.

  13. Critical perspectives in public health

    National Research Council Canada - National Science Library

    Green, Judith; Labonte, Ronald N

    2008-01-01

    ... the contemporary roles of 'critical voices' in public health research and practice from a range of disciplines and contexts. The book covers many of the pressing concerns for public health practitioners and researchers, including: * * * * * the implications of new genetic technologies for public health; the impact of globalisation on local practice...

  14. Chile: perspectives in school health.

    Science.gov (United States)

    Langdon, M C; Gazmuri, C; Venegas, L

    1990-09-01

    The leading health problems of children and adolescents in Chile is reviewed. The Chilean educational system and how the system addresses its principal health problems are described. A school health program is described as well as other educational programs designed and developed by nongovernmental institutions which have a smaller coverage. Current research studies regarding growth and development, child morbidity, nutritional level, and mental health studies are reviewed. In addition, principal challenges that include developing more efficient ways of referring children, enriching the curriculum and teacher training, assigning school hours for health teachers, and enlarging coverage of the health care evaluation programs are outlined. Of special importance is developing prevention programs for parents and children using school and community leaders to prevent health problems in areas such as human sexuality education, decision-making, social abilities, and alcohol and drug abuse. Main efforts should be directed toward low-income families and children to improve life conditions.

  15. Conducting qualitative research in mental health: Thematic and content analyses.

    Science.gov (United States)

    Crowe, Marie; Inder, Maree; Porter, Richard

    2015-07-01

    The objective of this paper is to describe two methods of qualitative analysis - thematic analysis and content analysis - and to examine their use in a mental health context. A description of the processes of thematic analysis and content analysis is provided. These processes are then illustrated by conducting two analyses of the same qualitative data. Transcripts of qualitative interviews are analysed using each method to illustrate these processes. The illustration of the processes highlights the different outcomes from the same set of data. Thematic and content analyses are qualitative methods that serve different research purposes. Thematic analysis provides an interpretation of participants' meanings, while content analysis is a direct representation of participants' responses. These methods provide two ways of understanding meanings and experiences and provide important knowledge in a mental health context. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  16. Information in mental health: qualitative study of mental health service users

    OpenAIRE

    Powell, John; Clarke, Aileen

    2006-01-01

    Background  Despite the widespread proliferation of consumer health information provision, little is known about information needs or information‐seeking behaviour in mental health. A qualitative study was therefore undertaken to explore these issues for mental health service users.

  17. Qualitative research with children : the perspectives of elite researchers

    OpenAIRE

    Smith, Carmel A.

    2011-01-01

    This quantative study investigates the ways in which leading children’s researchers position themselves in their research relationships with children in qualitative research within psychology and the broader ‘childhood studies’ paradigm. Against the backdrop of the continuing prevalence of a positivist-empiricist approach within psychology, the conceptual focus of the present study is rooted in the multiple challenges to developmental psychology in recent decades, from within and outside the ...

  18. Work organization, health, and obesity in urban transit operators: A qualitative study.

    Science.gov (United States)

    Dobson, Marnie; Choi, BongKyoo; Schnall, Peter L

    2017-11-01

    Urban transit operators have high rates of obesity, hypertension, and other cardiovascular risk-factors compared to other occupations. There have been few qualitative studies exploring the interrelationships between the organization of transit work, stress, and health including obesity, from the perspective of operators. Five focus groups were conducted at five Divisions in a transit authority in Southern California and included 65 bus and rail operators. Operators reported a great deal of stress related to their work, including 1) time pressures and lack of recovery time; 2) long work shifts and overtime; 3) feeling unsafe when dealing with the public; 4) lack of respect from supervisors and management. Operators believed stressful working conditions negatively impacted their health and weight. This qualitative study yielded new as well as confirmatory data about stress and transit work organization, health, and weight in operators. This study will add to future survey research and interventions in this population. © 2017 Wiley Periodicals, Inc.

  19. Qualitative description – the poor cousin of health research?

    Science.gov (United States)

    2009-01-01

    Background The knowledge and use of qualitative description as a qualitative research approach in health services research is limited. The aim of this article is to discuss the potential benefits of a qualitative descriptive approach, to identify its strengths and weaknesses and to provide examples of use. Discussion Qualitative description is a useful qualitative method in much medical research if you keep the limitations of the approach in mind. It is especially relevant in mixed method research, in questionnaire development and in research projects aiming to gain firsthand knowledge of patients', relatives' or professionals' experiences with a particular topic. Another great advantage of the method is that it is suitable if time or resources are limited. Summary As a consequence of the growth in qualitative research in the health sciences, researchers sometimes feel obliged to designate their work as phenomenology, grounded theory, ethnography or a narrative study when in fact it is not. Qualitative description might be a useful alternative approach to consider. PMID:19607668

  20. Full-Range Public Health Leadership, Part 2: Qualitative Analysis and Synthesis

    Science.gov (United States)

    Carlton, Erik L.; Holsinger, James W.; Riddell, Martha C.; Bush, Heather

    2015-01-01

    Public health leadership is an important topic in the era of U.S. health reform, population health innovation, and health system transformation. This study utilized the full-range leadership model in order to examine the public health leadership. We sought to understand local public health leadership from the perspective of local health department leaders and those who work with and for them. Public health leadership was explored through interviews and focus groups with directors (n = 4) and staff (n = 33) from local health departments. Qualitative analytic methods included reflexive journals, code-recode procedures, and member checking, with analysis facilitated by Atlas.ti v.6.0. Qualitative results supported and expanded upon previously reported quantitative findings. Leading by example and providing individual consideration to followers were found to be more important than other leader factors, such as intellectual stimulation, inspirational motivation, or idealized attributes of leaders. Having a clear and competent vision of public health, being able to work collaboratively with other community agencies, and addressing the current challenges to public health with creativity and innovation were also important findings. Idealized leadership behaviors and individual consideration should be the focus of student and professional development. Models that incorporate contextual considerations, such as the situational leadership model, could be utilized to ensure that optimal individual consideration is given to followers. PMID:26217654

  1. Full-Range Public Health Leadership, Part 2: Qualitative Analysis and Synthesis.

    Science.gov (United States)

    Carlton, Erik L; Holsinger, James W; Riddell, Martha C; Bush, Heather

    2015-01-01

    Public health leadership is an important topic in the era of U.S. health reform, population health innovation, and health system transformation. This study utilized the full-range leadership model in order to examine the public health leadership. We sought to understand local public health leadership from the perspective of local health department leaders and those who work with and for them. Public health leadership was explored through interviews and focus groups with directors (n = 4) and staff (n = 33) from local health departments. Qualitative analytic methods included reflexive journals, code-recode procedures, and member checking, with analysis facilitated by Atlas.ti v.6.0. Qualitative results supported and expanded upon previously reported quantitative findings. Leading by example and providing individual consideration to followers were found to be more important than other leader factors, such as intellectual stimulation, inspirational motivation, or idealized attributes of leaders. Having a clear and competent vision of public health, being able to work collaboratively with other community agencies, and addressing the current challenges to public health with creativity and innovation were also important findings. Idealized leadership behaviors and individual consideration should be the focus of student and professional development. Models that incorporate contextual considerations, such as the situational leadership model, could be utilized to ensure that optimal individual consideration is given to followers.

  2. Disaster Management: Mental Health Perspective.

    Science.gov (United States)

    Math, Suresh Bada; Nirmala, Maria Christine; Moirangthem, Sydney; Kumar, Naveen C

    2015-01-01

    Disaster mental health is based on the principles of 'preventive medicine' This principle has necessitated a paradigm shift from relief centered post-disaster management to a holistic, multi-dimensional integrated community approach of health promotion, disaster prevention, preparedness and mitigation. This has ignited the paradigm shift from curative to preventive aspects of disaster management. This can be understood on the basis of six 'R's such as Readiness (Preparedness), Response (Immediate action), Relief (Sustained rescue work), Rehabilitation (Long term remedial measures using community resources), Recovery (Returning to normalcy) and Resilience (Fostering). Prevalence of mental health problems in disaster affected population is found to be higher by two to three times than that of the general population. Along with the diagnosable mental disorders, affected community also harbours large number of sub-syndromal symptoms. Majority of the acute phase reactions and disorders are self-limiting, whereas long-term phase disorders require assistance from mental health professionals. Role of psychotropic medication is very limited in preventing mental health morbidity. The role of cognitive behaviour therapy (CBT) in mitigating the mental health morbidity appears to be promising. Role of Psychological First Aid (PFA) and debriefing is not well-established. Disaster management is a continuous and integrated cyclical process of planning, organising, coordinating and implementing measures to prevent and to manage disaster effectively. Thus, now it is time to integrate public health principles into disaster mental health.

  3. Adolescents' Perspectives on the Barriers and Facilitators of Physical Activity: A Systematic Review of Qualitative Studies

    Science.gov (United States)

    Martins, João; Marques, Adilson; Sarmento, Hugo; Carreiro da Costa, Francisco

    2015-01-01

    This article examined qualitative studies of adolescents' perspectives about the facilitators and barriers of physical activity, published from 2007 to 2014. A systematic review of "Web of Science", "EBSCO", "Psychinfo" and "ERIC" databases was performed according to Preferred Reporting Items for Systematic…

  4. Perspectives of Students with Disabilities toward Physical Education: A Qualitative Inquiry Review

    Science.gov (United States)

    Haegele, Justin A.; Sutherland, Sue

    2015-01-01

    The purpose of this article is to review published qualitative inquiries that examine the perspective of students with disabilities toward experiences in physical education. Keyword searches were used to identify articles from electronic databases published from 1995 to 2014. Thirteen articles met all inclusion criteria, and findings were…

  5. Understanding Special Olympics Experiences from the Athlete Perspectives Using Photo-Elicitation: A Qualitative Study

    Science.gov (United States)

    Weiss, Jonathan A.; Burnham Riosa, Priscilla; Robinson, Suzanne; Ryan, Stephanie; Tint, Ami; Viecili, Michelle; MacMullin, Jennifer A.; Shine, Rebecca

    2017-01-01

    Background: Many individuals with intellectual disabilities experience challenges to participating in organized sport, despite its known benefits. The aim of this qualitative study was to understand the experiences of participating in sport (Special Olympics) from the perspectives of athletes with intellectual disabilities. Methods: Five…

  6. Tourette's Syndrome and the School Experience: A Qualitative Study of Children's and Parents' Perspectives

    Science.gov (United States)

    Grace, Rebekah; Russell, Cherry

    2005-01-01

    This article reports on research exploring the school experiences of 26 children (aged between 8 and 15.5 years) diagnosed with Tourette's Syndrome. The research adopted a qualitative methodology, and is reported here from the perspective of both the parents and the children themselves. Three different groups of families emerged: those who were…

  7. Youth experiences of transition from child mental health services to adult mental health services: a qualitative thematic synthesis.

    Science.gov (United States)

    Broad, Kathleen L; Sandhu, Vijay K; Sunderji, Nadiya; Charach, Alice

    2017-11-28

    Adolescence and young adulthood is a vulnerable time during which young people experience many development milestones, as well as an increased incidence of mental illness. During this time, youth also transition between Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). This transition puts many youth at risk of disengagement from service use; however, our understanding of this transition from the perspective of youth is limited. This systematic review aims to provide a more comprehensive understanding of youth experiences of transition from CAMHS to AMHS, through a qualitative thematic synthesis of the extant literature in this area. Published and unpublished literature was searched using keywords targeting three subject areas: Transition, Age and Mental Health. Studies were included if they qualitatively explored the perceptions and experiences of youth who received mental health services in both CAMHS and AMHS. There were no limitations on diagnosis or age of youth. Studies examining youth with chronic physical health conditions were excluded. Eighteen studies, representing 14 datasets and the experiences of 253 unique service-users were included. Youth experiences of moving from CAMHS and AMHS are influenced by concurrent life transitions and their individual preferences regarding autonomy and independence. Youth identified preparation, flexible transition timing, individualized transition plans, and informational continuity as positive factors during transition. Youth also valued joint working and relational continuity between CAMHS and AMHS. Youth experience a dramatic culture shift between CAMHS and AMHS, which can be mitigated by individualized and flexible approaches to transition. Youth have valuable perspectives to guide the intelligent design of mental health services and their perspectives should be used to inform tools to evaluate and incorporate youth perspectives into transitional service improvement

  8. [Prescribing, the perspectives of health professionals].

    Science.gov (United States)

    Debout, Christophe; Lescot, Thomas; Loyer, Frédérique; Ambrosino, Florence

    2016-10-01

    While, in France, various health professionals are authorised to prescribe, they approach this activity in a different way, depending on the professional category to which they belong. The areas and products concerned are specific to each profession, and inevitably evolve. This article presents the different perspectives of a doctor, a midwife and a nurse. Copyright © 2016. Published by Elsevier Masson SAS.

  9. Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions.

    Science.gov (United States)

    Pons-Vigués, Mariona; Berenguera, Anna; Coma-Auli, Núria; Pombo-Ramos, Haizea; March, Sebastià; Asensio-Martínez, Angela; Moreno-Peral, Patricia; Mora-Simón, Sara; Martínez-Andrés, Maria; Pujol-Ribera, Enriqueta

    2017-06-13

    Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having

  10. Finding Qualitative Research Evidence for Health Technology Assessment.

    Science.gov (United States)

    DeJean, Deirdre; Giacomini, Mita; Simeonov, Dorina; Smith, Andrea

    2016-08-01

    Health technology assessment (HTA) agencies increasingly use reviews of qualitative research as evidence for evaluating social, experiential, and ethical aspects of health technologies. We systematically searched three bibliographic databases (MEDLINE, CINAHL, and Social Science Citation Index [SSCI]) using published search filters or "hedges" and our hybrid filter to identify qualitative research studies pertaining to chronic obstructive pulmonary disease and early breast cancer. The search filters were compared in terms of sensitivity, specificity, and precision. Our screening by title and abstract revealed that qualitative research constituted only slightly more than 1% of all published research on each health topic. The performance of the published search filters varied greatly across topics and databases. Compared with existing search filters, our hybrid filter demonstrated a consistently high sensitivity across databases and topics, and minimized the resource-intensive process of sifting through false positives. We identify opportunities for qualitative health researchers to improve the uptake of qualitative research into evidence-informed policy making. © The Author(s) 2016.

  11. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    "Voluntary migrants to Canada are generally healthier than the average Canadian, but after ten years in the country they report poorer health and higher rates of chronic disease than those born here...

  12. Headteachers' prior beliefs on child health and their engagement in school based health interventions: a qualitative study.

    Science.gov (United States)

    Todd, Charlotte; Christian, Danielle; Davies, Helen; Rance, Jaynie; Stratton, Gareth; Rapport, Frances; Brophy, Sinead

    2015-04-18

    Schools play an important role in promoting the health of children. However, little consideration is often given to the influence that headteachers' and school staff's prior beliefs have on the implementation of public health interventions. This study examined primary school headteachers' and school health co-ordinators' views regarding child health in order to provide greater insights on the school's perspective for those designing future school-based health interventions. A qualitative study was conducted using 19 semi-structured interviews with headteachers, deputy headteachers and school health co-ordinators in the primary school setting. All transcripts were analysed using thematic analysis. Whilst many participants in this study believed good health was vital for learning, wide variance was evident regarding the perceived health of school pupils and the magnitude of responsibility schools should take in addressing child health behaviours. Although staff in this study acknowledged the importance of their role, many believed the responsibility placed upon schools for health promotion was becoming too much; suggesting health interventions need to better integrate school, parental and societal components. With mental health highlighted as an increasing priority in many schools, incorporating wellbeing outcomes into future school based health interventions is advocated to ensure a more holistic understanding of child health is gained. Understanding the health beliefs of school staff when designing interventions is crucial as there appears to be a greater likelihood of interventions being successfully adopted if staff perceive a health issue as important among their pupils. An increased dependability on schools for addressing health was expressed by headteachers in this study, highlighting a need for better understanding of parental, child and key stakeholder perspectives on responsibility for child health. Without this understanding, there is potential for certain

  13. Qualitative research and its place in health research in Nepal.

    Science.gov (United States)

    van Teijlingen, E; Simkhada, B; Porter, M; Simkhada, P; Pitchforth, E; Bhatta, P

    2011-01-01

    There has been a steady growth in recent decades in Nepal in health and health services research, much of it based on quantitative research methods. Over the same period international medical journals such as The Lancet, the British Medical Journal (BMJ), The Journal of the American Medical Association (JAMA) and the Journal of Family Planning and Reproductive Health Care and many more have published methods papers outlining and promoting qualitative methods. This paper argues in favour of more high-quality qualitative research in Nepal, either on its own or as part of a mixed-methods approach, to help strengthen the country's research capacity. After outlining the reasons for using qualitative methods, we discuss the strengths and weaknesses of the three main approaches: (a) observation; (b) in-depth interviews; and (c) focus groups. We also discuss issues around sampling, analysis, presentation of findings, reflexivity of the qualitative researcher and theory building, and highlight some misconceptions about qualitative research and mistakes commonly made.

  14. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    .... Focusing on the context of Canadian policy and society, the contributors illuminate migrants' testimonies of struggle, resistance, and solidarity as they negotiate a place for themselves in a new country. Topics range from the difficulties of Francophone refugees and the changing roles of fathers, to the experiences of queer newcomers and the importance of social unity to communal and individual health."--pub. desc.

  15. Engendering migrant health: Canadian perspectives

    National Research Council Canada - National Science Library

    Spitzer, Denise L

    2011-01-01

    ... these and other issues at the intersections of gender, immigration, and health in the lives of new Canadians. Situating their work within the context of Canadian policy and society, the contributors illuminate migrants' testimonies of struggle, resistance, and solidarity as they negotiate a place for themselves in a new country. Topics range fr...

  16. School-Based Health Promotion Intervention: Parent and School Staff Perspectives

    Science.gov (United States)

    Patino-Fernandez, Anna M.; Hernandez, Jennifer; Villa, Manuela; Delamater, Alan

    2013-01-01

    Background: The prevalence of childhood obesity is high, particularly among minority youth. The objective of this article was to evaluate parent and school staff perspectives of childhood health and weight qualitatively to guide the development of a school-based obesity prevention program for minority youth. Methods: Hispanic parents (N?=?9) of…

  17. Patient perspectives on navigating the field of traumatic brain injury rehabilitation: a qualitative thematic analysis.

    Science.gov (United States)

    Graff, Heidi J; Christensen, Ulla; Poulsen, Ingrid; Egerod, Ingrid

    2018-04-01

    This study aimed to provide an understanding of the lived experience of rehabilitation in adults with traumatic brain injury (TBI) from hospital discharge up to four years post-injury. We used a qualitative explorative design with semi-structured in-depth interviews. Twenty participants with TBI were included from a level I Trauma Center in Denmark at 1-4 years post-injury. Qualitative thematic analysis was applied for data analysis. Three main themes emerged during analysis: A new life, Family involvement, and Rehabilitation impediments. These themes and their sub-themes described the patient perspective of TBI and rehabilitation post hospitalization. Participants reassessed their values and found a new life after TBI. Family caregivers negotiated rehabilitation services and helped the participant to overcome barriers to rehabilitation. Although participants were entitled to TBI rehabilitation, they had to fight for the services they were entitled to. Individuals with TBI found ways of coping after injury and created a meaningful life. Barriers to TBI rehabilitation were overcome with help from family caregivers rather than health care professionals. Future studies need to find ways to ease the burden on family caregivers and pave the way for more accessible rehabilitation in this vulnerable group of patients. Implications for rehabilitation TBI rehabilitation might benefit from:    • Increased transparency in rehabilitation options    • More systematic follow-up programs    • Age-appropriate rehabilitation facilities    • Inclusion of patient and family in the planning of long-term rehabilitation.

  18. Universal free school breakfast: a qualitative process evaluation according to the perspectives of senior stakeholders

    Directory of Open Access Journals (Sweden)

    Louise Harvey-Golding

    2016-08-01

    Full Text Available In the last decade the provision of school breakfast has increased significantly in the UK. However, there is an absence of knowledge regarding senior stakeholder views on the processes and potential outcomes on different groups, within the communities served by school breakfast programs. The purpose of this study was to examine the views and experiences of senior level stakeholders and thereby provide an original qualitative contribution to the research. A sample of senior level stakeholders were recruited, including senior officers, directors and elected members, from within a Local Authority (LA involved in the leadership, implementation and delivery of a council-wide universal free school breakfast (USFB program, and from the senior staff body of mainstream primary and special schools, participating in the program. A grounded theory analysis of the data collected identified issues encountered in the implementation and delivery, and views on the funding and future of a USFB program, in addition to perceived outcomes of children, parents, families, schools and the wider community. The results refer to both positive and negative issues and implications associated with the program, according to the perspectives of senior level stakeholders. Perceived positive outcomes included benefits to children, families, schools and the community. For instance, alleviating hunger, improving health outcomes, and conferring financial benefits, with the potential to cumulate in overall improvements in educational, social and behavioral outcomes. Reported negative implications included the absence of an effective communication strategy in implementing the USFB program; in addition to concerns about the impacts of ‘double-breakfasting’ on obesity levels among children, particularly in less deprived communities. Findings were validated using theoretical sampling and saturation, triangulation methods, member checks, and inter-rater reliability measures. In

  19. Coping experience of health concerns and physical disability for older Chinese people: A qualitative, descriptive study.

    Science.gov (United States)

    Mei, He; Turale, Sue

    2017-12-01

    In this qualitative, descriptive study, we explored the perspectives of older, community-dwelling Chinese people regarding their experiences of coping with a physical disability and their health concerns. Twenty participants were interviewed in-depth, and data were analyzed using content analysis. Five themes with 13 subthemes emerged that described older people's experiences of coping with health concerns and disability: (i) ignoring health concerns; (ii) managing self; (iii) seeking medical help; (iv) living with physical disability; and (v) relying on limited resources. Most participants did not have sufficient access to health services due to physical disability and financial deficits, so they tended to ignore their health conditions or tackle them independently before seeking medical help. At the same time, they were impacted on by social and cultural factors. Policies are required that offer more resources to community-dwelling people with disabilities in China. © 2017 John Wiley & Sons Australia, Ltd.

  20. Parents' Qualitative Perspectives on Child Asking for Fruit and Vegetables.

    Science.gov (United States)

    Beltran, Alicia; O'Connor, Teresia M; Hughes, Sheryl O; Thompson, Debbe; Baranowski, Janice; Nicklas, Theresa A; Baranowski, Tom

    2017-06-05

    Children can influence the foods available at home, but some ways of approaching a parent may be better than others; and the best way may vary by type of parent. This study explored how parents with different parenting styles would best receive their 10 to 14 years old child asking for fruits and vegetables (FV). An online parenting style questionnaire was completed and follow-up qualitative telephone interviews assessed home food rules, child influence on home food availability, parents' preferences for being asked for food, and common barriers and reactions to their child's FV requests. Parents ( n = 73) with a 10 to 14 years old child were grouped into authoritative, authoritarian, permissive, or uninvolved parenting style categories based on responses to questionnaires, and interviewed. Almost no differences in responses were detected by parenting style or ethnicity. Parents reported their children had a voice in what foods were purchased and available at home and were receptive to their child's asking for FV. The most important child asking characteristic was politeness, especially among authoritarian parents. Other important factors were asking in person, helping in the grocery store, writing requests on the grocery shopping list, and showing information they saw in the media. The barrier raising the most concern was FV cost, but FV quality and safety outside the home environment were also considerations.

  1. Supporting early career health investigators in Kenya: A qualitative ...

    African Journals Online (AJOL)

    Introduction: strategies to transfer international health research training programs to sub-Saharan African institutions focus on developing cadres of local investigators who will lead such programs. Using a critical leadership theory framework, we conducted a qualitative study of one program to understand how collaborative ...

  2. Work-based assessment: qualitative perspectives of novice nutrition and dietetics educators.

    Science.gov (United States)

    Palermo, C; Beck, E J; Chung, A; Ash, S; Capra, S; Truby, H; Jolly, B

    2014-10-01

    The assessment of competence for health professionals including nutrition and dietetics professionals in work-based settings is challenging. The present study aimed to explore the experiences of educators involved in the assessment of nutrition and dietetics students in the practice setting and to identify barriers and enablers to effective assessment. A qualitative research approach using in-depth interviews was employed with a convenience sample of inexperienced dietitian assessors. Interviews explored assessment practices and challenges. Data were analysed using a thematic approach within a phenomenological framework. Twelve relatively inexperienced practice educators were purposefully sampled to take part in the present study. Three themes emerged from these data. (i) Student learning and thus assessment is hindered by a number of barriers, including workload demands and case-mix. Some workplaces are challenged to provide appropriate learning opportunities and environment. Adequate support for placement educators from the university, managers and their peers and planning are enablers to effective assessment. (ii) The role of the assessor and their relationship with students impacts on competence assessment. (iii) There is a lack of clarity in the tasks and responsibilities of competency-based assessment. The present study provides perspectives on barriers and enablers to effective assessment. It highlights the importance of reflective practice and feedback in assessment practices that are synonymous with evidence from other disciplines, which can be used to better support a work-based competency assessment of student performance. © 2013 The British Dietetic Association Ltd.

  3. Family physicians' perspectives on interprofessional teamwork: Findings from a qualitative study.

    Science.gov (United States)

    Szafran, Olga; Torti, Jacqueline M I; Kennett, Sandra L; Bell, Neil R

    2018-03-01

    The aim of this study was to describe family physicians' perspectives of their role in the primary care team and factors that facilitate and hinder teamwork. A qualitative study was conducted employing individual interviews with 19 academic/community-based family physicians who were part of interprofessional primary care teams in Edmonton, Alberta, Canada. Professional responsibilities and roles of physicians within the team and the facilitators and barriers to teamwork were investigated. Interviews were audiotaped, transcribed and analysed for emerging themes. The study findings revealed that family physicians consistently perceived themselves as having the leadership role on in the primary care team. Facilitators of teamwork included: communication; trust and respect; defined roles/responsibilities of team members; co-location; task shifting to other health professionals; and appropriate payment mechanisms. Barriers to teamwork included: undefined roles/responsibilities; lack of space; frequent staff turnover; network boundaries; and a culture of power and control. The findings suggest that moving family physicians toward more integrative and interdependent functioning within the primary care team will require overcoming the culture of traditional professional roles, addressing facilitators and barriers to teamwork, and providing training in teamwork.

  4. Healthy Ageing in People with Intellectual Disabilities from Managers' Perspective: A Qualitative Study.

    Science.gov (United States)

    Johansson, Maria; Björne, Petra; Runesson, Ingrid; Ahlström, Gerd

    2017-08-18

    An increasing number of people with intellectual disability (ID) are reaching older ages today although they experience more health problems than the older population without ID. Leaders in intellectual disability services can greatly influence the conditions for a healthy ageing, and the aim of the present study was to explore healthy ageing in this group from the perspective of the leaders. Interviews with 20 leaders were subjected to qualitative content analysis. The findings gave rise to the overall theme ageing in dependence, which emerged from the following six categories: Supporting self-determination; Inaccessible activities after retirement; Signs of decline; Increased and specific needs for support and care; A non-question of gender; Aspects concerning the end of life and death. A prerequisite for healthy ageing in the case of people with ID is, according to the leaders, that they can live the life according to their preferences and make independent choices whilst at the same time receiving adequate support. With the shrinking of their social network after retirement, they become increasingly dependent on staff and leaders in the group home, who need to know what healthy ageing implies.

  5. 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.

  6. A qualitative study of continuing education needs of rural nursing unit staff: the nurse administrator's perspective.

    Science.gov (United States)

    Fairchild, Roseanne Moody; Everly, Marcee; Bozarth, Lisa; Bauer, Renee; Walters, Linda; Sample, Marilyn; Anderson, Louise

    2013-04-01

    This study reports perceptions of the continuing education (CE) needs of nursing unit staff in 40 rural healthcare facilities (10 hospitals and 30 long-term care facilities) in a rural Midwestern U.S. region from the perspective of nurse administrators in an effort to promote a community-based academic-practice CE partnership. Qualitative data collection involving naturalistic inquiry methodology was based on key informant interviews with nurse administrators (n=40) working and leading in the participating health care facilities. Major themes based on nurse administrators' perceptions of CE needs of nursing unit staff were in four broad conceptual areas: "Cultural issues", "clinical nursing skills", "patient care", and "patient safety". Major sub-themes for each conceptual area are highlighted and discussed with narrative content as expressed by the participants. Related cultural sub-themes expressed by the nurse administrators included "horizontal violence" (workplace-hospital and LTC nursing unit staff) and "domestic violence" (home-LTC nursing unit staff). The uniqueness of nurses' developmental learning needs from a situational point of view can be equally as important as knowledge-based and/or skill-based learning needs. Psychological self-reflection is discussed and recommended as a guiding concept to promote the development and delivery of relevant, empowering and evidence-based CE offerings for rural nursing unit staff. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Managing dental fear and anxiety in pediatric patients: A qualitative study from the public's perspective.

    Science.gov (United States)

    Hamzah, Hajar S; Gao, Xiaoli; Yung Yiu, Cynthia K; McGrath, Colman; King, Nigel M

    2014-01-01

    Internet social media offers a rich source for soliciting the public's views on health issues. This qualitative research, using You-Tube as a platform, aimed to explore the public's perspectives on management of dental fear and anxiety (DFA) in pediatric patients. Using three keywords ("dental fear," "dental phobia," and "dental anxiety"), YouTube videos were searched. Twenty-seven videos related to DFA in children and adolescents were reviewed by three investigators, including a nondental layperson. Inductive thematic analysis was adopted for interpreting the data. Several strategies were considered useful for controlling DFA in pediatric patients, including: verbal and nonverbal communication to establish closeness and effective guidance (explanation, permission-seeking, reassurance, and negotiation); desensitization to dental settings and procedures; tell-show-do; positive reinforcement; distraction by imagination and thoughtful designs of clinic; and parental presence and support. Some self-coping strategies adopted by patients alleviated their DFA, such as self-reasoning and trust-building through long-term connection. Dentists' clinical competence, favorable treatment outcomes, and state-of-the-art devices and technologies (dental lasers, intraoral camera, and adapted anaesthesia method) contributed to reducing DFA. Authentic testimonials in YouTube videos endorsed and interpreted a variety of strategies adoptable by patients, parents, and dental professionals for managing children's and adolescents' dental fears and anxieties.

  8. Needs and Problems of Posbindu Program: Community Health Volunteers Perspective

    Science.gov (United States)

    Putri, S. T.; Andriyani, S.

    2018-01-01

    Posbindu is a form of public participation to conduct early detection and monitoring of risk factors for non-communicable diseases(NCD), and where it was carried out in as an integrated manner, routine and periodic event. This paper aims to investigates the needs and problems on Posbindu Program based on community health volunteers(CHVs) perspective. This study used descriptive qualitative method by open ended questions. Content analysis using to explicating the result. There are 3 theme finding about elderly needs in Posbindu; medical care, support group community, and health education. We found four theme problems which in Posbindu program: low motivation from elderly, Inadequate of facilities, physical disability, failed communication. To be effective in Posbindu program, all the stakeholders have reached consensus on the Posbindu program as elderly need. CHVs need given wide knowledge about early detection, daily care, control disease continuously so that the elderly keep feeling the advantages of coming to the Posbindu.

  9. The role of theory in qualitative health research.

    Science.gov (United States)

    Kelly, Moira

    2010-06-01

    The role of theory in qualitative research is often underplayed but it is relevant to the quality of such research in three main ways. Theory influences research design, including decisions about what to research and the development of research questions. Theory underpins methodology and has implications for how data are analyzed and interpreted. Finally, theory about a particular health issue may be developed, contributing to what is already known about the topic that is the focus of the study. This paper will critically consider the role of theory in qualitative primary care research in relation to these three areas. Different approaches to qualitative research will be drawn upon in order to illustrate the ways in which theory might variably inform qualitative research, namely generic qualitative research, grounded theory and discourse analysis. The aim is to describe and discuss key issues and provide practical guidance so that researchers are more aware of the role theory has to play and the importance of being explicit about how theory affects design, analysis and the quality of qualitative research.

  10. Health promotion among older adults in Austria: a qualitative study.

    Science.gov (United States)

    Boggatz, Thomas; Meinhart, Christoph Matthias

    2017-04-01

    To determine the types of attitudes to health promotion among older Austrians. Health promotion in old age becomes increasingly important in the current period of demographic transition. Interventions are likely to be successful if they take the attitude of older persons into consideration. There may be several types of attitudes to health promotion among older adults. Cross-sectional qualitative study. Semi-structured interviews were conducted in a purposive sample consisting of 36 home-dwelling older persons from local communities in the federal province of Salzburg, Austria. Data were analysed using qualitative content analysis according to Mayring and subsequent construction of types. There are three main types of attitudes to health promotion. 'Health promoters through everyday activities' considered domestic work and walks to be sufficient in keeping up their health. Fitness-oriented persons practised sports of some type. Users of complementary methods practised such methods to some degree. These types of attitudes could be further differentiated according to their outcome expectations. In addition to benefits for health, socialising was also an important outcome. Physical decline may reduce a fitness-oriented attitude, whereas encouragement by others may trigger it. Older adults have various attitudes to health promotion, but these are not immutable. Health promotion programmes that are not restricted to a narrow focus on health but provide the opportunity to socialise may support older adults in maintaining a healthy lifestyle. © 2016 John Wiley & Sons Ltd.

  11. Rigor or Reliability and Validity in Qualitative Research: Perspectives, Strategies, Reconceptualization, and Recommendations.

    Science.gov (United States)

    Cypress, Brigitte S

    Issues are still raised even now in the 21st century by the persistent concern with achieving rigor in qualitative research. There is also a continuing debate about the analogous terms reliability and validity in naturalistic inquiries as opposed to quantitative investigations. This article presents the concept of rigor in qualitative research using a phenomenological study as an exemplar to further illustrate the process. Elaborating on epistemological and theoretical conceptualizations by Lincoln and Guba, strategies congruent with qualitative perspective for ensuring validity to establish the credibility of the study are described. A synthesis of the historical development of validity criteria evident in the literature during the years is explored. Recommendations are made for use of the term rigor instead of trustworthiness and the reconceptualization and renewed use of the concept of reliability and validity in qualitative research, that strategies for ensuring rigor must be built into the qualitative research process rather than evaluated only after the inquiry, and that qualitative researchers and students alike must be proactive and take responsibility in ensuring the rigor of a research study. The insights garnered here will move novice researchers and doctoral students to a better conceptual grasp of the complexity of reliability and validity and its ramifications for qualitative inquiry.

  12. Reconsidering Evaluation Criteria for Scientific Adequacy in Health Care Research: An Integrative Framework of Quantitative and Qualitative Criteria

    Directory of Open Access Journals (Sweden)

    Hiroaki Miyata PhD

    2009-03-01

    Full Text Available It is important to reconsider evaluation criteria regarding scientific adequacy in health care research. In this article the authors review the four pairs of quantitative/qualitative paradigms. They discuss the use of evaluation criteria based on a pragmatic perspective after examining the epistemological issues behind the criteria. Validity/credibility is concerned with research framework, whereas reliability/dependability refers to the range of stability in observations, objectivity/ confirmability reflects influences between observers and subjects, and generalizability/transferability has epistemological differences in the way findings are applied. Qualitative studies should not always choose qualitative paradigms, and vice versa. If stability can be assumed to some extent in a qualitative study, it is better to use a quantitative paradigm. Regardless of whether it is quantitative or qualitative research, it is important to recognize the four epistemological axes.

  13. Workplace learning and career progression: qualitative perspectives of UK dietitians.

    Science.gov (United States)

    Boocock, R C; O'Rourke, R K

    2018-06-10

    Post-graduate education and continuous professional development (CPD) within dietetics lack clearly defined pathways. The current literature primarily focuses on new graduate perceptions of workplace learning (WPL). The present study raises issues of how CPD is sustained throughout a National Health Service (NHS) career, how informal learning might be made more visible and whether the workplace withholds learning opportunities. Qualified dietitians participated in focus groups (n = 32) and a nominal group technique (n = 24). Data from audio recordings were transcribed and triangulated. Thematic analysis took an interpretative approach. One size for WPL for dietetics and, likely, other allied health professionals (AHPs) did not meet the learning needs of everyone. The informal implicit learning affordances often went unrecognised. A greater emphasis on teaching, picking up on the strong preference for discussion with others voiced in the present study, may improve recognition of all WPL opportunities. Better scaffolding or guided support of entry level dietitians may ease the transition from study to workplace and challenge any perception of 'clipped wings'. Where development and career progression proves difficult for experienced dietitians, mentoring or stepping outside the NHS may revitalise by providing new communities of practice. WPL cannot be understood as a unitary concept. Dietitians engage with WPL differently across their careers. Future visions of WPL, especially explicit post-graduate career and education frameworks, must accommodate these differences to retain the highest calibre dietitians. The implications of a period of learning 'maintenance' rather than CPD among experienced dietitians offers a topic for further research, particularly as the workforce ages. © 2018 The British Dietetic Association Ltd.

  14. Experiences and perspectives of adults living with systemic lupus erythematosus: thematic synthesis of qualitative studies.

    Science.gov (United States)

    Sutanto, Bernadet; Singh-Grewal, Davinder; McNeil, H Patrick; O'Neill, Sean; Craig, Jonathan C; Jones, Julie; Tong, Allison

    2013-11-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that significantly impairs patients’ quality of life and can be life threatening. This study aimed to describe the experiences and perspectives of adults living with SLE. We conducted a systematic review and thematic synthesis of qualitative studies that explored the experiences of adults living with SLE. We searched MEDLINE, Embase, PsycINFO, CINAHL (to November week 1, 2012), Google Scholar, a thesis database, and reference lists of relevant articles. Forty-six studies involving 1,385 participants were included. Five themes were identified: restricted lifestyle(including subthemes of pervasive pain, debilitating fatigue, mental deterioration, disruptive episodic symptoms, and postponing parenthood), disrupted identity (gaining diagnostic closure, prognostic uncertainty, being a burden, hopelessness, heightened self-consciousness, fearing rejection, and guilt and punishment), societal stigma and indifference(illness trivialization, socially ostracized, and averse to differential treatment), gaining resilience (optimism, control and empowerment, being informed and involved, and valuing mutual understanding), and treatment adherence (preserving health, rapport with clinicians, negotiating medication regimens, and financial burden). SLE has a severe and pervasive impact on patients’ self-esteem and independence. Their physical and social functioning is limited and they feel anxious about their future. Patients perceive that SLE is trivialized, misunderstood,and stigmatized by their family, friends, and physicians, which intensifies their sense of isolation. Educational, psychosocial, and self-care interventions are needed to promote mental resilience, positive coping strategies, self-advocacy, and capacities for social participation, and thereby to achieve better treatment and health outcomes in patients with SLE.

  15. A qualitative study of experienced nurses' voluntary turnover: learning from their perspectives.

    Science.gov (United States)

    Hayward, Dana; Bungay, Vicky; Wolff, Angela C; MacDonald, Valerie

    2016-05-01

    The purpose of this research was to critically examine the factors that contribute to turnover of experienced nurses' including their decision to leave practice settings and seek alternate nursing employment. In this study, we explore experienced nurses' decision-making processes and examine the personal and environmental factors that influenced their decision to leave. Nursing turnover remains a pressing problem for healthcare delivery. Turnover contributes to increased recruitment and orientation cost, reduced quality patient care and the loss of mentorship for new nurses. A qualitative, interpretive descriptive approach was used to guide the study. Interviews were conducted with 12 registered nurses, averaging 16 years in practice. Participants were equally represented from an array of acute care inpatient settings. The sample drew on perspectives from point-of-care nurses and nurses in leadership roles, primarily charge nurses and clinical nurse educators. Nurses' decisions to leave practice were influenced by several interrelated work environment and personal factors: higher patient acuity, increased workload demands, ineffective working relationships among nurses and with physicians, gaps in leadership support and negative impacts on nurses' health and well-being. Ineffective working relationships with other nurses and lack of leadership support led nurses to feel dissatisfied and ill equipped to perform their job. The impact of high stress was evident on the health and emotional well-being of nurses. It is vital that healthcare organisations learn to minimise turnover and retain the wealth of experienced nurses in acute care settings to maintain quality patient care and contain costs. This study highlights the need for healthcare leaders to re-examine how they promote collaborative practice, enhance supportive leadership behaviours, and reduce nurses' workplace stressors to retain the skills and knowledge of experienced nurses at the point-of-care. © 2016

  16. Exploring access to care among older people in the last phase of life using the behavioural model of health services use: a qualitative study from the perspective of the next of kin of older persons who had died in a nursing home.

    Science.gov (United States)

    Condelius, Anna; Andersson, Magdalena

    2015-10-26

    There is little investigation into what care older people access during the last phase of their life and what factors enable access to care in this group. Illuminating this from the perspective of the next of kin may provide valuable insights into how the health and social care system operates with reference to providing care for this vulnerable group. The behavioural model of health services use has a wide field of application but has not been tested conceptually regarding access to care from the perspective of the next of kin. The aim of this study was to explore the care accessed by older people during the last phase of their life from the perspective of the next of kin and to conceptually test the behavioural model of health services use. The data collection took place in 2011 by means of qualitative interviews with 14 next of kin of older people who had died in a nursing home. The interviews were analysed using directed content analysis. The behavioural model of health services use was used in deriving the initial coding scheme, including the categories: utilization of health services, consumer satisfaction and characteristics of the population at risk. Utilization of health services in the last phase of life was described in five subcategories named after the type of care accessed i.e. admission to a nursing home, primary healthcare, hospital care, dental care and informal care. The needs were illuminated in the subcategories: general deterioration, medical conditions and acute illness and deterioration when death approaches. Factors that enabled access to care were described in three subcategories: the organisation of care, next of kin and the older person. These factors could also constitute barriers to accessing care. Next of kin's satisfaction with care was illuminated in the subcategories: satisfaction, dissatisfaction and factors influencing satisfaction. One new category was constructed inductively: the situation of the next of kin. A bed in a nursing

  17. IMPACTS OF HIPPOTHERAPY ON CHILDREN WITH CEREBRAL PALSY FROM PARENTS PERSPECTIVE: A QUALITATIVE RESEARCH

    OpenAIRE

    Athanasia Laiou; Anna Christakou; Vaios Kaminiotis

    2015-01-01

    Background: Hippotherapy is a physical treatment strategy with the help of horses and refers to the use of horse’s movement as a treatment tool for children with Cerebral Palsy (CP). Hippotherapy refers to the incorporation of equine movement by physiotherapists, occupational therapists and speech therapists. The present qualitative study investigated the impacts of hippotherapy on Greek children with Cerebral Palsy from parents’ perspective due to their better understanding of child’s specia...

  18. Independent older adults perspectives on oral health.

    Science.gov (United States)

    Khabra, K K; Compton, S M; Keenan, L P

    2017-11-01

    The purpose of this study was to explore oral health experiences from the perspective of older adults' living in community dwellings. The two objectives of this study were to identify facilitators and barriers to oral health care, and to determine how utilization of oral health services compares to utilization of other healthcare services. An interpretive descriptive methodology was employed with a purposive sample of 12 adults, aged 70 years or older. The inclusion criterion was English-speaking seniors residing in community dwellings. Community dwellings were defined as any housing outside of long-term care or other supportive living facilities. Semi-structured interviews were 30-80 min, audio-recorded and transcribed verbatim. Three researchers participated in the comparative analysis process to develop codes, generate categories, interpret patterns and construct themes. Three central themes surfacing from the data were as follows: life course influences on oral health, transparency in delivery of oral health services and interrelationships between oral health and overall health. Older adults in this study emphasized the value of establishing collaborative and trusting relationships between oral health practitioners and older adults. Oral health practitioners should be clear and transparent when communicating information about oral health costs and be cognizant of different circumstances from childhood to older adulthood that inhibit or promote routine utilization of oral health services. Including oral health services as part of interdisciplinary care teams could help promote understandings of the reciprocal relationship between oral health and general health and improve oral health status for older adults. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Patients’ perspectives on the medical primary–secondary care interface: systematic review and synthesis of qualitative research

    Science.gov (United States)

    Sampson, Rod; Cooper, Jamie; Barbour, Rosaline; Polson, Rob; Wilson, Philip

    2015-01-01

    Objectives To synthesise the published literature on the patient experience of the medical primary–secondary care interface and to determine priorities for future work in this field aimed at improving clinical outcomes. Design Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore patients’ perspectives of the medical primary–secondary care interface. Setting International primary–secondary care interface. Data sources EMBASE, MEDLINE, CINAHL Plus with Full text, PsycINFO, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, eBook Collection, Web of Science Core Collection: Citation Indexes and Social Sciences Citation Index, and grey literature. Eligibility criteria for selecting studies Studies were eligible for inclusion if they were full research papers employing qualitative methodology to explore patients’ perspectives of the medical primary–secondary care interface. Review methods The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. Results The search identified 690 articles, of which 39 were selected for full-text review. 20 articles were included in the systematic review that encompassed a total of 689 patients from 10 countries. 4 important areas specific to the primary–secondary care interface from the patients’ perspective emerged: barriers to care, communication, coordination, and ‘relationships and personal value’. Conclusions and implications of key findings Patients should be the focus of any transfer of care between primary and secondary systems. From their perspective, areas for improvement may be classified into four domains that should usefully guide future work aimed at improving quality at this important interface. Trial registration number

  20. Patients' perspectives on the medical primary-secondary care interface: systematic review and synthesis of qualitative research.

    Science.gov (United States)

    Sampson, Rod; Cooper, Jamie; Barbour, Rosaline; Polson, Rob; Wilson, Philip

    2015-10-15

    To synthesise the published literature on the patient experience of the medical primary-secondary care interface and to determine priorities for future work in this field aimed at improving clinical outcomes. Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore patients' perspectives of the medical primary-secondary care interface. International primary-secondary care interface. EMBASE, MEDLINE, CINAHL Plus with Full text, PsycINFO, Psychology and Behavioural Sciences Collection, Health Business Elite, Biomedica Reference Collection: Comprehensive Library, Information Science & Technology Abstracts, eBook Collection, Web of Science Core Collection: Citation Indexes and Social Sciences Citation Index, and grey literature. Studies were eligible for inclusion if they were full research papers employing qualitative methodology to explore patients' perspectives of the medical primary-secondary care interface. The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. The search identified 690 articles, of which 39 were selected for full-text review. 20 articles were included in the systematic review that encompassed a total of 689 patients from 10 countries. 4 important areas specific to the primary-secondary care interface from the patients' perspective emerged: barriers to care, communication, coordination, and 'relationships and personal value'. Patients should be the focus of any transfer of care between primary and secondary systems. From their perspective, areas for improvement may be classified into four domains that should usefully guide future work aimed at improving quality at this important interface. PROSPERO CRD42014009486. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. The future of qualitative research in psychology--a students' perspective.

    Science.gov (United States)

    Terkildsen, Thomas; Petersen, Sofie

    2015-06-01

    The aim of this article is to explore the future of qualitative research as seen from a students' perspective. This exploration will initially be incited through a discussion of the use of the term 'qualitative research', and the risks associated with the use of such an umbrella term. It is discussed that the use of an overarching umbrella term can lead to an overhomogenized understanding of qualitative research, that fails to represent the diversity and variety of methodological and epistemological approaches that exist within this research paradigm. It is also discussed that this overhomogenization reinforces the idea of qualitative research as an anti-doctrine to quantitative research, which is argued to discourage interparadigmatic integration. Lastly, it is considered how these (mis)conceptions of qualitative research influence how psychology students are taught about research methodology and how this education could affect these (mis)conceptions. We advocate that the future for qualitative research in psychology should be ensured through a restructure and a refocus on an educational level. This change should overall be centered around teaching students how to be reflective research practitioners based on an in-depth understanding of the variety of epistemologies within both meta-research-paradigms.

  2. Perspectives of HIV-related stigma in a community in Vietnam: a qualitative study.

    Science.gov (United States)

    Gaudine, Alice; Gien, Lan; Thuan, Tran T; Dung, Do V

    2010-01-01

    While HIV/AIDS is increasing in Vietnam, very few published studies focus on HIV-related stigma in Vietnam. This study reports on findings from a community development project to reduce HIV-related stigma within one community in Vietnam. The purpose of this qualitative study is to describe HIV-related stigma from the perspective of three groups within one community in Vietnam: people living with HIV, their family members, and community members and leaders, including health care professionals. SETTING, PARTICIPANTS AND METHODS: Fifty-eight individuals from a poor, industrial district on the outskirts of a large city participated in the study and were asked to describe HIV-related stigma. Interviews were conducted with 10 people living with HIV, 10 family members of a person living with HIV, and 10 community members and 5 community leaders including health care professionals. We also conducted three focus groups, one with people living with HIV (n=8), one with family members of people living with HIV (n=8), and one with community leaders including health care professionals (n=7). Stigma across the three groups is characterized by four dimensions of HIV-related stigma: feeling shamed and scorned, behaving differently, stigma due to association, and fear of transmission. The manifestation of these dimensions differs for each group. Four themes of HIV-related stigma as described by people living with HIV are: being avoided, experiencing anger and rejection, being viewed as a social ill, and hiding the illness. Seven themes of HIV-related stigma as described by family members are: shunned by neighbors, viewed as poor parents, discriminated by health professionals, overhearing discussions about people with HIV, maintaining the secret, financial hardship for family, and fear of contracting HIV. Four themes of HIV-related stigma as described by community members and leaders including health professionals are: stigma as a fair reward, avoidance and shunning by neighbors

  3. Are we ready to accept the challenge? Addressing the shortcomings of contemporary qualitative health research.

    Science.gov (United States)

    Lau, Sofie Rosenlund; Traulsen, Janine M

    Qualitative approaches represent an important contributor to health care research. However, several researchers argue that contemporary qualitative research does not live up to its full potential. By presenting a snapshot of contemporary qualitative research in the field of social and administrative pharmacy, this study challenges contributors to the field by asking: Are we ready to accept the challenge and take qualitative research one step further? The purpose of this study was to initiate a constructive dialogue on the need for increased transparency in qualitative data analysis, including explicitly reflecting upon theoretical perspectives affecting the research process. Content analysis was used to evaluate levels of theoretical visibility and analysis transparency in selected qualitative research articles published in Research in Social and Administrative Pharmacy between January 2014 and January 2015. In 14 out of 21 assessed papers, the use of theory was found to be Seemingly Absent (lowest level of theory use), and the data analyses did not include any interpretive endeavors. Only two papers consistently applied theory throughout the entire study and clearly took the data analyses from a descriptive to an interpretive level. It was found that the aim of the majority of assessed papers was to change or modify a given practice, which however, resulted in a lack of both theoretical underpinnings and analysis transparency. This study takes the standpoint that theory and high-quality analysis go hand-in-hand. Based on the content analysis, articles that were deemed to be high in quality were explicit about the theoretical framework of their study and transparent in how they analyzed their data. It was found that theory contributed to the transparency of how the data were analyzed and interpreted. Two ways of improving contemporary qualitative research in the field of social and administrative pharmacy are discussed: engaging with social theory and establishing

  4. Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: a qualitative study.

    Science.gov (United States)

    Gault, Iris; Gallagher, Ann; Chambers, Mary

    2013-01-01

    To explore and analyze perceptions of service users and caregivers on adherence and nonadherence to medication in a mental health care context. Mental health medication adherence is considered problematic and legal coercion exists in many countries. This was a qualitative study aiming to explore perceptions of medication adherence from the perspective of the service user (and their caregiver, where possible). Eighteen mental health service users (and six caregivers) with histories of medication nonadherence and repeated compulsory admission were recruited from voluntary sector support groups in England. Data were collected between 2008 and 2010. Using qualitative coding techniques, the study analyzed interview and focus group data from service users, previously subjected to compulsory medication under mental health law, or their caregivers. The process of medication adherence or nonadherence is encapsulated in an explanatory narrative. This narrative constitutes participants' struggle to negotiate acceptable and effective routes through variable quality of care. Results indicated that service users and caregivers eventually accepted the reality of their own mental illness and their need for safety and treatment. They perceived the behavior of professionals as key in their recovery process. Professionals could be enabling or disabling with regard to adherence to medication. This study investigated service user and caregiver perceptions of medication adherence and compulsory treatment. Participants described a process perceived as variable and potentially doubly faceted. The behavior of professionals was seen as crucial in collaborative decision making on medication adherence.

  5. Experiences and perspectives of older people regarding advance care planning: A meta-synthesis of qualitative studies.

    Science.gov (United States)

    Ke, Li-Shan; Huang, Xiaoyan; Hu, Wen-Yu; O'Connor, Margaret; Lee, Susan

    2017-05-01

    Studies have indicated that family members or health professionals may not know or predict their older relatives' or patients' health preferences. Although advance care planning is encouraged for older people to prepare end-of-life care, it is still challenging. To understand the experiences and perspectives of older people regarding advance care planning. A systematic review of qualitative studies and meta-synthesis was conducted. CINAHL, MEDLINE, EMBASE, and PsycINFO databases were searched. A total of 50 articles were critically appraised and a thematic synthesis was undertaken. Four themes were identified: life versus death, internal versus external, benefits versus burdens, and controlling versus being controlled. The view of life and death influenced older people's willingness to discuss their future. The characteristics, experiences, health status, family relationship, and available resources also affected their plans of advance care planning. Older people needed to balance the benefits and burdens of advance care planning, and then judge their own ability to make decisions about end-of-life care. Older people's perspectives and experiences of advance care planning were varied and often conflicted; cultural differences amplified variances among older people. Truthful information, available resources, and family support are needed to enable older people to maintain dignity at the end of life. The views of life and death for older people from different cultures should be compared to assist health professionals to understand older people's attitudes toward advance care planning, and thus to develop appropriate strategies to promote advance care planning in different cultures.

  6. Alcohol advertising and public health: systems perspectives versus narrow perspectives.

    Science.gov (United States)

    Petticrew, M; Shemilt, I; Lorenc, T; Marteau, T M; Melendez-Torres, G J; O'Mara-Eves, A; Stautz, K; Thomas, J

    2017-03-01

    Alcohol consumption is influenced by a complex causal system of interconnected psychological, behavioural, social, economic, legal and environmental factors. These factors are shaped by governments (eg, licensing laws and taxation), by consumers (eg, patterns of alcohol consumption drive demand) and by alcohol industry practices, such as advertising. The marketing and advertising of alcoholic products contributes to an 'alcogenic environment' and is a modifiable influence on alcohol consumption and harm. The public health perspective is that there is sufficient evidence that alcohol advertising influences consumption. The alcohol industry disputes this, asserting that advertising only aims to help consumers choose between brands. We review the evidence from recent systematic reviews, including their theoretical and methodological assumptions, to help understand what conclusions can be drawn about the relationships between alcohol advertising, advertising restrictions and alcohol consumption. A wide evidence base needs to be drawn on to provide a system-level overview of the relationship between alcohol advertising, advertising restrictions and consumption. Advertising aims to influence not just consumption, but also to influence awareness, attitudes and social norms; this is because advertising is a system-level intervention with multiple objectives. Given this, assessments of the effects of advertising restrictions which focus only on sales or consumption are insufficient and may be misleading. For this reason, previous systematic reviews, such as the 2014 Cochrane review on advertising restrictions (Siegfried et al ) contribute important, but incomplete representations of 'the evidence' needed to inform the public health case for policy decisions on alcohol advertising. We conclude that an unintended consequence of narrow, linear framings of complex system-level issues is that they can produce misleading answers. Systems problems require systems perspectives

  7. Workplace health improvement: perspectives of environmental health officers.

    Science.gov (United States)

    Reynolds, J; Wills, J

    2012-01-01

    Environmental health practice in the field of occupational health and safety is traditionally concerned with protecting health relating to the workplace. However, little is currently known about environmental health officers' (EHOs) perceptions of their role in workplace health improvement, a pertinent topic in light of the recent government agenda for improving the health of the workforce in the UK. To explore how EHOs perceive workplace health improvement and its relevance to their professional role. A qualitative methodology was employed, using a case-study design with thematic analysis of 15 transcripts of in-depth telephone interviews with EHOs working in London, UK. EHOs view themselves primarily as enforcement officers, with legislation guiding their understandings of workplace health. Many interpret work-related ill health in terms of safety and physical injury and do not feel competent in assessing broader psychosocial elements of ill health. However, a few EHOs welcomed the opportunity to promote health in the workplace, recognizing the importance of prevention. This study indicates a gap between the contemporary EHO role framed by professional bodies as holistic and contributing to public health goals and the role perceived by EHOs 'on the ground'. A more traditional, protective and enforcement-based approach persists among EHOs in this sample, and few feel they have skills to address determinants beyond physical hazards to health. Yet, a minority of EHOs adopted a more health-promoting approach, suggesting that the potential contribution of EHOs to the workplace health improvement agenda should be explored further.

  8. Lack of individualized perspective: a qualitative study of diabetes care for immigrants in Sweden.

    Science.gov (United States)

    Brämberg, Elisabeth Björk; Dahlborg-Lyckhage, Elisabeth; Määttä, Sylvia

    2012-06-01

    This study describes the care provided by a diabetes nurse specialist, and the care needs expressed by people with type 2 diabetes mellitus and an immigrant background. Clinical encounters between a diabetes nurse specialist and 10 people diagnosed with type 2 diabetes mellitus were observed and analyzed by means of qualitative content analysis. One theme, "the diabetes nurse specialist as the conductor of the visit", and four categories emerged from the findings, illustrating the power imbalance between the patients and the diabetes nurse specialist, as well as the lack of an individual perspective. Shifting from a medical perspective to one of openness towards the people's experiences provides a possibility for caregivers to empower patients suffering from type 2 diabetes mellitus. The medical perspective seemed to steer the visit towards curative activities. Thus, technique-centered care should be developed by including individualized care. © 2012 Blackwell Publishing Asia Pty Ltd.

  9. Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record.

    Science.gov (United States)

    Forchuk, Cheryl; Reiss, Jeffrey P; O'Regan, Tony; Ethridge, Paige; Donelle, Lorie; Rudnick, Abraham

    2015-10-14

    health issuesin any place at almost any time without feeling stigmatized. Assessing clients' perspectives regarding the use of smart technologies in mental health care provides an invaluable addition to the current literature. Qualitative findings support the feasibility of implementing a smartphone and electronic personal health record intervention with individuals who are living in the community and experiencing a mental illness, and provide considerations for future development and implementation.

  10. Qualitative Perspectives from African American Youth and Caregivers for Developing the Families Improving Together (FIT) for Weight Loss Intervention.

    Science.gov (United States)

    Kitzman-Ulrich, Heather E; Wilson, Dawn K; Lyerly, Jordan E

    2016-09-01

    This study obtained qualitative data from African American (AA) youth and caregiver dyads to inform the Families Improving Together (FIT) for Weight Loss Trial. Focus groups were conducted with 55 AA parent and caregiver dyads to gather perspectives on facilitators and barriers, motivators, and program preferences for health and weight loss using a socio-ecological framework. Four main themes emerged: using a positive health promotion framework for weight loss programs, social support and the role of parents in providing positive support, using a socio-ecological approach to examine factors that contribute to weight, and creating programs that are convenient, fun, and reduce barriers to participation. The findings from this study were used to develop the FIT intervention and indicate important individual, interpersonal, and environmental factors to consider when developing weight management and healthy lifestyle programs for AA families.

  11. [Self-perception of health care team leaders in Andalusia. A quantitative and qualitative study].

    Science.gov (United States)

    García-Romera, I; Danet, A; March-Cerdà, J C

    To determine the perception and self-assessment on leadership among health care team leaders in Andalusia. Design: Exploratory descriptive study using quantitative and qualitative methodology, developed between 2013 and 2015, using a questionnaire and semi-structured interviews. Andalusia. All health managers from the Primary Care Management Units and Health Management Areas of the Departments of Paediatrics, Emergency and Internal Medicine, for the quantitative study. A purposive sample of 24 health managers was used for the qualitative study. Descriptive statistical study and bivariate analysis of comparison of means. Content analysis of the semi-structured interviews: Codification, category tree, and triangulation of results. The best self-assessment dimension relates to support, and the worst to considering oneself as a 'good leader'. The definition of a 'good leader' includes: Honesty, trust, and attitudes of good communication, closeness, appreciation, and reinforcement of the health team members. Different leadership styles were perceived. Main difficulties for leadership are related to the economic crisis and the management of personal conflicts. Health managers describe an adaptive leadership style, based on personal and professional support, and using communication as the main cohesive element for the team project. More studies on leaders' perspectives are important, in order to better understand their experiences, needs and expectations. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs.

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    Arianna Rubin Means

    2016-10-01

    Full Text Available While some evidence supports the beneficial effects of integrating neglected tropical disease (NTD programs to optimize coverage and reduce costs, there is minimal information regarding when or how to effectively operationalize program integration. The lack of systematic analyses of integration experiences and of integration processes may act as an impediment to achieving more effective NTD programming. We aimed to learn about the experiences of NTD stakeholders and their perceptions of integration.We evaluated differences in the definitions, roles, perceived effectiveness, and implementation experiences of integrated NTD programs among a variety of NTD stakeholder groups, including multilateral organizations, funding partners, implementation partners, national Ministry of Health (MOH teams, district MOH teams, volunteer rural health workers, and community members participating in NTD campaigns. Semi-structured key informant interviews were conducted. Coding of themes involved a mix of applying in-vivo open coding and a priori thematic coding from a start list.In total, 41 interviews were conducted. Salient themes varied by stakeholder, however dominant themes on integration included: significant variations in definitions, differential effectiveness of specific integrated NTD activities, community member perceptions of NTD programs, the influence of funders, perceived facilitators, perceived barriers, and the effects of integration on health system strength. In general, stakeholder groups provided unique perspectives, rather than contrarian points of view, on the same topics. The stakeholders identified more advantages to integration than disadvantages, however there are a number of both unique facilitators and challenges to integration from the perspective of each stakeholder group.Qualitative data suggest several structural, process, and technical opportunities that could be addressed to promote more effective and efficient integrated NTD

  13. Adoption of electronic health records: a qualitative study of academic and private physicians and health administrators.

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    Grabenbauer, L; Fraser, R; McClay, J; Woelfl, N; Thompson, C B; Cambell, J; Windle, J

    2011-01-01

    Less than 20% of hospitals in the US have an electronic health record (EHR). In this qualitative study, we examine the perspectives of both academic and private physicians and administrators as stakeholders, and their alignment, to explore their perspectives on the use of technology in the clinical environment. Focus groups were conducted with 74 participants who were asked a series of open-ended questions. Grounded theory was used to analyze the transcribed data and build convergent themes. The relevance and importance of themes was constructed by examining frequency, convergence, and intensity. A model was proposed that represents the interactions between themes. Six major themes emerged, which include the impact of EHR systems on workflow, patient care, communication, research/outcomes/billing, education/learning, and institutional culture. Academic and private physicians were confident of the future benefits of EHR systems, yet cautious about the current implementations of EHR, and its impact on interactions with other members of the healthcare team and with patients, and the amount of time necessary to use EHR's. Private physicians differed on education and were uneasy about the steep learning curve necessary for use of new systems. In contrast to physicians, university and hospital administrators are optimistic, and value the availability of data for use in reporting. The results of our study indicate that both private and academic physicians concur on the need for features that maintain and enhance the relationship with the patient and the healthcare team. Resistance to adoption is related to insufficient functionality and its potential negative impact on patient care. Integration of data collection into clinical workflows must consider the unexpected costs of data acquisition.

  14. Visual methods in health dialogues: A qualitative study of public health nurse practice in schools.

    Science.gov (United States)

    Laholt, Hilde; Guillemin, Marilys; Mcleod, Kim; Olsen, Randi Elisabeth; Lorem, Geir Fagerjord

    2017-12-01

    We aimed to explore how using visual methods might improve or complicate the dynamics of the health dialogue between public health nurses (PHNs) and school pupils. This was done from the perspective of PHNs, specifically examining how they understood their role and practice as a PHN and the application of visual methods in this practice. The health dialogue is a method used by PHNs in school nursing in Norway. In this practice, there can be communicative barriers between pupils and PHNs. Investigating how PHNs understand their professional practice can lead to ways of addressing these communicative barriers, which can affect pupil satisfaction and achievement of health-related behaviours in the school context. Specifically, the use of visual methods by PHNs may address these communicative barriers. The research design was qualitative, using focus groups combined with visual methods. We conducted focus group interviews using a semi-structured discussion guide and visual methods with five groups of PHNs (n = 31) working in northern Norwegian school health services. The data were collected during January and February 2016. Discussions were audio recorded, transcribed and coded into themes and sub-themes using systematic text condensation and drawings were analysed using interpretive engagement, a method of visual analysis. Drawings and focus group discussions showed that PHNs perceived their professional practice as primarily a relational praxis. The PHNs used a variety of visual methods as part of the health dialogue with school pupils. This active use of visualization worked to build and strengthen relations when words were inadequate and served to enhance the flexible and relational practice employed by the PHNs. PHNs used different kinds of visualization methods to establish relations with school pupils, especially when verbalization by the pupils was difficult. PHNs were aware of both the benefits and challenges of using visualization with school pupils in

  15. Older People's Perspectives on Health, Physical Activity and Nutritional Behaviors

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    Leila Alizadeh

    2015-12-01

    Full Text Available Background: Approaches for investigating health-promoting lifestyle generally focus on physical activ­ity and regular diet. To explore the perspectives of Iranian elders regarding health, healthy eating and physical activity (PA this study was conducted in 2012. Methods: Participants in this qualitative study were selected through purposeful sampling. Ten focus groups were conducted with 60 older adults in 3 elderly centers in Tehran. A moderator’s guideline that consisted of general and specific questions was used. Focus groups were audio recorded, transcribed verbatim and analysis was performed using conventional content analysis. Results: Participants explained their perspectives regarding health, healthy eating and PA in the follow­ing 5 categories: meaning of health was represented based on issues such as absence of pain and disor­der, complete body wellbeing, staying away from hazards, complete individual satisfaction, experiencing positive events, effective communication, faithfulness and trust in God. The healthy eating category was featured by adequate eating, age balanced diet, refraining from under or over nutrition and sensible consumption of fruits and vegetables. The PA was described - according to the level of performing outdoor activities or household tasks. Expressions about the perceived benefits and barriers of healthy eating and PA were aligned the two remaining categories. Conclusions: Participants have referred to the association between both PA and dietary practices and health. Understanding how older people define physical activity and nutritional behavior and recognition of the most important perceived benefits and barriers that might contribute to have a healthy eating or adequate PA profile could procure insight into the type of interventions that are required to promote healthy lifestyle among Iranian older adults.

  16. Men's perspectives of prostate cancer screening: A systematic review of qualitative studies.

    Directory of Open Access Journals (Sweden)

    Laura J James

    Full Text Available Prostate cancer is the most commonly diagnosed non-skin cancer in men. Screening for prostate cancer is widely accepted; however concerns regarding the harms outweighing the benefits of screening exist. Although patient's play a pivotal role in the decision making process, men may not be aware of the controversies regarding prostate cancer screening. Therefore we aimed to describe men's attitudes, beliefs and experiences of prostate cancer screening.Systematic review and thematic synthesis of qualitative studies on men's perspectives of prostate cancer screening. Electronic databases and reference lists were searched to October 2016.Sixty studies involving 3,029 men aged from 18-89 years, who had been screened for prostate cancer by Prostate Specific Antigen (PSA or Digital Rectal Examination (DRE and not screened, across eight countries were included. Five themes were identified: Social prompting (trusting professional opinion, motivation from family and friends, proximity and prominence of cancer; gaining decisional confidence (overcoming fears, survival imperative, peace of mind, mental preparation, prioritising wellbeing; preserving masculinity (bodily invasion, losing sexuality, threatening manhood, medical avoidance; avoiding the unknown and uncertainties (taboo of cancer-related death, lacking tangible cause, physiological and symptomatic obscurity, ambiguity of the procedure, confusing controversies; and prohibitive costs.Men are willing to participate in prostate cancer screening to prevent cancer and gain reassurance about their health, particularly when supported or prompted by their social networks or healthcare providers. However, to do so they needed to mentally overcome fears of losing their masculinity and accept the intrusiveness of screening, the ambiguities about the necessity and the potential for substantial costs. Addressing the concerns and priorities of men may facilitate informed decisions about prostate cancer screening

  17. Performing masculinity, influencing health: a qualitative mixed-methods study of young Spanish men

    Science.gov (United States)

    Marcos, Jorge Marcos; Avilés, Nuria Romo; Lozano, María del Río; Cuadros, Juan Palomares; Calvente, María del Mar García

    2013-01-01

    Background The literature shows how gender mandates contribute to differences in exposure and vulnerability to certain health risk factors. This paper presents the results of a study developed in the south of Spain, where research aimed at understanding men from a gender perspective is still limited. Objective The aim of this paper is to explore the lay perceptions and meanings ascribed to the idea of masculinity, identifying ways in which gender displays are related to health. Design The study is based on a mixed-methods data collection strategy typical of qualitative research. We performed a qualitative content analysis focused on manifest and latent content. Results Our analysis showed that the relationship between masculinity and health was mainly defined with regard to behavioural explanations with an evident performative meaning. With regard to issues such as driving, the use of recreational drugs, aggressive behaviour, sexuality, and body image, important connections were established between manhood acts and health outcomes. Different ways of understanding and performing the male identity also emerged from the results. The findings revealed the implications of these aspects in the processes of change in the identity codes of men and women. Conclusions The study provides insights into how the category ‘man’ is highly dependent on collective practices and performative acts. Consideration of how males perform manhood acts might be required in guidance on the development of programmes and policies aimed at addressing gender inequalities in health in a particular local context. PMID:24044583

  18. Reflexivity and the "Acting Subject": Conceptualizing the Unit of Analysis in Qualitative Health Research.

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    Shaw, James A

    2016-07-06

    The ways in which social scientists conceptualize the "reflexive" human subject have important consequences for how we go about our research. Whether and how we understand human subjects to be the authors of our own actions helps to structure what we say about health, health care, and the many other topics addressed in qualitative health research. In this article, I critically discuss assumptions of human reflexivity that are built into qualitative social science of health and medicine. I describe three alternative ways of understanding reflexive thought and human action derived from the theoretical works of Pierre Bourdieu, Bruno Latour, and George Lakoff and Mark Johnson, respectively. I then apply these three different ways of thinking about reflexivity and the acting subject to the analysis of an excerpt of participant observation data from a health services research study of transitions from hospital to home, illuminating the different kinds of analyses that arise from each perspective. I conclude with a call for social scientists to commit to the search for better ways of understanding the human subject, resisting the temptation to "settle" on theoretical statements that close down the path to more sophisticated conceptualizations of human thought and action. © The Author(s) 2016.

  19. Mental health of refugees: global perspectives.

    Science.gov (United States)

    Abou-Saleh, Mohammed T; Christodoulou, George N

    2016-11-01

    Refugees have high rates of mental health morbidity as a result of conflict. However, their needs for mental healthcare and psychosocial support are often unmet, despite the efforts of professional and humanitarian organisations. The war refugee crisis is a global challenge that needs a global solution. We call on all governments, regional and international organisations to take responsible humanitarian actions to intervene and support people affected by these disasters and for all humanity to unite against the forces of injustice and degradation. The thematic papers in this issue report on the Syrian crisis from a variety of perspectives.

  20. Health management in past disasters in Iran: A qualitative study

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    Maryam Nakhaei

    2014-06-01

    Background: Disaster management is relied on prediction of problems and providing necessary preparations in right time and place. In this study researchers intended to explore passed experiences of health disaster management. Method: This study conducted using qualitative content analysis methods. Participants were selected purposefully and data were collected through interviews, observation, and other documents. Results: Transcribed data from 18interviews, field notes and other documents were analyzed. In data analysis reactive management was emerged as main theme. It was included some categories such as ‘exposure shock’, ‘non deliberative relief’, ‘lack of comprehensive health disaster plan’, ‘lack of preparedness’, and ‘poor coordination in health service delivery’ and contextual factors. Discussion: The results clarified deep perception of participants’ experiences about health management in disasters. The professionals' and non-professionals' emotion-based reactions and behaviors, if accompanied with deficiencies in planning and preparedness, can lead to ineffective services, and aggravates the damages.

  1. Improving early detection initiatives: a qualitative study exploring perspectives of older people and professionals.

    Science.gov (United States)

    Lette, Manon; Stoop, Annerieke; Lemmens, Lidwien C; Buist, Yvette; Baan, Caroline A; de Bruin, Simone R

    2017-06-23

    A wide range of initiatives on early detection and intervention have been developed to proactively identify problems related to health and wellbeing in (frail) older people, with the aim of supporting them to live independently for as long as possible. Nevertheless, it remains unclear what the best way is to design such initiatives and how older people's needs and preferences can be best addressed. This study aimed to address this gap in the literature by exploring: 1) older people's perspectives on health and living environment in relation to living independently at home; 2) older people's needs and preferences in relation to initiating and receiving care and support; and 3) professionals' views on what would be necessary to enable the alignment of early detection initiatives with older people's own needs and preferences. In this qualitative study, we conducted semi-structured interviews with 36 older people and 19 professionals in proactive elderly care. Data were analysed using the framework analysis method. From the interviews with older people important themes in relation to health and living environment emerged, such as maintaining independence, appropriate housing, social relationships, a supporting network and a sense of purpose and autonomy. Older people preferred to remain self-sufficient, and they would rather not ask for help for psychological or social problems. However, the interviews also highlighted that they were not always able or willing to anticipate future needs, which can hinder early detection or early intervention. At the same time, professionals indicated that older people tend to over-estimate their self-reliance and therefore advocated for early detection and intervention, including social and psychological issues. Older people have a broad range of needs in different domains of life. Discrepancies exist between older people and professionals with regard to their views on timing and scope of early detection initiatives. This study aimed

  2. History of health informatics: a global perspective.

    Science.gov (United States)

    Cesnik, Branko; Kidd, Michael R

    2010-01-01

    In considering a 'history' of Health Informatics it is important to be aware that the discipline encompasses a wide array of activities, products, research and theories. Health Informatics is as much a result of evolution as planned philosophy, having its roots in the histories of information technology and medicine. The process of its growth continues so that today's work is tomorrow's history. A 'historical' discussion of the area is its history to date, a report rather than a summation. As well as its successes, the history of Health Informatics is populated with visionary promises that have failed to materialise despite the best intentions. For those studying the subject or working in the field, the experiences of others' use of Information Technologies for the betterment of health care can provide a necessary perspective. This chapter starts by noting some of the major events and people that form a technological backdrop to Health Informatics and ends with some thoughts on the future. This chapter gives an educational overview of: * The history of computing * The beginnings of the health informatics discipline.

  3. Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: a qualitative study

    Directory of Open Access Journals (Sweden)

    Chambers M

    2013-08-01

    Full Text Available Iris Gault,1 Ann Gallagher,2 Mary Chambers31Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, Kingston, Surrey, UK; 2International Centre for Nursing Ethics, School of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK; 3Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, St George's University of London, Tooting, London, UKAim: To explore and analyze perceptions of service users and caregivers on adherence and nonadherence to medication in a mental health care context.Background: Mental health medication adherence is considered problematic and legal coercion exists in many countries.Design: This was a qualitative study aiming to explore perceptions of medication adherence from the perspective of the service user (and their caregiver, where possible.Participants: Eighteen mental health service users (and six caregivers with histories of medication nonadherence and repeated compulsory admission were recruited from voluntary sector support groups in England.Methods: Data were collected between 2008 and 2010. Using qualitative coding techniques, the study analyzed interview and focus group data from service users, previously subjected to compulsory medication under mental health law, or their caregivers.Results: The process of medication adherence or nonadherence is encapsulated in an explanatory narrative. This narrative constitutes participants' struggle to negotiate acceptable and effective routes through variable quality of care. Results indicated that service users and caregivers eventually accepted the reality of their own mental illness and their need for safety and treatment. They perceived the behavior of professionals as key in their recovery process. Professionals could be enabling or disabling with regard to adherence to medication.Conclusion: This study investigated service user

  4. Health Coaching in Severe COPD After a Hospitalization: A Qualitative Analysis of a Large Randomized Study.

    Science.gov (United States)

    Benzo, Roberto P; Kirsch, Janae L; Hathaway, Julie C; McEvoy, Charlene E; Vickers, Kristin S

    2017-11-01

    We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore the health-coaching intervention as seen from the perspective of the participants who received the intervention and the coaches who delivered it. Semistructured participant interviews ( n = 24) and a focus group of all health coaches ( n = 3) who participated in this study were conducted. Interviews and focus group were recorded and transcribed verbatim. Transcripts were analyzed using coding and categorizing techniques and thematic analysis. Mixed-method triangulation was used to merge quantitative and qualitative data. Content analysis revealed 4 predominant themes of the coaching intervention: health-coaching relationship, higher participant confidence and reassurance (most related to improvement in physical quality of life), improved health-care system access (most related to decreased hospital readmissions), and increased awareness of COPD symptoms (most related to improvement in emotional quality of life). The strongest theme was the relationship with the health coach, including coach style and motivational interviewing approach. Health coaches' focus group also noted the importance of the coaching relationship as the most significant theme. This study provided themes to further inform the delivery and implementation of health-coaching interventions in patients with COPD after hospital discharge. Health coaching forged partnerships and created a platform for patient engagement, which was confirmed by both participants and health coaches. Copyright © 2017 by Daedalus Enterprises.

  5. Technological Health Intervention in Population Aging to Assist People to Work Smarter not Harder: Qualitative Study

    Science.gov (United States)

    2018-01-01

    Background Technology-based health care has been promoted as an effective tool to enable clinicians to work smarter. However, some health stakeholders believe technology will compel users to work harder by creating extra work. Objective The objective of this study was to investigate how and why electronic health (eHealth) has been applied in Taiwan and to suggest implications that may inspire other countries facing similar challenges. Methods A qualitative methodology was adopted to obtain insightful inputs from deeper probing. Taiwan was selected as a typical case study, given its aging population, advanced technology, and comprehensive health care system. This study investigated 38 stakeholders in the health care ecosystem through in-depth interviews and focus groups, which provides an open, flexible, and enlightening way to study complex, dynamic, and interactive situations through informal conversation or a more structured, directed discussion. Results First, respondents indicated that the use of technology can enable seamless patient care and clinical benefits such as flexibility in time management. Second, the results suggested that a leader’s vision, authority, and management skills might influence success in health care innovation. Finally, the results implied that both internal and external organizational governance are highly relevant for implementing technology-based innovation in health care. Conclusions This study provided Taiwanese perspectives on how to intelligently use technology to benefit health care and debated the perception that technology prevents human interaction between clinicians and patients. PMID:29301736

  6. Regions and media from quantitative and qualitative perspectives: the case of Czech Republic

    Directory of Open Access Journals (Sweden)

    Jan Sucháček

    2013-01-01

    Full Text Available Media become increasingly important in co-creating the image of spatial units at various scales. The situation is even more intriguing in transition/post-transitions countries, which were exposed to modernization trends in rather short, almost compressed periods. The article aims at showing how media shape the image of NUTS III regions in the Czech Republic. Comparisons show TV coverage embodies media agenda in a satisfactory manner as it has one of the highest impacts on the public on the one hand and is representative enough on the other. That is why TV coverage at the national level with contributions related to individual NUTS III in the Czech Republic was chosen as a point of departure. Thus, the objective of the paper is to analyze and interpret TV news related to NUTS III regions in the Czech Republic. This will be accomplished from both quantitative and qualitative perspectives. Quantitative analysis is focusing on the number of contributions related to the size of the region in question. Nonetheless, self-governing regions in the Czech Republic will be evaluated also from qualitative perspective when the composition of TV news will be accentuated. Although it is stated only seldom media analysis is of utmost importance in relation to regional development. In order to quantify and evaluate afore mentioned dependencies the methods of regression and correlation analysis will be utilized. Moreover, correspondence analysis and analysis of contingency tables will be used in the qualitative part of our research.

  7. Baccalaureate nursing students' perspectives on learning about caring in China: a qualitative descriptive study.

    Science.gov (United States)

    Ma, Fang; Li, Jiping; Liang, Hongmin; Bai, Yangjuan; Song, Jianhua

    2014-03-04

    The need to provide humanistic care in the contemporary healthcare system is more imperative now and the importance of cultivating caring in nursing education is urgent. Caring as the primary work of nursing has been discussed extensively, such as the meaning of caring, and teaching and learning strategies to improve nursing students' caring ability. Yet attempts to understand students' perspectives on learning about caring and to know their learning needs are seldom presented. The aim of this qualitative descriptive study was to explore the baccalaureate nursing students' perspectives on learning about caring in China. A qualitative descriptive study using focus group interviews were undertaken in two colleges in Yunnan Province, China from February 2010 to April 2010. Purposeful sampling of 20 baccalaureate nursing students were recruited. Content analysis of the transcribed data was adopted to identify the themes. Four categories with some sub-categories related to students' perspectives on learning about caring were identified from the data: 1) Learning caring by role model; 2) conducive learning environment as the incentive to the learning about caring; 3) lack of directive substantive way of learning as the hindrance to the learning about caring; 4) lack of cultural competency as the barrier to the learning about caring. Both caring and uncaring experiences can promote the learning about caring in a way of reflective practice. The formal, informal and hidden curricula play an important role in the learning about caring. Cultural awareness, sensitivity and humility are important in the process of learning to care in a multicultural area.

  8. Understanding institutional stakeholders’ perspectives on multidrug-resistant bacterial organism at the end of life: a qualitative study

    Science.gov (United States)

    Heckel, Maria; Herbst, Franziska A; Adelhardt, Thomas; Tiedtke, Johanna M; Sturm, Alexander; Stiel, Stephanie; Ostgathe, Christoph

    2017-01-01

    Background Information lacks about institutional stakeholders’ perspectives on management approaches of multidrug-resistant bacterial organism in end-of-life situations. The term “institutional stakeholder” includes persons in leading positions with responsibility in hospitals’ multidrug-resistant bacterial organism management. They have great influence on how strategies on multidrug-resistant bacterial organism management approaches in institutions of the public health system are designed. This study targeted institutional stakeholders’ individual perspectives on multidrug-resistant bacterial organism colonization or infection and isolation measures at the end of life. Methods Between March and December 2014, institutional stakeholders of two study centers, a German palliative care unit and a geriatric ward, were queried in semistructured interviews. Interviews were audiotaped, transcribed verbatim, and analyzed qualitatively with the aid of the software MAXQDA for qualitative data analysis using principles of Grounded Theory. In addition, two external stakeholders were interviewed to enrich data. Results Key issues addressed by institutional stakeholders (N=18) were the relevance of multidrug-resistant bacterial organism in palliative and geriatric care, contradictions between hygiene principles and patients’ and family caregivers’ needs and divergence from standards, frame conditions, and reflections on standardization of multidrug-resistant bacterial organism end-of-life care procedures. Results show that institutional stakeholders face a dilemma between their responsibility in protecting third persons and ensuring patients’ quality of life. Until further empirical evidence establishes a clear multidrug-resistant bacterial organism management approach in end-of-life care, stakeholders suggest a case-based approach. Conclusion The institutional stakeholders’ perspectives and their suggestion of a case-based approach advance the development

  9. Understanding institutional stakeholders' perspectives on multidrug-resistant bacterial organism at the end of life: a qualitative study.

    Science.gov (United States)

    Heckel, Maria; Herbst, Franziska A; Adelhardt, Thomas; Tiedtke, Johanna M; Sturm, Alexander; Stiel, Stephanie; Ostgathe, Christoph

    2017-01-01

    Information lacks about institutional stakeholders' perspectives on management approaches of multidrug-resistant bacterial organism in end-of-life situations. The term "institutional stakeholder" includes persons in leading positions with responsibility in hospitals' multidrug-resistant bacterial organism management. They have great influence on how strategies on multidrug-resistant bacterial organism management approaches in institutions of the public health system are designed. This study targeted institutional stakeholders' individual perspectives on multidrug-resistant bacterial organism colonization or infection and isolation measures at the end of life. Between March and December 2014, institutional stakeholders of two study centers, a German palliative care unit and a geriatric ward, were queried in semistructured interviews. Interviews were audiotaped, transcribed verbatim, and analyzed qualitatively with the aid of the software MAXQDA for qualitative data analysis using principles of Grounded Theory. In addition, two external stakeholders were interviewed to enrich data. Key issues addressed by institutional stakeholders (N=18) were the relevance of multidrug-resistant bacterial organism in palliative and geriatric care, contradictions between hygiene principles and patients' and family caregivers' needs and divergence from standards, frame conditions, and reflections on standardization of multidrug-resistant bacterial organism end-of-life care procedures. Results show that institutional stakeholders face a dilemma between their responsibility in protecting third persons and ensuring patients' quality of life. Until further empirical evidence establishes a clear multidrug-resistant bacterial organism management approach in end-of-life care, stakeholders suggest a case-based approach. The institutional stakeholders' perspectives and their suggestion of a case-based approach advance the development process of a patient-, family-, staff-, and institutional

  10. Negative health care experiences of immigrant patients: a qualitative study

    Directory of Open Access Journals (Sweden)

    Stronks Karien

    2011-01-01

    Full Text Available Abstract Background Negative events are abusive, potentially dangerous or life-threatening health care events, as perceived by the patient. Patients' perceptions of negative events are regarded as a potentially important source of information about the quality of health care. We explored negative events in hospital care as perceived by immigrant patients. Methods Semi-structured individual and group interviews were conducted with respondents about negative experiences of health care. Interviews were transcribed and analyzed using a framework method. A total of 22 respondents representing 7 non-Dutch ethnic origins were interviewed; each respondent reported a negative event in hospital care or treatment. Results Respondents reported negative events in relation to: 1 inadequate information exchange with care providers; 2 different expectations between respondents and care providers about medical procedures; 3 experienced prejudicial behavior on the part of care providers. Conclusions We identified three key situations in which negative events were experienced by immigrant patients. Exploring negative events from the immigrant patient perspective offers important information to help improve health care. Our results indicate that care providers need to be trained in adequately exchanging information with the immigrant patient and finding out specific patient needs and perspectives on illness and treatment.

  11. Social perspective: the missing element in mental health practice

    National Research Council Canada - National Science Library

    U'Ren, Richard C

    2011-01-01

    .... ________________________________________________________________ Library and Archives Canada Cataloguing in Publication U'Ren, Richard, 1939- Social perspective : the missing element in mental health practice / Richard U'Ren...

  12. Does cultural context make a difference to women's experiences of maternity care? A qualitative study comparing the perspectives of breast-feeding women of Bangladeshi origin and health practitioners.

    Science.gov (United States)

    McFadden, Alison; Renfrew, Mary J; Atkin, Karl

    2013-12-01

    Maternity services struggle to provide culturally appropriate care that meets the needs of women from diverse populations. Problems include simplistic understandings of ethnicity and the role of culture in women's lives, and stereotypes held by health practitioners. To explore the extent to which cultural context makes a difference to experiences of breast-feeding support for women of Bangladeshi origin and to consider the implications for the provision of culturally appropriate care. The study comprised individual interviews with 23 women of Bangladeshi origin and four health service managers, and focus group discussions with 28 health practitioners between February and December 2008. Participants were recruited from four localities in northern England. Women's rich descriptions of various facets of their identities were in contrast to practitioners' representations of women of Bangladeshi origin as homogenous. Practitioners did not recognize when the needs of women of Bangladeshi origin were similar to those of the majority white population, or where cultural context made a difference to their experiences of breast-feeding and breast-feeding support. Some practitioners used cultural stereotypes which, combined with organizational constraints, resulted in services not meeting many of the women's needs. Implications for education, policy and practice include the need for training of health practitioners to work with diverse populations, implementing evidence-based practice and providing an organizational context which supports practitioners to respond to diversity without using cultural stereotypes. © 2012 John Wiley & Sons Ltd.

  13. Does cultural context make a difference to women’s experiences of maternity care? A qualitative study comparing the perspectives of breast‐feeding women of Bangladeshi origin and health practitioners

    Science.gov (United States)

    McFadden, Alison; Renfrew, Mary J; Atkin, Karl

    2012-01-01

    Abstract Background  Maternity services struggle to provide culturally appropriate care that meets the needs of women from diverse populations. Problems include simplistic understandings of ethnicity and the role of culture in women’s lives, and stereotypes held by health practitioners. Objective  To explore the extent to which cultural context makes a difference to experiences of breast‐feeding support for women of Bangladeshi origin and to consider the implications for the provision of culturally appropriate care. Methods  The study comprised individual interviews with 23 women of Bangladeshi origin and four health service managers, and focus group discussions with 28 health practitioners between February and December 2008. Participants were recruited from four localities in northern England. Results  Women’s rich descriptions of various facets of their identities were in contrast to practitioners’ representations of women of Bangladeshi origin as homogenous. Practitioners did not recognize when the needs of women of Bangladeshi origin were similar to those of the majority white population, or where cultural context made a difference to their experiences of breast‐feeding and breast‐feeding support. Some practitioners used cultural stereotypes which, combined with organizational constraints, resulted in services not meeting many of the women’s needs. Conclusions  Implications for education, policy and practice include the need for training of health practitioners to work with diverse populations, implementing evidence‐based practice and providing an organizational context which supports practitioners to respond to diversity without using cultural stereotypes. PMID:22429489

  14. Religious leaders' opinions and guidance towards oral health maintenance and promotion: a qualitative study.

    Science.gov (United States)

    Zini, Avraham; Sgan-Cohen, Harold D; Feder-Bubis, Paula

    2015-04-01

    Religions emphasize the supreme value of life. However, potential or concrete conflicts of perception between dictates of faith and science often present an inescapable dilemma. The aim of this qualitative research was to examine the views of spiritual and religious leaders towards general and oral health issues. A total of 11 eminent Jewish spiritual and religious community leaders were purposively chosen. They were interviewed using a semi-structured questionnaire. The verbatim transcriptions of the interviews were analysed in the spirit of grounded theory, using qualitative data analysis software. Open, axial, and thematic coding served to build categories and themes. Analysis of participants' perspectives reflected that they, based upon Jewish theology, attributed high importance to primary prevention at both personal and community levels. Religious and orthodox people were depicted as being motivated towards maintaining oral health behaviours due to a sense of obligation to follow religious edicts, strong social support, and elevated perceived spiritual levels. We offer a theoretical model that can explain the potential high motivation among these communities towards implementing positive general and oral health behaviours. Religiosity may be regarded as an example of a psycho-social health determinant, encompassing spiritual belief ("psycho") and social support ("social") components.

  15. Does cultural context make a difference to women?s experiences of maternity care? A qualitative study comparing the perspectives of breast?feeding women of Bangladeshi origin and health practitioners

    OpenAIRE

    McFadden, Alison; Renfrew, Mary J; Atkin, Karl

    2012-01-01

    Abstract Background? Maternity services struggle to provide culturally appropriate care that meets the needs of women from diverse populations. Problems include simplistic understandings of ethnicity and the role of culture in women?s lives, and stereotypes held by health practitioners. Objective? To explore the extent to which cultural context makes a difference to experiences of breast?feeding support for women of Bangladeshi origin and to consider the implications for the provision of cult...

  16. Teachers' Perspectives on Preventing Suicide in Children and Adolescents in Schools: A Qualitative Study.

    Science.gov (United States)

    Ross, Victoria; Kõlves, Kairi; De Leo, Diego

    2017-07-03

    Given the important role teachers play as gatekeepers in school suicide prevention, this study explored teachers' perspectives on what should be done to improve current suicide prevention efforts. The study, in Queensland, Australia, was part of a large-scale survey examining teachers' knowledge, attitudes and experience of suicidality. One hundred and fifteen teachers responded to an online survey question regarding their views on the requirements for school suicide prevention. Qualitative analysis identified five themes from teachers' responses: awareness and stigma reduction, support services for students, education and training, bullying and the role of social media. The results of this study provide some profound insights into teachers' perspectives on suicide and highlight the critical need for improved suicide prevention efforts in schools.

  17. Family planning providers' perspectives on family planning service delivery in Ibadan and Kaduna, Nigeria: a qualitative study.

    Science.gov (United States)

    Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna

    2013-01-01

    In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.

  18. Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

    Science.gov (United States)

    2012-01-01

    Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of quality prenatal care, clinical and

  19. Ethical issues in public health surveillance: a systematic qualitative review.

    Science.gov (United States)

    Klingler, Corinna; Silva, Diego Steven; Schuermann, Christopher; Reis, Andreas Alois; Saxena, Abha; Strech, Daniel

    2017-04-04

    Public health surveillance is not ethically neutral and yet, ethics guidance and training for surveillance programmes is sparse. Development of ethics guidance should be based on comprehensive and transparently derived overviews of ethical issues and arguments. However, existing overviews on surveillance ethics are limited in scope and in how transparently they derived their results. Our objective was accordingly to provide an overview of ethical issues in public health surveillance; in addition, to list the arguments put forward with regards to arguably the most contested issue in surveillance, that is whether to obtain informed consent. Ethical issues were defined based on principlism. We assumed an ethical issue to arise in surveillance when a relevant normative principle is not adequately considered or two principles come into conflict. We searched Pubmed and Google Books for relevant publications. We analysed and synthesized the data using qualitative content analysis. Our search strategy retrieved 525 references of which 83 were included in the analysis. We identified 86 distinct ethical issues arising in the different phases of the surveillance life-cycle. We further identified 20 distinct conditions that make it more or less justifiable to forego informed consent procedures. This is the first systematic qualitative review of ethical issues in public health surveillance resulting in a comprehensive ethics matrix that can inform guidelines, reports, strategy papers, and educational material and raise awareness among practitioners.

  20. Building Connections While Conducting Qualitative Health Fieldwork in Vietnam

    Directory of Open Access Journals (Sweden)

    Victoria L. Boggiano

    2015-11-01

    Full Text Available Researchers are increasingly embarking on international qualitative health research projects, where unknown social structures and government systems make inquiry uniquely challenging. In this article, we document our experiences conducting two related studies on HIV/AIDS in Northern Vietnam. We describe how our research relied on harnessing the social capital of vital community stakeholders, such as key informants, interpreters, and host organizations, to effectively engage with government bodies on a macro level and with local communities on a microlevel. By highlighting our processes, pitfalls, and successes, we provide current and future scholars with strategies to use when conducting cross-national field research.

  1. Attitudes, barriers and facilitators for health promotion in the elderly in primary care. A qualitative focus group study.

    Science.gov (United States)

    Badertscher, Nina; Rossi, Pascal Olivier; Rieder, Arabelle; Herter-Clavel, Catherine; Rosemann, Thomas; Zoller, Marco

    2012-07-11

    Effective health promotion is of great importance from clinical as well as from public health perspectives and therefore should be encouraged. Especially regarding health promotion in the elderly, general practitioners (GPs) have a key role. Nevertheless, evidence suggests a lack of health promotion by GPs, especially in this age group. The aim of our study was to assess self-perceived attitudes, barriers and facilitators of GPs to provide health promotion in the elderly. We performed a qualitative focus group study with 37 general practitioners. The focus group interviews were recorded digitally, transcribed literally and analysed with ATLAS.ti, a software program for qualitative text analysis. Among the participating GPs, definitions of health promotion varied widely and the opinions regarding its effectiveness were very heterogeneous. The two most important self-perceived barriers for GPs to provide health promotion in the elderly were lack of time and insufficient reimbursement for preventive and health promotion advice. As intervention to increase health promotion in the elderly, GPs suggested, for example, integration of health promotion into under and postgraduate training. Changes at the practice level such as involving the practice nurse in health promotion and counselling were discussed very controversially. Health promotion, especially in the elderly, is crucial but in the opinion of the GPs we involved in our study, there is a gap between public health requirements and the reimbursement system. Integration of health promotion in medical education may be needed to increase knowledge as well as attitudes of GPs regarding this issue.

  2. A Qualitative Investigation of Parents’ Perspectives about Feeding Practices with Siblings among Racially/Ethnically and Socioeconomically Diverse Households

    Science.gov (United States)

    Berge, Jerica M.; Trofholz, Amanda; Schulte, Anna; Conger, Katherine; Neumark-Sztainer, Dianne

    2016-01-01

    Objective Little is known about parent feeding practices with siblings. Because this is a new area of research, qualitative research is needed to understand parents’ perspectives about how they make decisions about feeding siblings and whether they adapt their feeding practices dependent on sibling characteristics such as weight status. The main objective of the current study was to describe parent feeding practices with siblings. Design Qualitative cross-sectional study with 88 parents with at least two siblings. Setting Parents were interviewed in their homes in Minneapolis/St. Paul Minnesota. Participants Parents were from racially/ethnically diverse (64% African American) and low-income households (77% earned siblings. Analysis Qualitative interviews were coded using a hybrid deductive and inductive content analysis approach. Results Parents indicated that they used child food preferences, in-the-moment decisions, and planned meals when deciding how to feed siblings. Additionally, the majority of parents indicated that they managed picky eating by making one meal or giving some flexibility/leeway to siblings about having other food options. Furthermore, parents endorsed using different feeding practices (e.g., food restriction, portion control, pressure-to-eat, opportunities for healthful eating) with siblings dependent on child weight status or age/developmental stage. Conclusions and Implications Findings from the current study may inform future research regarding how to measure parent feeding practices with siblings in the home environment and the development of interventions tailored for families with multiple children in the home. Future quantitative research is needed to confirm these qualitative findings. PMID:27373864

  3. A Qualitative Investigation of Parents' Perspectives About Feeding Practices With Siblings Among Racially/Ethnically and Socioeconomically Diverse Households.

    Science.gov (United States)

    Berge, Jerica M; Trofholz, Amanda; Schulte, Anna; Conger, Katherine; Neumark-Sztainer, Dianne

    2016-01-01

    Little is known about parent feeding practices with siblings. Because this is a new area of research, qualitative research is needed to understand parents' perspectives about how they make decisions about feeding siblings and whether they adapt their feeding practices dependent on sibling characteristics such as weight status. The main objective of the current study was to describe parent feeding practices with siblings. Qualitative cross-sectional study with 88 parents with at least 2 siblings. Parents were interviewed in their homes in Minneapolis/St Paul Minnesota. Parents were from racially/ethnically diverse (64% African American) and low-income households (77% earned Parents' perceptions of feeding practices with siblings. Qualitative interviews were coded using a hybrid deductive and inductive content analysis approach. Parents indicated that they used child food preferences, in-the-moment decisions, and planned meals when deciding how to feed siblings. Additionally, the majority of parents indicated that they managed picky eating by making 1 meal or giving some flexibility/leeway to siblings about having other food options. Furthermore, parents endorsed using different feeding practices (eg, food restriction, portion control, pressure-to-eat, opportunities for healthful eating) with siblings dependent on child weight status or age/developmental stage. Findings from the current study may inform future research regarding how to measure parent feeding practices with siblings in the home environment and the development of interventions tailored for families with multiple children in the home. Future quantitative research is needed to confirm these qualitative findings. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  4. Maternal care of undocumented pregnant women under the Fees Act (Medical) for Foreigners 1951. Perspectives of health and non-health actors

    OpenAIRE

    Loo, Pei Shan

    2017-01-01

    With the unprecedented international migration around the world, policies that restrict immigrants' health care access have become prevailing. In 2014, the amendment to The Fees Act (Medical) for Foreigners 1951 had further hindered the health care access of undocumented pregnant women. This qualitative study aimed to obtain perspectives of health and non-health actors regarding the implications of the amendment to the undocumented pregnant women. Ten semi-structured interviews were conducted...

  5. Primary health care to elderly people: Occupational Therapy actions perspectives

    Directory of Open Access Journals (Sweden)

    Cassio Batista Alves

    2015-09-01

    Full Text Available In Brazil, Occupational Therapy (OT was legislated in 1969, and was introduced into the Primary Health Care (PHC in the 90s. At this level of care, the OT serves various stages of human development, including aging, in a perspective of care and active aging line, seeks to optimize opportunities for health, participation and safety, using clinical reasoning in order to plan, guide, conduct and reflect their actions in producing the line of care. This career considers human activities as part of the construction of the man himself as an expertise area and seeks to understand the relationships that the active human establishes in its life and health. This study aimed to verify the actions and identify the occupational therapy line of care with the elderly in APS. This is a qualitative study that used a semi-structured interview applied during April to May 2013 with six occupational therapists that cared for older people in the APS at Uberaba-MG. The data was analyzed using the Collective Subject Discourse (CSD technique. We observed that the OT actions to produce line of care for the elderly happen according to the general public care, whether individual or group, with the team during case discussions, referrals or work management and the territory during the territorial diagnosis and networks formation, all permeated by the principles of fairness, integrity, intersectoriality and clinical reasoning in OT.

  6. Nursing students' experiences with refugees with mental health problems in Jordan: A qualitative content analysis.

    Science.gov (United States)

    Dotevall, Camilla; Winberg, Elin; Rosengren, Kristina

    2018-02-01

    The aim of this study was to describe Jordanian nursing students' experience of caring for refugees with mental health problems. According to refugees' experiences of crisis, a well-educated staff is needed to provide high quality of care due to mental health problems. Therefore, health professionals play an important role in creating an environment that promotes human rights regardless of ethnic origin. The study comprised eight interviews and was analysed using content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nursing students' perspective and thoughts regarding caring for refugees with mental health problems. The results formed one category: to be challenged by refugees' mental health issues and three subcategories: managing refugees' mental health needs, affected by refugees' mental health, and improve mental healthcare for refugees. Language problems could be managed by using interpreters to decrease cultural clashes to facilitate equal healthcare. In addition, well-educated (theoretical knowledge) and trained (practical knowledge) nursing students have potential to fulfil refugees' care needs regardless of ethnicity or background by using nursing interventions built on communication skills and cultural competences (theory, practice) to facilitate high quality of healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. The Value of Qualitative Description in Health Services and Policy Research

    Science.gov (United States)

    2017-01-01

    Health services and policy (HSP) researchers have long used qualitative research methodologies to explore health system issues. However, the appropriateness of one approach, qualitative description, for HSP research is still often overlooked. In this article, I discuss the role that qualitative description can play in HSP research, and argue for its greater acceptance as a valid form of academic scholarship. PMID:28277201

  8. Rural mental health workforce difficulties: a management perspective.

    Science.gov (United States)

    Moore, T; Sutton, K; Maybery, D

    2010-01-01

    The recruitment, retention and training of mental health workers is of major concern in rural Australia, and the Gippsland region of Victoria is no exception. Previous studies have identified a number of common factors in these workforce difficulties, including rurality, difficulties of access to professional development and training, and professional and personal isolation. However, those previous studies have often focused on medicine and been based on the perspectives of practitioners, and have almost ignored the perspectives of managers of rural mental health services. The study reported in this article sought to contribute to the development of a more sustainable and effective regional mental health workforce by complementing earlier insights with those of leading administrators, managers and senior clinicians in the field. The study took a qualitative approach. It conducted semi-structured in-person interviews with 24 managers of health/mental-health services and senior administrators and clinicians working in organisations of varying sizes in the public and private sectors. Thematic content analysis of the transcribed interviews identified core difficulties these managers experienced in the recruitment, retention and training of employees. The study found that some of the issues commonly resulting in difficulties in recruiting, retaining and developing a trained workforce in rural areas, such as rurality (implying personal and professional isolation, distances to deliver service and small organisations) and a general shortage of trained personnel, are significant in Gippsland. Through its focus on the perspectives of leaders in the management of rural mental health services, however, the study found other key issues that contribute to workforce difficulties. Many, including the unattractive nature of mental health work, the fragmented administration of the mental health system, short-term and tied funding, and shortcomings in training are external to

  9. Patient's and health care provider's perspectives on music therapy in palliative care - an integrative review.

    Science.gov (United States)

    Schmid, W; Rosland, J H; von Hofacker, S; Hunskår, I; Bruvik, F

    2018-02-20

    The use of music as therapy in multidisciplinary end-of-life care dates back to the 1970s and nowadays music therapy (MT) is one of the most frequently used complementary therapy in in-patient palliative care in the US. However existing research investigated music therapy's potential impact mainly from one perspective, referring to either a quantitative or qualitative paradigm. The aim of this review is to provide an overview of the users' and providers' perspectives on music therapy in palliative care within one research article. A systematic literature search was conducted using several databases supplemented with a hand-search of journals between November 1978 and December 2016. Inclusion criteria were: Music therapy with adults in palliative care conducted by a certified music therapist. Both quantitative and qualitative studies in English, German or a Scandinavian language published in peer reviewed journals were included. We aimed to identify and discuss the perspectives of both patients and health care providers on music therapy's impact in palliative care to forward a comprehensive understanding of it's effectiveness, benefits and limitations. We investigated themes mentioned by patients within qualitative studies, as well as commonly chosen outcome measures in quantitative research. A qualitative approach utilizing inductive content analysis was carried out to analyze and categorize the data. Twelve articles, reporting on nine quantitative and three qualitative research studies were included. Seven out of the nine quantitative studies investigated pain as an outcome. All of the included quantitative studies reported positive effects of the music therapy. Patients themselves associated MT with the expression of positive as well as challenging emotions and increased well-being. An overarching theme in both types of research is a psycho-physiological change through music therapy. Both quantitative as well as qualitative research showed positive changes in

  10. Dropout From an eHealth Intervention for Adults With Type 2 Diabetes: A Qualitative Study.

    Science.gov (United States)

    Lie, Silje Stangeland; Karlsen, Bjørg; Oord, Ellen Renate; Graue, Marit; Oftedal, Bjørg

    2017-05-30

    Adequate self-management is the cornerstone of type 2 diabetes treatment, as people make the majority of daily treatment measures and health decisions. The increasing prevalence of type 2 diabetes mellitus (T2DM) and the complexity of diabetes self-management demonstrate the need for innovative and effective ways to deliver self-management support. eHealth interventions are promoted worldwide and hold a great potential in future health care for people with chronic diseases such as T2DM. However, many eHealth interventions face high dropout rates. This led to our interest in the experiences of participants who dropped out of an eHealth intervention for adults with T2DM, based on the Guided Self-Determination (GSD) counseling method. In this study, we aimed to explore experiences with an eHealth intervention based on GSD in general practice from the perspective of those who dropped out and to understand their reasons for dropping out. To the best of our knowledge, no previous qualitative study has focused on participants who withdrew from an eHealth self-management support intervention for adults with T2DM. A qualitative design based on telephone interviews was used to collect data. The sample comprised 12 adults with type 2 diabetes who dropped out of an eHealth intervention. Data were collected in 2016 and subjected to qualitative content analysis. We identified one overall theme: "Losing motivation for intervention participation." This theme was illustrated by four categories related to the participants' experiences of the eHealth intervention: (1) frustrating technology, (2) perceiving the content as irrelevant and incomprehensible, (3) choosing other activities and perspectives, and (4) lacking face-to-face encounters. Our findings indicate that the eHealth intervention based on GSD without face-to-face encounters with nurses reduced participants' motivation for engagement in the intervention. To maintain motivation, our study points to the importance of

  11. Barriers to partnership working in public health: a qualitative study.

    Directory of Open Access Journals (Sweden)

    David Carlton Taylor-Robinson

    Full Text Available Public health provision in England is undergoing dramatic changes. Currently established partnerships are thus likely to be significantly disrupted by the radical reforms outlined in the Public Health White Paper. We therefore explored the process of partnership working in public health, in order to better understand the potential opportunities and threats associated with the proposed changes.70 participants took part in an in-depth qualitative study involving 40 semi-structured interviews and three focus group discussions. Participants were senior and middle grade public health decision makers working in Primary Care Trusts, Local Authorities, Department of Health, academia, General Practice and Hospital Trusts and the third sector in England. Despite mature arrangements for partnership working in many areas, and much support for joint working in principle, many important barriers exist. These include cultural issues such as a lack of shared values and language, the inherent complexity of intersectoral collaboration for public health, and macro issues including political and resource constraints. There is particular uncertainty and anxiety about the future of joint working relating to the availability and distribution of scarce and diminishing financial resources. There is also the concern that existing effective collaborative networks may be completely disrupted as the proposed changes unfold. The extent to which the proposed reforms might mitigate or potentiate these issues remains unclear. However the threats currently remain more salient than opportunities.The current re-organisation of public health offers real opportunity to address some of the barriers to partnership working identified in this study. However, significant threats exist. These include the breakup of established networks, and the risk of cost cutting on effective public health interventions.

  12. Using the realist perspective to link theory from qualitative evidence synthesis to quantitative studies: Broadening the matrix approach.

    Science.gov (United States)

    van Grootel, Leonie; van Wesel, Floryt; O'Mara-Eves, Alison; Thomas, James; Hox, Joop; Boeije, Hennie

    2017-09-01

    This study describes an approach for the use of a specific type of qualitative evidence synthesis in the matrix approach, a mixed studies reviewing method. The matrix approach compares quantitative and qualitative data on the review level by juxtaposing concrete recommendations from the qualitative evidence synthesis against interventions in primary quantitative studies. However, types of qualitative evidence syntheses that are associated with theory building generate theoretical models instead of recommendations. Therefore, the output from these types of qualitative evidence syntheses cannot directly be used for the matrix approach but requires transformation. This approach allows for the transformation of these types of output. The approach enables the inference of moderation effects instead of direct effects from the theoretical model developed in a qualitative evidence synthesis. Recommendations for practice are formulated on the basis of interactional relations inferred from the qualitative evidence synthesis. In doing so, we apply the realist perspective to model variables from the qualitative evidence synthesis according to the context-mechanism-outcome configuration. A worked example shows that it is possible to identify recommendations from a theory-building qualitative evidence synthesis using the realist perspective. We created subsets of the interventions from primary quantitative studies based on whether they matched the recommendations or not and compared the weighted mean effect sizes of the subsets. The comparison shows a slight difference in effect sizes between the groups of studies. The study concludes that the approach enhances the applicability of the matrix approach. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research.

    OpenAIRE

    Pope, C.; Mays, N.

    1995-01-01

    Qualitative research methods have a long history in the social sciences and deserve to be an essential component in health and health services research. Qualitative and quantitative approaches to research tend to be portrayed as antithetical; the aim of this series of papers is to show the value of a range of qualitative techniques and how they can complement quantitative research.

  14. What Is Qualitative Research?

    Science.gov (United States)

    Otani, Takashi

    2017-01-01

    The article is an in-depth explanation of qualitative research, an approach increasingly prevalent among today's research communities. After discussing its present spread within the health sciences, the author addresses: 1. Its definition. 2. Its characteristics, as well as its theoretical and procedural background. 3. Its procedures. 4. Differences between qualitative and quantitative approaches. 5. Mixed methods incorporating quantitative research. And in conclusion: 6. The importance of establishing an epistemological perspective in qualitative research.

  15. Transition from specialist to primary diabetes care: A qualitative study of perspectives of primary care physicians

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    Liddy Clare

    2009-06-01

    Full Text Available Abstract Background The growing prevalence of diabetes and heightened awareness of the benefits of early and intensive disease management have increased service demands and expectations not only of primary care physicians but also of diabetes specialists. While research has addressed issues related to referral into specialist care, much less has been published about the transition from diabetes specialists back to primary care. Understanding the concerns of family physicians related to discharge of diabetes care from specialist centers can support the development of strategies that facilitate this transition and result in broader access to limited specialist services. This study was undertaken to explore primary care physician (PCP perspectives and concerns related to reassuming responsibility for diabetes care after referral to a specialized diabetes center. Methods Qualitative data were collected through three focus groups. Sessions were audio-taped and transcribed verbatim. Data were coded and sorted with themes identified using a constant comparison method. The study was undertaken through the regional academic referral center for adult diabetes care in Ottawa, Canada. Participants included 22 primary care physicians representing a variety of referral frequencies, practice types and settings. Results Participants described facilitators and barriers to successful transition of diabetes care at the provider, patient and systems level. Major facilitators included clear communication of a detailed, structured plan of care, ongoing access to specialist services for advice or re-referral, continuing education and mentoring for PCPs. Identified provider barriers were gaps in PCP knowledge and confidence related to diabetes treatment, excessive workload and competing time demands. Systems deterrents included reimbursement policies for health professionals and inadequate funding for diabetes medications and supplies. At the PCP-patient interface

  16. Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study.

    Science.gov (United States)

    Rose, Diana; Trevillion, Kylee; Woodall, Anna; Morgan, Craig; Feder, Gene; Howard, Louise

    2011-03-01

    Mental health service users are at high risk of domestic violence but this is often not detected by mental health services. To explore the facilitators and barriers to disclosure of domestic violence from a service user and professional perspective. A qualitative study in a socioeconomically deprived south London borough, UK, with 18 mental health service users and 20 mental health professionals. Purposive sampling of community mental health service users and mental healthcare professionals was used to recruit participants for individual interviews. Thematic analysis was used to determine dominant and subthemes. These were transformed into conceptual maps with accompanying illustrative quotations. Service users described barriers to disclosure of domestic violence to professionals including: fear of the consequences, including fear of Social Services involvement and consequent child protection proceedings, fear that disclosure would not be believed, and fear that disclosure would lead to further violence; the hidden nature of the violence; actions of the perpetrator; and feelings of shame. The main themes for professionals concerned role boundaries, competency and confidence. Service users and professionals reported that the medical diagnostic and treatment model with its emphasis on symptoms could act as a barrier to enquiry and disclosure. Both groups reported that enquiry and disclosure were facilitated by a supportive and trusting relationship between the individual and professional. Mental health services are not currently conducive to the disclosure of domestic violence. Training of professionals in how to address domestic violence to increase their confidence and expertise is recommended.

  17. The spectrum of ethical issues in a Learning Health Care System: a systematic qualitative review.

    Science.gov (United States)

    McLennan, Stuart; Kahrass, Hannes; Wieschowski, Susanne; Strech, Daniel; Langhof, Holger

    2018-04-01

    To determine systematically the spectrum of ethical issues that is raised for stakeholders in a 'Learning Health Care System' (LHCS). The systematic review was conducted in PubMed and Google Books between the years 2007 and 2015. The literature search retrieved 1258 publications. Each publication was independently screened by two reviewers for eligibility for inclusion. Ethical issues were defined as arising when a relevant normative principle is not adequately considered or two principles come into conflict. A total of 65 publications were included in the final analysis and were analysed using an adapted version of qualitative content analysis. A coding frame was developed inductively from the data, only the highest-level categories were generated deductively for a life-cycle perspective. A total of 67 distinct ethical issues could be categorized under different phases of the LHCS life-cycle. An overarching theme that was repeatedly raised was the conflict between the current regulatory system and learning health care. The implementation of a LHCS can help realize the ethical imperative to continuously improve the quality of health care. However, the implementation of a LHCS can also raise a number of important ethical issues itself. This review highlights the importance for health care leaders and policy makers to balance the need to protect and respect individual participants involved in learning health care activities with the social value of improving health care.

  18. Baccalaureate nursing Students’ perspectives on learning about caring in China: a qualitative descriptive study

    Science.gov (United States)

    2014-01-01

    Background The need to provide humanistic care in the contemporary healthcare system is more imperative now and the importance of cultivating caring in nursing education is urgent. Caring as the primary work of nursing has been discussed extensively, such as the meaning of caring, and teaching and learning strategies to improve nursing students’ caring ability. Yet attempts to understand students’ perspectives on learning about caring and to know their learning needs are seldom presented. The aim of this qualitative descriptive study was to explore the baccalaureate nursing students’ perspectives on learning about caring in China. Methods A qualitative descriptive study using focus group interviews were undertaken in two colleges in Yunnan Province, China from February 2010 to April 2010. Purposeful sampling of 20 baccalaureate nursing students were recruited. Content analysis of the transcribed data was adopted to identify the themes. Results Four categories with some sub-categories related to students’ perspectives on learning about caring were identified from the data: 1) Learning caring by role model; 2) conducive learning environment as the incentive to the learning about caring; 3) lack of directive substantive way of learning as the hindrance to the learning about caring; 4) lack of cultural competency as the barrier to the learning about caring. Conclusions Both caring and uncaring experiences can promote the learning about caring in a way of reflective practice. The formal, informal and hidden curricula play an important role in the learning about caring. Cultural awareness, sensitivity and humility are important in the process of learning to care in a multicultural area. PMID:24589087

  19. A student's perspective of managing data collection in a complex qualitative study.

    Science.gov (United States)

    Dowse, Eileen Mary; van der Riet, Pamela; Keatinge, Diana Rosemary

    2014-11-01

    To highlight from a doctoral student's perspective some of the unexpected and challenging issues that may arise when collecting data in a complex, qualitative study. Using a qualitative approach to undertaking a PhD requires commitment to the research topic, the acquisition of a variety of research skills and the development of expertise in writing. Despite close research supervision and guidance, the first author of this paper experienced unexpected hurdles when collecting data. This article highlights these hurdles and compares them with similar and dissimilar challenges raised by a social researcher with 30 years' experience (White 2012). The first author's experience of field research during her PhD candidature. Informed by a critical theoretical perspective, a snowballing technique was used to examine issues related to data collection by a doctoral student in a qualitative research study. The first author found the logistics of qualitative data collection, concerns about transparency, role confusion and power differentials with participants, and the effective use of video recording technology, unexpectedly challenging. Many of these issues are highlighted in the literature and/or during research supervision. However, the student researcher remains a novice when entering the field. It is often only on reflection after encountering the hurdle that the student recognises future pre-emptive or alternative methods of data collection. The challenges faced as a doctoral student managing the data collection phase of the study concurred with White's discussion of some of the 'real life challenges that novice researchers might face' (2012). Specific guidance and prudence are needed by research students to know when enough data have been collected for manageable analysis within the limits of candidature. Use of reflexivity and mindfulness practised by the student during this phase assisted the ability to reflect, respond and learn from issues as they arose and aim for a

  20. Male IPV Perpetrator's Perspectives on Intervention and Change: A Systematic Synthesis of Qualitative Studies.

    Science.gov (United States)

    McGinn, Tony; McColgan, Mary; Taylor, Brian

    2017-01-01

    To add to our understanding of change processes by analyzing perpetrators' perspectives on intervention. Fourteen databases were searched and 27 articles reporting relevant qualitative findings were identified. Analytic coding was applied across the findings and discussion sections of all 27 study reports to form an interpretive account of the data set. Studies were also grouped according to their perceived theoretical standpoints, and a summary of themes in each grouping is presented. Study participants were largely positive about their experiences in intervention; new learning such as conflict interruption techniques and new communication skills were commonly cited benefits. Perpetrators attend perpetrator intervention programs with a range of motivations, ranging from a determination to change who they are, to a determination to avoid a custodial sentence. The most common barriers to change, found in this analysis, were cognitive distortions, emotional dysregulation, gendered social constructions, and self-esteem issues. Further qualitative investigation, of rigor, with the intention-to-treat population of intimate partner violence perpetrators involved in perpetrator programs is needed. At this point, we would venture that qualitative research, with perpetrators, underlines the precept that formidable barriers to change exist in this population. The centrality of group work to perpetrator interventions should be reconsidered in light of the complexity of the change task and in light of the heterogeneity of this population.

  1. Perspectives of People Living with HIV on Access to Health Care: Protocol for a Scoping Review.

    Science.gov (United States)

    Asghari, Shabnam; Maybank, Allison; Hurley, Oliver; Modir, Hilary; Farrell, Alison; Marshall, Zack; Kendall, Claire; Johnston, Sharon; Hogel, Matthew; Rourke, Sean B; Liddy, Clare

    2016-05-18

    Strategies to improve access to health care for people living with human immunodeficiency virus (PLHIV) have demonstrated limited success. Whereas previous approaches have been informed by the views of health providers and decision-makers, it is believed that incorporating patient perspectives into the design and evaluations of health care programs will lead to improved access to health care services. We aim to map the literature on the perspectives of PLHIV concerning access to health care services, to identify gaps in evidence, and to produce an evidence-informed research action plan to guide the Living with HIV program of research. This scoping review includes peer-reviewed and grey literature from 1946 to May 2014 using double data extraction. Variations of the search terms "HIV", "patient satisfaction", and "health services accessibility" are used to identify relevant literature. The search strategy is being developed in consultation with content experts, review methodologists, and a librarian, and validated using gold standard studies identified by those stakeholders. The inclusion criteria are (1) the study includes the perspectives of PLHIV, (2) study design includes qualitative, quantitative, or mixed methods, and (3) outcome measures are limited to patient satisfaction, their implied needs, beliefs, and desires in relation to access to health care. The papers are extracted by two independent reviewers, including quality assessment. Data is then collated, summarized, and thematically analyzed. A total of 12,857 references were retrieved, of which 326 documents were identified as eligible in pre-screening, and 64 articles met the inclusion criteria (56% qualitative studies, 38% quantitative studies and 6% mixed-method studies). Only four studies were conducted in Canada. Data synthesis is in progress and full results are expected in June, 2016. This scoping review will record and characterize the extensive body of literature on perspectives of PLHIV

  2. A patient post hoc perspective on advantages and disadvantages of blended cognitive behaviour therapy for depression: A qualitative content analysis.

    Science.gov (United States)

    Urech, Antoine; Krieger, Tobias; Möseneder, Laura; Biaggi, Adriana; Vincent, Alessia; Poppe, Christine; Meyer, Björn; Riper, Heleen; Berger, Thomas

    2018-01-31

    Blended cognitive behavioural therapy (bCBT), which combines face-to-face (FtF), and internet-based cognitive behavioural therapy (iCBT), may be a particularly promising approach, but little is known about the effectiveness and patients' subjective evaluations of the bCBT format. The aim of this qualitative study is to explore perceived advantages and disadvantages of bCBT from the patients' perspective in specialized mental health care. Semi-structured interviews were conducted with 15 patients suffering from major depression who underwent treatment in a bCBT format. The interview data were processed by means of a qualitative content analysis. The content analysis generated 18 advantages and 15 disadvantages which were grouped into 6 main topics. In general, bCBT was perceived as purposive and effective for treating depression. The patients perceived the combined treatment as complementary and emphasized the advantage of the constant availability of the online programme. Furthermore, a segment analysis revealed that patients reported different advantages and disadvantages of bCBT as a function of the severity of their depressive episode. The findings of the present study reveal advantages and disadvantages of bCBT, which should be taken into account in the further implementation of this new treatment format.

  3. The diabetic from the health promotion perspective

    Directory of Open Access Journals (Sweden)

    Cleide Chagas da Cunha Faria

    2013-08-01

    Full Text Available Objective: To identify the overall health and living conditions of diabetes patients, the main risk factors for the disease as well as the complications, difficulties, expectations andproblems relating to health service monitoring, from the perspective of “Health Field”model. Methods: Descriptive, cross-sectional study conducted with 187 diabetes patientsof both sexes, living in the urban area and enrolled at five Primary Healthcare Units of amunicipality of Minas Gerais. Data was collected during home visits, applying an interviewform created for diabetes patients, based on data from human biology, environment, lifestyle and health services’ organization, elements of the adopted model. Data was analyzed descriptively and presented as frequencies, averages and percentages. Results: Type 2 diabetes mellitus, female gender, age above 60, married status, incomplete elementary school education, and monthly income of less than three minimum wages were prevalent. Of the participants, 71 (41.5% had abnormal glucose levels, 94 (55.1% had blood pressure higher than recommendations and 131 (70.1% were using oral hypoglycemic agents. Also,138 (73.8% did not exercise on a regular basis and 133 (71.1% were overweight or obese. Living with family was reported by 141 (75.4% participants and 100 (53.5% reported participating in meetings. The family was the main source of support for 96 (65.8% of them. Conclusions: The results raised discussions on the clinical conditions, expectations and difficulties experienced by the participants, and highlighted the challenge to be faced by healthcare professionals in order to maintain the compliance of healthcare users with the long-term treatment, typical of chronic conditions such as diabetes.

  4. Cognitive apprenticeship in health sciences education: a qualitative review.

    Science.gov (United States)

    Lyons, Kayley; McLaughlin, Jacqueline E; Khanova, Julia; Roth, Mary T

    2017-08-01

    Cognitive apprenticeship theory emphasizes the process of making expert thinking "visible" to students and fostering the cognitive and meta-cognitive processes required for expertise. The purpose of this review was to evaluate the use of cognitive apprenticeship theory with the primary aim of understanding how and to what extent the theory has been applied to the design, implementation, and analysis of education in the health sciences. The initial search yielded 149 articles, with 45 excluded because they contained the term "cognitive apprenticeship" only in reference list. The remaining 104 articles were categorized using a theory talk coding scheme. An in depth qualitative synthesis and review was conducted for the 26 articles falling into the major theory talk category. Application of cognitive apprenticeship theory tended to focus on the methods dimension (e.g., coaching, mentoring, scaffolding), with some consideration for the content and sociology dimensions. Cognitive apprenticeship was applied in various disciplines (e.g., nursing, medicine, veterinary) and educational settings (e.g., clinical, simulations, online). Health sciences education researchers often used cognitive apprenticeship to inform instructional design and instrument development. Major recommendations from the literature included consideration for contextual influences, providing faculty development, and expanding application of the theory to improve instructional design and student outcomes. This body of research provides critical insight into cognitive apprenticeship theory and extends our understanding of how to develop expert thinking in health sciences students. New research directions should apply the theory into additional aspects of health sciences educational research, such as classroom learning and interprofessional education.

  5. Health Management in Disasters in Iran: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Maryam Nakhaei

    2015-10-01

    Full Text Available Background:  Disaster  management  relies  on  the  prediction  of  problems  and  providing necessary preparations at the right time and place. In this study, researchers intended to explore previous experiences of health disaster management. Materials and Methods: This study conducted using qualitative content analysis method. Participants  were  selected  purposefully  and  data  were  collected  through  interviews, observation, and relevant documents. Results: Transcribed data from 18 interviews, field notes, and other documents were analyzed. In data analysis, “reactive management” was emerged as the main theme. It included some categories such as “exposure shock,” “nondeliberative relief,” “lack of comprehensive health disaster plan,” “lack of preparedness,” and “poor coordination in health service delivery” as well as contextual factors. Conclusion: The results clarified deep perception of participants’ experiences about health management in disasters. The professionals and nonprofessionals’ emotion-based reactions and behaviors, if accompanied with deficiencies in planning and preparedness, can lead to ineffective services and aggravate the damages

  6. Street-level bureaucracy and policy implementation in community public health nursing: a qualitative study of the experiences of student and novice health visitors.

    Science.gov (United States)

    Hughes, Alison; Condon, Louise

    2016-11-01

    Aim To explore the experiences of student and novice health visitors in implementing health visiting policy reform pre- and post-qualification. In England, public health nursing has been subject to major policy reform. The Health Visitor Implementation Plan (2011) set out a plan to recruit increasing numbers of nurses and midwives to the profession to deliver an expanded and refocussed health visiting service. Exploring this policy change from the viewpoint of those new to health visiting offers a unique perspective into how a specific policy vision is translated into nursing practice. A descriptive qualitative study in which participants were enrolled on a one-year post-graduate health visiting course at a University in South West of England. Qualitative data were collected pre- and post-qualification. A total of 16 interviews and a focus group were conducted with nine participants between September 2012 and March 2013. Findings Descriptive data were interpreted using Lipsky's theoretical framework of street-level bureaucracy. Three themes emerged which relate to this 'bottom-up' perspective on policy implementation; readiness to operationalise policy, challenges in delivering the service vision; and using discretion in delivering the vision. Community public health nurses operate as street-level bureaucrats in negotiating the demands of policy and practice, and by this means, attempt to reconcile professional values with institutional constraints. Barriers to policy implementation at a local level mediate the effects of policy reform, ultimately impacting upon outcomes for children and families.

  7. Marketing occupational health: exploring the purchaser perspective.

    Science.gov (United States)

    Keyes-Evans, O; Woods, A

    2013-01-01

    There may be scope for providers of occupational health (OH) services to improve their communication and marketing to those who purchase their services, but the research literature contains little information about purchasers' perceptions of OH. There is no documented overview that fully captures the purchasers' perspective. To explore current and potential purchasers' thinking about OH. Iterative purposive sampling was carried out to identify participants for semi-structured interviews. Respondents were obtained through progressively wider networking, starting with personal and organizational contacts and networking events. This was continued until no major new information was appearing. Health issues were not always recognized as related to OH. Some respondents had little understanding of OH or perceived it with very negative connotations. Some also sought information at first from the internet and personal contacts. The giving of expert advice on a situation was generally seen as a central feature of OH services. Most believed OH included sickness absence management. Respondents spoke of problems such as insufficient, inappropriate or partisan recommendations and also process or turnaround time problems. Clarity and building good working relationships were identified as positive factors. OH providers should review their various activities to address these points, as well as reviewing the knowledge and skills that their staff can contribute.

  8. Vztah tělesné aktivity a duševního zdraví – současný pohled kvalitativního výzkumu The physical activity and mental health relationship – a contemporary perspective from qualitative research

    Directory of Open Access Journals (Sweden)

    Brendan Gough

    2006-02-01

    interrelated combining the disciplines of psychology, biochemistry and physiology. In an attempt to understand further the complexities of the relationship the paper presents findings from qualitative research that investigated the relationship from the perspectives of people that experience mental health benefits from exercise. Using grounded theory methodology the study investigated the experiences of participants on exercise programmes in the UK. The paper concludes that qualitative methodologies which explore people experiences, and what helps to facilitate them, provide further insight into the interrelated nature of the physical activity and mental health relationship.

  9. Qualitative study of patient consent for health information exchange in an HIV clinic.

    Science.gov (United States)

    Ramos, S Raquel; Bakken, Suzanne

    2014-01-01

    Health information exchange (HIE) is the secure, electronic transfer and/or accessibility of clinical data among healthcare providers. In the United States (US), the consent process for participation varies state to state. New York State (NYS) mandates written patient consent. The purpose of this study was to examine workflow and perceptions related to obtaining HIE consent in an HIV clinic. We used contextual inquiry to observe the HIE consent-related workflow of four registration clerks for a total of 4 hours on two weekdays and subsequently created a flow chart and sequence model diagram. Clerks were also interviewed and the resulting narrative data were coded into themes. Observational and interview data suggested that patient privacy/confidentiality/trust, high volume workflow, and multiple competing demands affect the patient HIE consent process. Additional qualitative data needs to be gathered from the perspectives of patients and clinicians about the HIE consent process.

  10. Improving adoption and acceptability of digital health interventions for HIV disease management: a qualitative study.

    Science.gov (United States)

    Claborn, Kasey R; Meier, Ellen; Miller, Mary Beth; Leavens, Eleanor L; Brett, Emma I; Leffingwell, Thad

    2018-03-01

    Disease management remains a challenge for many people living with HIV (PLWH). Digital health interventions (DHIs) may assist with overcoming these challenges and reducing burdens on clinical staff; however, there is limited data regarding methods to improve uptake and acceptability of DHIs among PLWH. This qualitative study aimed to assess patient and provider perspectives on the use of DHIs and strategies to promote uptake among PLWH. Eight focus groups with patients (k = 5 groups; n = 24) and providers (k = 3 groups; n = 12) were conducted May through October of 2014. Focus groups (~90 min) followed a semi-structured interview guide. Data were analyzed using thematic analysis on three main themes: (a) perspectives towards the adoption and use of DHIs for HIV management; (b) perceptions of barriers and facilitators to patient usage; and (c) preferences regarding content, structure, and delivery. Analyses highlighted barriers and facilitators to DHI adoption. Patients and providers agreed that DHIs feel "impersonal" and "lack empathy," may be more effective for certain subpopulations, should be administered in the clinic setting, and should use multimodal delivery methods. Emergent themes among the providers included development of DHIs for providers as the target market and the need for culturally adapted DHIs for patient subpopulations. DHIs have potential to improve HIV management and health outcomes. DHIs should be developed in conjunction with anticipated consumers, including patients, providers, and other key stakeholders. DHIs tailored for specific HIV subpopulations are needed. Future studies should evaluate dissemination methods and marketing strategies to promote uptake.

  11. Health and wellbeing during transition to adulthood for young people with intellectual disabilities: A qualitative study.

    Science.gov (United States)

    Young-Southward, Genevieve; Cooper, Sally-Ann; Philo, Christopher

    2017-11-01

    Transition to adulthood may have negative consequences for health and wellbeing in individuals with intellectual disabilities (ID), but this aspect of transition has received little investigation. This qualitative study aimed to explore the transition experiences of individuals with ID from their own perspectives, and from that of their parents, in order to identify health or wellbeing implications of transition. Semi-structured interviews were conducted with 17 young people with mild, moderate and severe ID aged 16-27 years and with 23 parents of young people with mild, moderate, severe and profound ID aged 16-26 years. Interviews were analysed using thematic analysis, deploying both emic and etic coding categories. This study provides direct insights into the issues on health and wellbeing that young people with ID and their parents find important during transition. The primary health implication of transition centred on mental health and wellbeing; young people experienced heightened anxiety during transition, and themes identified as contributing to anxiety included: a lack of meaningful activity following school exit; inadequate support during transition; and difficulties associated with 'growing up'. Problem behaviours and obesity were also implicated. The transition from school needs to be better supported in order to ease anxiety for young people during this difficult period. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Health, ethics and environment: a qualitative study of vegetarian motivations.

    Science.gov (United States)

    Fox, Nick; Ward, Katie

    2008-01-01

    This qualitative study explored the motivations of vegetarians by means of online ethnographic research with participants in an international message board. The researcher participated in discussions on the board, gathered responses to questions from 33 participants, and conducted follow-up e-mail interviews with 18 of these participants. Respondents were predominantly from the US, Canada and the UK. Seventy per cent were females, and ages ranged from 14 to 53, with a median of 26 years. Data were analysed using a thematic approach. While this research found that health and the ethical treatment of animals were the main motivators for participants' vegetarianism, participants reported a range of commitments to environmental concerns, although in only one case was environmentalism a primary motivator for becoming a vegetarian. The data indicate that vegetarians may follow a trajectory, in which initial motivations are augmented over time by other reasons for sustaining or further restricting their diet.

  13. Fasting: Benefits and probable health harmfulness from the Islamic perspective

    OpenAIRE

    Mahdi Ebrahimi; Saeedeh Behrooznia

    2015-01-01

    Fasting is a form of Islamic worship to approach God.  There is a direct relationship between fasting, abstaining from eating and drinking, and an individual’s health as well as his ill-health. Therefore, it is of utmost importance in the Islamic perspective to weigh the spiritual benefits achieved through fasting against its probable harmfulness to an individual’s health. Regarding fasting, the Islamic perspective is based on spiritual and social goals whose achievement centers around fas...

  14. Patient Perspectives on Quality of Life With Uncontrolled Type 1 Diabetes Mellitus: A Systematic Review and Qualitative Meta-synthesis.

    Science.gov (United States)

    Vanstone, Meredith; Rewegan, Alex; Brundisini, Francesca; Dejean, Deirdre; Giacomini, Mita

    2015-01-01

    Patients with uncontrolled type 1 diabetes mellitus may be candidates for pancreatic islet cell transplantation. This report synthesizes qualitative research on how patients with uncontrolled type 1 diabetes perceive their quality of life. The objective of this analysis was to examine the perceptions of patients with uncontrolled type 1 diabetes on how it affects their lived experience and quality of life. This report synthesizes 31 primary qualitative studies to examine quality of life from the perspectives of adult patients with type 1 diabetes mellitus and their families or partners. We performed a qualitative meta-synthesis to integrate findings across primary research studies. Long- and short-term negative consequences of uncontrolled type 1 diabetes affect all aspects of patients' lives: physical, emotional, practical, and social. The effect on each domain is far-reaching, and effects interact across domains. Uncontrolled blood sugar levels lead to substantial psychological distress, negative moods, cognitive difficulties, irritable or aggressive behaviour, and closely associated problems with relationships, self-image, and confidence. Emotional distress is pervasive and under-addressed by health care providers. Patients live in fear of complications from diabetes over the long term. In the shorter term, they are anxious about the personal, social, and professional consequences of hypoglycemic episodes (e.g., injury, humiliation), and may curtail normal activities such as driving or socializing because they are worried about having an episode. The quality of life for patients' family members is also negatively impacted by uncontrolled type 1 diabetes. Uncontrolled type 1 diabetes has significant negative impacts on the quality of life of both people with the disease and their families.

  15. Exploring health researchers’ perceptions of policymaking in Argentina: a qualitative study

    Science.gov (United States)

    Corluka, Adrijana; Hyder, Adnan A; Winch, Peter J; Segura, Elsa

    2014-01-01

    Much of the published research on evidence-informed health policymaking in low- and middle-income countries has focused on policymakers, overlooking the role of health researchers in the research-to-policy process. Through 20 semi-structured, in-depth qualitative interviews conducted with researchers in Argentina’s rural northwest and the capital of Buenos Aires, we explore the perspectives, experiences and attitudes of Argentine health researchers regarding the use and impact of health research in policymaking in Argentina. We find that the researcher, and the researcher’s function of generating evidence, is nested within a broader complex system that influences the researcher’s interaction with policymaking. This system comprises communities of practice, government departments/civil society organizations, bureaucratic processes and political governance and executive leadership. At the individual level, researcher capacity and determinants of research availability also play a role in contributing to evidence-informed policymaking. In addition, we find a recurrent theme around ‘lack of trust’ and explore the role of trust within a research system, finding that researchers’ distrust towards policymakers and even other researchers are linked inextricably to the sociopolitical history of Argentina, which contributes to shaping researchers’ identities in opposition to policymakers. For policymakers, national research councils and funders of national health research systems, this article provides a deeper understanding of researchers’ perceptions which can help inform and improve programme design when developing interventions to enhance research utilization and develop equitable and rational health policies. For donors and development agencies interested in health research capacity building and achieving development goals, this research demonstrates a need for investment in building research capacity and training health researchers to interact with the

  16. Exploring health researchers' perceptions of policymaking in Argentina: a qualitative study.

    Science.gov (United States)

    Corluka, Adrijana; Hyder, Adnan A; Winch, Peter J; Segura, Elsa

    2014-09-01

    Much of the published research on evidence-informed health policymaking in low- and middle-income countries has focused on policymakers, overlooking the role of health researchers in the research-to-policy process. Through 20 semi-structured, in-depth qualitative interviews conducted with researchers in Argentina's rural northwest and the capital of Buenos Aires, we explore the perspectives, experiences and attitudes of Argentine health researchers regarding the use and impact of health research in policymaking in Argentina. We find that the researcher, and the researcher's function of generating evidence, is nested within a broader complex system that influences the researcher's interaction with policymaking. This system comprises communities of practice, government departments/civil society organizations, bureaucratic processes and political governance and executive leadership. At the individual level, researcher capacity and determinants of research availability also play a role in contributing to evidence-informed policymaking. In addition, we find a recurrent theme around 'lack of trust' and explore the role of trust within a research system, finding that researchers' distrust towards policymakers and even other researchers are linked inextricably to the sociopolitical history of Argentina, which contributes to shaping researchers' identities in opposition to policymakers. For policymakers, national research councils and funders of national health research systems, this article provides a deeper understanding of researchers' perceptions which can help inform and improve programme design when developing interventions to enhance research utilization and develop equitable and rational health policies. For donors and development agencies interested in health research capacity building and achieving development goals, this research demonstrates a need for investment in building research capacity and training health researchers to interact with the public policy

  17. Technological Health Intervention in Population Aging to Assist People to Work Smarter not Harder: Qualitative Study.

    Science.gov (United States)

    Chen, Sonia Chien-I

    2018-01-04

    Technology-based health care has been promoted as an effective tool to enable clinicians to work smarter. However, some health stakeholders believe technology will compel users to work harder by creating extra work. The objective of this study was to investigate how and why electronic health (eHealth) has been applied in Taiwan and to suggest implications that may inspire other countries facing similar challenges. A qualitative methodology was adopted to obtain insightful inputs from deeper probing. Taiwan was selected as a typical case study, given its aging population, advanced technology, and comprehensive health care system. This study investigated 38 stakeholders in the health care ecosystem through in-depth interviews and focus groups, which provides an open, flexible, and enlightening way to study complex, dynamic, and interactive situations through informal conversation or a more structured, directed discussion. First, respondents indicated that the use of technology can enable seamless patient care and clinical benefits such as flexibility in time management. Second, the results suggested that a leader's vision, authority, and management skills might influence success in health care innovation. Finally, the results implied that both internal and external organizational governance are highly relevant for implementing technology-based innovation in health care. This study provided Taiwanese perspectives on how to intelligently use technology to benefit health care and debated the perception that technology prevents human interaction between clinicians and patients. ©Sonia Chien-I Chen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.01.2018.

  18. Allied health research positions: a qualitative evaluation of their impact.

    Science.gov (United States)

    Wenke, Rachel J; Ward, Elizabeth C; Hickman, Ingrid; Hulcombe, Julie; Phillips, Rachel; Mickan, Sharon

    2017-02-06

    Research positions embedded within healthcare settings have been identified as an enabler to allied health professional (AHP) research capacity; however, there is currently limited research formally evaluating their impact. In 2008, a Health Practitioner industrial agreement funded a research capacity building initiative within Queensland Health, Australia, which included 15 new allied health research positions. The present project used a qualitative and realist approach to explore the impact of these research positions, as well as the mechanisms which facilitated or hindered their success within their respective organisations. Forty-four AHP employees from six governmental health services in Queensland, Australia, participated in the study. Individual interviews were undertaken, with individuals in research positions (n = 8) and their reporting line managers (n = 8). Four stakeholder focus groups were also conducted with clinicians, team leaders and professional heads who had engaged with the research positions. Nine key outcomes of the research positions were identified across individual, team/service and organisational/community levels. These outcomes included clinician skill development, increased research activity, clinical and service changes, increased research outputs and collaborations, enhanced research and workplace culture, improved profile of allied health, development of research infrastructure, and professional development of individuals in the research positions. Different mechanisms that influenced these outcomes were identified. These mechanisms were grouped by those related to the (1) research position itself, (2) organisational factors and (3) implementation factors. The present findings highlight the potential value of the research positions for individuals, teams and clinical services across different governmental healthcare services, and demonstrate the impact of the roles on building the internal and external profile of allied health

  19. Understanding of Factors that Enable Health Promoters in Implementing Health-Promoting Schools: A Systematic Review and Narrative Synthesis of Qualitative Evidence

    Science.gov (United States)

    Hung, Tommy Tsz Man; Chiang, Vico Chung Lim; Dawson, Angela; Lee, Regina Lai Tong

    2014-01-01

    Health-promoting schools have been regarded as an important initiative in promoting child and adolescent health in school settings using the whole-school approach. Quantitative research has proved its effectiveness in various school-based programmes. However, few qualitative studies have been conducted to investigate the strategies used by health promoters to implement such initiatives. In this study, the researchers conducted a systematic review and narrative synthesis of the qualitative literature to identify important enablers assisting the implementation of health-promoting schools from the perspectives of health promoters. Five enablers have been identified from the review: (a) Following a framework/guideline to implement health-promoting schools; (b) Obtaining committed support and contributions from the school staff, school board management, government authorities, health agencies and other stakeholders; (c) Adopting a multidisciplinary, collaborative approach to implementing HPS; (d) Establishing professional networks and relationships; and (e) Continuing training and education in school health promotion. This highlights the importance of developing school health policies that meet local health needs, and socio-cultural characteristics that can foster mutual understanding between the health and education sectors so as to foster health promotion in children and adolescents. PMID:25264789

  20. 'And when a certain health issue happen, they try to cover it': Stakeholder perspectives on the health of temporary foreign workers and their families.

    Science.gov (United States)

    Salami, Bukola; Hegadoren, Kathleen; Kirova, Anna; Meherali, Salima; Nsaliwa, Christina; Chiu, Yvonne

    2018-01-01

    This study examines stakeholders' perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. We used a critically informed qualitative methodology. We interviewed 13 stakeholders, including service providers and policy makers. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.

  1. Reducing Negative Outcomes of Online Consumer Health Information: Qualitative Interpretive Study with Clinicians, Librarians, and Consumers

    Science.gov (United States)

    Pluye, Pierre; Thoër, Christine; Rodriguez, Charo

    2018-01-01

    Background There has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced. Objective The aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives. Methods This included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis. Results We found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating

  2. Perspectives of speech-language pathologists on the use of telepractice in schools: the qualitative view.

    Science.gov (United States)

    Tucker, Janice K

    2012-01-01

    Telepractice in speech-language pathology shows the potential to mitigate the current shortage of speech-language pathologists (SLPs) available to serve a growing number of persons with communication disorders. Since a majority of American Speech-Language-Hearing Association (ASHA) certified SLPs work in schools and the population of communicatively impaired clients in schools continues to grow, research into the use of telepractice in the educational setting is warranted. This article reports upon the perspectives of SLPs regarding the use of telepractice in school settings. In-depth qualitative interviews were conducted with five SLPs experienced in the delivery of telepractice. Four major themes emerged: barriers, benefits, reasons for acceptance and use of telepractice, and suggestions to resolve telepractice professional issues.

  3. End-of-Life Dreams and Visions: A Qualitative Perspective From Hospice Patients.

    Science.gov (United States)

    Nosek, Cheryl L; Kerr, Christopher W; Woodworth, Julie; Wright, Scott T; Grant, Pei C; Kuszczak, Sarah M; Banas, Anne; Luczkiewicz, Debra L; Depner, Rachel M

    2015-05-01

    End-of-life dreams and visions (ELDVs) are well documented throughout history and across cultures with impact on the dying person and their loved ones having profound meaning. Published studies on ELDVs are primarily based on surveys or interviews with clinicians or families of dead persons. This study uniquely examined patient dreams and visions from their personal perspective. This article reports the qualitative findings from dreams and visions of 63 hospice patients. Inductive content analysis was used to examine the content and subjective significance of ELDVs. Six categories emerged: comforting presence, preparing to go, watching or engaging with the deceased, loved ones waiting, distressing experiences, and unfinished business. © The Author(s) 2014.

  4. Health effects of Chernobyl: newer perspectives

    International Nuclear Information System (INIS)

    Desai, Usha

    1996-01-01

    On the 26th of April 1986, the 4th unit of the Chernobyl Nuclear Power Plant in the former Soviet Union exploded, following a scheduled but not-well-planned testing of a turbo-generator prior to a shutdown of the reactor. This led to a release of large amounts of radioactive material into the atmosphere, resulting in a cloud not only over in the Soviet Union, but due to prevailing meteorological condition, over the Eastern Europe as well. Over the past ten years, a large number of agencies in the areas of human health and hygiene, agriculture and veterinary sciences in addition to those involved in radiation protection and radiation safety have studied the impact of the accident. These studies were also extended to evaluate and mitigate the consequences. The accident has been a warning, and has provided lessons in mitigating the consequences of any industrial accident. Newer perspectives have emerged in the area of early diagnosis and treatment of the acute effects of radiation. Research in the areas of genetics, molecular biology and radiation biology will contribute to better medical care in future. (author). 3 tabs

  5. Students' perspectives to health care services in lithuania

    OpenAIRE

    Brancevič, Jolita

    2016-01-01

    Students' Perspectives to Health Care Services in Lithuania Introduction. The Rights of Patients and Compensation for the Damage to Their Health Act defines health care services as safe and effective means to take care of health, identify, diagnose and treat diseases and provide nursing services. The aims set out in a policy of health care services are fairly broad and, among others, include the improvement of both the quality and the availability of health care services. The issues of increa...

  6. Perspectives on Smoking Initiation and Maintenance: A Qualitative Exploration among Singapore Youth.

    Science.gov (United States)

    Subramaniam, Mythily; Shahwan, Shazana; Fauziana, Restria; Satghare, Pratika; Picco, Louisa; Vaingankar, Janhavi Ajit; Chong, Siow Ann

    2015-07-31

    Studies among adolescents have shown that several important interpersonal, intrapersonal and environmental factors are associated with smoking behaviour. The current qualitative research project aimed to explore the determinants of smoking initiation and maintenance, from a youth perspective, among young people who smoked, living in a multi-ethnic Asian country. Focus group discussions (FGDs) were conducted with youths in Singapore in youth-friendly and accessible locations. Young people, from a variety of social contexts-varying on age, gender, ethnicity and educational level, were included in the study. All FGDs were conducted in English and participants were recruited using a mix of network and purposive sampling. All FGDs were audio recorded and transcribed verbatim. The data were analyzed using qualitative content analysis, allowing themes to emerge from the data with the goal of answering the research question. Ninety-one youth smokers (54 males, 37 females), aged between 14 to 29 years, participated in the study. The majority were males (59%) and of Chinese ethnicity (52%). Participants identified multiple personal, social, and familial influences on young adults' smoking behaviors. Peer and family influences, as well as risk minimization, played a key role in smoking initiation and maintenance. While young people were aware of policies that restricted smoking, these did not directly affect their decision to start smoking. The theory of triadic influence provided a promising theoretical framework to understand smoking initiation and maintenance in a sample of young adult smokers from a multi-ethnic Asian country. It also provides actionable information for initiatives to prevent smoking in young people, which includes their perspectives and emphasizes an inclusive approach without stigmatizing those who smoke.

  7. Perspectives on Smoking Initiation and Maintenance: A Qualitative Exploration among Singapore Youth

    Directory of Open Access Journals (Sweden)

    Mythily Subramaniam

    2015-07-01

    Full Text Available Studies among adolescents have shown that several important interpersonal, intrapersonal and environmental factors are associated with smoking behaviour. The current qualitative research project aimed to explore the determinants of smoking initiation and maintenance, from a youth perspective, among young people who smoked, living in a multi-ethnic Asian country. Focus group discussions (FGDs were conducted with youths in Singapore in youth-friendly and accessible locations. Young people, from a variety of social contexts—varying on age, gender, ethnicity and educational level, were included in the study. All FGDs were conducted in English and participants were recruited using a mix of network and purposive sampling. All FGDs were audio recorded and transcribed verbatim. The data were analyzed using qualitative content analysis, allowing themes to emerge from the data with the goal of answering the research question. Ninety-one youth smokers (54 males, 37 females, aged between 14 to 29 years, participated in the study. The majority were males (59% and of Chinese ethnicity (52%. Participants identified multiple personal, social, and familial influences on young adults’ smoking behaviors. Peer and family influences, as well as risk minimization, played a key role in smoking initiation and maintenance. While young people were aware of policies that restricted smoking, these did not directly affect their decision to start smoking. The theory of triadic influence provided a promising theoretical framework to understand smoking initiation and maintenance in a sample of young adult smokers from a multi-ethnic Asian country. It also provides actionable information for initiatives to prevent smoking in young people, which includes their perspectives and emphasizes an inclusive approach without stigmatizing those who smoke.

  8. Perspectives on Queer Music Therapy: A Qualitative Analysis of Music Therapists' Reactions to Radically Inclusive Practice.

    Science.gov (United States)

    Boggan, Catherine E; Grzanka, Patrick R; Bain, Candice L

    2018-01-13

    The queer music therapy model was designed by Bain, Grzanka, and Crowe in 2016 as a novel therapeutic approach to affirm and empower LGBTQ+ identity through music. No data have been generated on how this model might actually be implemented, or the strengths and limitations of the model according to music therapy professionals. The purpose of this study was to build on Bain and colleagues' work by collecting music therapists' perspectives on queer music therapy and using these data to critically evaluate the model. Semi-structured qualitative interviews were conducted with twelve music therapists who identify as LGBTQ+ or have experience working with LGBTQ+ clients. Participants were prompted to discuss their music therapy backgrounds, experiences with LGBTQ+ clients, and reactions to the queer music therapy model. Interviews were analyzed using a critical discourse analysis approach. The qualitative findings revealed major strengths of the queer music therapy model and ways in which it could be improved by attending to: (a) the structural limitations of the music therapy discipline, including the demographic composition of the field and lack of critical perspectives in music therapy training; and (b) intersectional considerations of ageism and ableism within diverse LGBTQ+ populations. Queer music therapy has positive implications for future work with LGBTQ+ individuals, but it must more substantively integrate intersectionality theory to serve a diverse range of LGBTQ+ clients. Further, it must critically attend to the structural limitations of the music therapy discipline itself. © The Author(s) 2018. Published by Oxford University Press on behalf of American Music Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario.

    Science.gov (United States)

    Leung, Zee; Middleton, Dean; Morrison, Karen

    2012-05-16

    There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This

  10. Towards a concept of Communicative Competence in Health: a qualitative study in medical residents

    Directory of Open Access Journals (Sweden)

    Rodolfo A. Cabrales

    2015-06-01

    Full Text Available Despite the wealth of literature surrounding the importance of effective communication in the clinical practice, there is a dearth of consensus in the literature on what communicative competence in health (CCH is, and the practices of meaningful health communication. Seventeen residents (17 were invited to share their thoughts on the concept of communicative competence in health and on difficulties they encounter during their clinical practice related with communication. The aim of this study was to gain a better understanding of CCH with emphasis on the implications in the medical curriculum, teaching, learning and assessment. Three focus group discussions were conducted with the clinical supervisor. The results were audio-taped, transcribed verbatim and analyzed using principles from grounded theory for qualitative data analysis. The 135 open codes and defined axial codes were discussed and a number of conceptual frameworks were utilized to disentangle the concept of CCH. The focus group themes related to the concept of communication in health, its importance and difficulties, the role of the physician and health personnel. The participants felt their own training did not prepare them to establish effective communication with patients and relatives. Some barriers include lack of time and lack of institutional priority given to communication issues. The techniques originating from grounded theory permitted to define a broader concept of CCH with the following three specific scopes: biological perspective (objective world, social (social world and subjective world (expressive-aesthetic. This new concept of CCH is central to understanding how the health communication process occurs, where a myriad of individual (physician, patient, staff, relatives, organizational and societal interrelated factors influence health decisions and practice. These components need to be addressed by medicine schools, health institutions and other stakeholders in

  11. Perspectives of patients and physicians about neuroendocrine tumors. A qualitative study

    Science.gov (United States)

    Manolios, Emilie; Rebours, Vinciane; Revah-Levy, Anne; Ruszniewski, Philippe

    2018-01-01

    Purpose Gastrointestinal neuroendocrine tumors (NETs) are rare, complex to manage, and often have a chronic course. Qualitative methods are a tool of choice for focusing on patients' and physicians’ points of view especially when dealing with a complex and rare disease. Nonetheless, they remain undeveloped in research related to NETs. This study aimed to explore the experience of NETs among both patients and their physicians and to cross their perspectives for the purpose of finding pathways to improving care. Results Our analysis found two themes: (1) the questions raised by this disease, and (2) the complex experience of this singular disease. Our findings underlined the experience of confusion found among patients regarding the patient's unusual somatic experience and around the question of vocabulary, i.e. the naming of the disease and the semantic field of severity in the medical discourse. Conclusion Means for reducing the confusion that patients experience in this disease are needed. The explanations that the physician offers to the patient must clarify the issues related to NETs. We therefore propose a statement that all physicians can use to support patients diagnosed with neuroendocrine tumors to clear up potential confusion. Methods We conducted a qualitative study, based on 40 semi-structured interviews, in a specialized department of gastro-pancreatology. Participants, purposively selected until data saturation, came from two different sub-samples: (i) patients with a metastatic NETs (N = 20) and (ii) their referring physicians (N = 10). The data were examined by thematic analysis. PMID:29581833

  12. African American perspectives: A qualitative study of an informal science enrichment program

    Science.gov (United States)

    Simpson, Jamila Rashida

    The purposes of this study were to determine what program characteristics African American parents consider when they enroll their children into an informal science education enrichment program, the parents' evaluation of a program called Jordan Academy in which they enrolled their children, and the alignment of the parents' perspectives with Black Cultural Ethos (BCE). BCE refers to nine dimensions posited by Wade Boykin, a psychologist, as comprising African American culture. Participants were parents of students that attended Jordan Academy, an informal science enrichment program designed for third through sixth grade students from underserved populations. Qualitative methodologies were utilized to perform a thorough assessment of parents' perspectives. Data sources included classroom observations, student surveys, academy curriculum, photos and video-taped class sessions. Data included teachers and parents' responses to semi-structured, audio recorded interviews and students' written responses to open-ended items on the program's evaluation instrument. The data were analyzed for themes and the findings compared to Black Cultural Ethos. Findings revealed that the participants believed that informal science education offered their children opportunities not realized in the formal school setting - a means of impacting their children holistically. The parents expressed the academic, cultural, and personal development of their children in their characterizations of the ideal informal science education experience and in their evaluations of Jordan Academy. Overall, the parents' views emphasized the BCE values of harmony, affect, verve, movement, orality and communalism. The study has important implications for practices within and research on informal science education.

  13. Older persons' experiences and perspectives of receiving social care: a systematic review of the qualitative literature.

    Science.gov (United States)

    de São José, José; Barros, Rosanna; Samitca, Sanda; Teixeira, Ana

    2016-01-01

    The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research. © 2015 John Wiley & Sons Ltd.

  14. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study.

    Science.gov (United States)

    Smeulers, Marian; Onderwater, Astrid T; van Zwieten, Myra C B; Vermeulen, Hester

    2014-04-01

    To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative interview study of 20 nurses in an academic medical centre was conducted between March and December of 2011. Three themes emerged from this study: (1) nurses' roles and responsibilities in medication safety: aside from safe preparation and administration, the clinical reasoning of nurses is essential for medication safety; (2) nurses' ability to work safely: knowledge of risks and nurses' work circumstances influence their ability to work safely; and (3) nurses' acceptance of safety practices: advantages, feasibility and appropriateness are important incentives for acceptance of a safety practice. Nurses' experiences coincide with the assumption that they are in a pre-eminent position to enable safe medication management; however, their ability to adequately perform this role depends on sufficient knowledge to assess the risks of medication administration and on the circumstances in which they work. Safe medication management requires a learning climate and professional practice environment that enables further development of professional nursing skills and knowledge. © 2014 John Wiley & Sons Ltd.

  15. Optimizing antibiotic usage in hospitals: a qualitative study of the perspectives of hospital managers.

    Science.gov (United States)

    Broom, A; Gibson, A F; Broom, J; Kirby, E; Yarwood, T; Post, J J

    2016-11-01

    Antibiotic optimization in hospitals is an increasingly critical priority in the context of proliferating resistance. Despite the emphasis on doctors, optimizing antibiotic use within hospitals requires an understanding of how different stakeholders, including non-prescribers, influence practice and practice change. This study was designed to understand Australian hospital managers' perspectives on antimicrobial resistance, managing antibiotic governance, and negotiating clinical vis-à-vis managerial priorities. Twenty-three managers in three hospitals participated in qualitative semi-structured interviews in Australia in 2014 and 2015. Data were systematically coded and thematically analysed. The findings demonstrate, from a managerial perspective: (1) competing demands that can hinder the prioritization of antibiotic governance; (2) ineffectiveness of audit and monitoring methods that limit rationalization for change; (3) limited clinical education and feedback to doctors; and (4) management-directed change processes are constrained by the perceived absence of a 'culture of accountability' for antimicrobial use amongst doctors. Hospital managers report considerable structural and interprofessional challenges to actualizing antibiotic optimization and governance. These challenges place optimization as a lower priority vis-à-vis other issues that management are confronted with in hospital settings, and emphasize the importance of antimicrobial stewardship (AMS) programmes that engage management in understanding and addressing the barriers to change. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  16. Use of qualitative methods in published health services and management research: a 10-year review.

    Science.gov (United States)

    Weiner, Bryan J; Amick, Halle R; Lund, Jennifer L; Lee, Shoou-Yih Daniel; Hoff, Timothy J

    2011-02-01

    Over the past 10 years, the field of health services and management research has seen renewed interest in the use of qualitative research methods. This article examines the volume and characteristics of qualitative research articles published in nine major health services and management journals between 1998 and 2008. Qualitative research articles comprise 9% of research articles published in these journals. Although the publication rate of qualitative research articles has not kept pace with that of quantitative research articles, citation analysis suggests that qualitative research articles contribute comparably to the field's knowledge base. A wide range of policy and management topics has been examined using qualitative methods. Case study designs, interviews, and documentary sources were the most frequently used methods. Half of qualitative research articles provided little or no detail about key aspects the study's methods. Implications are discussed and recommendations are offered for promoting the publication of qualitative research.

  17. Taking part in Nordic collaboration; nursing students' experiences and perceptions from a learning perspective: A qualitative study.

    Science.gov (United States)

    Westerbotn, Margareta; Kneck, Åsa; Hovland, Olav Johannes; Elrond, Malene; Pedersen, Ingrid; Lejonqvist, Gun-Britt; Dulavik, Johild; Ecklon, Tove; Nilsson, Inga-Lill; Sigurdardottir, Árún K

    2015-05-01

    Nordic networking of different kinds has a long tradition aiming to increase collaboration and understanding between citizens in different countries. Cultural competence in relation to health care and nursing is important for clinical nurses and is a central issue in nurse education. To gain an understanding of what nurse students experienced and learned during an intensive course in diabetes together with students and nurse educators from Denmark, Finland, Iceland, Norway, Sweden and the Faroe Islands. In 2012, an intensive course within the Nordic network, Nordkvist, was conducted in Faroe Islands with the theme "Nursing - to live a good life with diabetes". To answer the objective of the study, 26 students conducted written reflections based on two questions. The data was analyzed using qualitative content analysis. Through meetings with nurse students and educators from the Nordic countries the intensive course strengthened the students' identification with the nursing profession. The students gained new perspectives on diabetes, such as how complex it can be to live with a chronic illness. Because of the difficulties in understanding one another and because of different mother tongues, the students gained a better understanding of patients' vulnerability in relation to hospital jargon and how it felt to be in an unfamiliar place. The intensive course increased the students' personal and professional growth, cross-cultural competence, and their identification with nursing. Students' understanding of health care in the Nordic countries improved as similarities and differences were recognized. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. IMPACTS OF HIPPOTHERAPY ON CHILDREN WITH CEREBRAL PALSY FROM PARENTS PERSPECTIVE: A QUALITATIVE RESEARCH

    Directory of Open Access Journals (Sweden)

    Athanasia Laiou

    2015-12-01

    Full Text Available Background: Hippotherapy is a physical treatment strategy with the help of horses and refers to the use of horse’s movement as a treatment tool for children with Cerebral Palsy (CP. Hippotherapy refers to the incorporation of equine movement by physiotherapists, occupational therapists and speech therapists. The present qualitative study investigated the impacts of hippotherapy on Greek children with Cerebral Palsy from parents’ perspective due to their better understanding of child’s special needs. Methods: Semi-structured interviews were undertaken with 10 participants. An interview topic guide and introductory closed questions were used to conduct the study. Thematic analysis of the qualitative interview data was carried out. Five themes were revealed from the interview process. Results: The results of this qualitative research provides evidence that hippotherapy is a promising intervention strategy having physical and psychological benefits for children with CP. Hippotherapy improved children’s daily activities, their independence and, in general, a better quality of life has been attained, while no negative impacts has been identified. The impacts of these results were discussed in relationship with relative published research. Additionally, new insights were provided. The professionalism and qualification of clinical specialist in hippotherapy were crucial and they influence positively the results of hippotherapy. This study also provided new insights into the context of the relationship-cooperation between clinical specialist in hippotherapy and child, and the financial factor participating in a hippotherapy programme. Conclusion: Discussion concerning the clinical implications of the present findings and suggestions for future research were provided. Future research should be conducted to provide a clear definition of what hippotherapy is meaning globally.

  19. Researching children's perspectives in pediatric palliative care: A systematic review and meta-summary of qualitative research.

    Science.gov (United States)

    Ghirotto, Luca; Busani, Elena; Salvati, Michela; Di Marco, Valeria; Caldarelli, Valeria; Artioli, Giovanna

    2018-05-29

    Qualitative research is pivotal in gaining understanding of individuals' experiences in pediatric palliative care. In the past few decades, the number of qualitative studies on pediatric palliative care has increased slightly, as has interest in qualitative research in this area. Nonetheless, a limited number of such studies have included the first-person perspective of children. The aim of this article is to understand the contribution of previous qualitative research on pediatric palliative care that included the voices of children. A systematic review of qualitative studies and a meta-summary were conducted. MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and ERIC were searched without limitations on publication date or language. Eligible articles were qualitative research articles in which the participants were children ranging in age from 3 to 18 years.ResultWe retrieved 16 qualitative research articles reporting on 12 unique studies, and we selected two mixed-method articles. The meta-summary shows eight themes: the relationship with professional caregivers, pain and its management, "living beyond pain," the relationship between pediatric patients and their families, children's view on their treatment and service provision, meanings children give to their end-of-life situation, consequences of clinical decisions, and the relationships among children in pediatric palliative care and their peers.Significance of resultsThis meta-summary presents the "state of the art" of pediatric palliative care qualitative research on children and highlights additional research areas that warrant qualitative study.

  20. Physicians' professional performance: an occupational health psychology perspective

    NARCIS (Netherlands)

    Scheepers, Renée A.

    2017-01-01

    Physician work engagement is considered to benefit physicians' professional performance in clinical teaching practice. Following an occupational health psychology perspective, this PhD report presents research on how physicians' professional performance in both doctor and teacher roles can be

  1. Health is a spiritual thing: perspectives of health care professionals and female Somali and Bangladeshi women on the health impacts of fasting during Ramadan.

    Science.gov (United States)

    Pathy, Rubini; Mills, Kelsey E; Gazeley, Sharon; Ridgley, Andrea; Kiran, Tara

    2011-02-01

    To explore perspectives of health care professionals and female Somali and Bangladeshi Muslim women on practices related to fasting during Ramadan, the impact of fasting on health and the role of health professionals during Ramadan. A cross-sectional qualitative study was conducted. Two culturally specific focus groups were conducted with six Somali and seven Bangladeshi Muslim women who observed Ramadan and lived in an inner-city neighbourhood of Toronto, Canada. Individual semi-structured interviews were conducted with 22 health care professionals practicing in this inner-city area (three of whom were Muslim). Data were analysed using thematic qualitative analysis. Both Muslim women and health care professionals recognised the spiritual significance of the Ramadan fast. Muslim participants considered the fast to be beneficial to health overall, whereas health care professionals tended to reflect on health concerns from fasting. Many health care professionals were not fully aware of fasting practices during Ramadan and some found it challenging to counsel patients about the health effects of fasting. Muslim women expressed disagreement regarding which medical interventions were permitted during fasting. They generally agreed that health care professionals should not specifically advise against fasting, but instead provide guidance on health maintenance while fasting. Both groups agreed that guidelines developed by the health care and faith communities together would be useful. There are a variety of health beliefs and observances among female Muslim Somali and Bangladeshi women and a range of knowledge, experience and opinions among health care professionals related to fasting during Ramadan and health. Overall, there is a need for improved communication between members of the Muslim community and health professionals in Canada about health issues related to fasting during Ramadan. Strategies could include published practice guidelines endorsed by the Muslim

  2. Asthma Symptoms in Early Childhood: A public health perspective

    NARCIS (Netherlands)

    E.H.D. Hafkamp-De Groen (Esther)

    2014-01-01

    markdownabstract__Abstract__ This thesis focuses on asthma symptoms in early childhood. From a public health perspective, we aim to improve health and health-related quality of life through the prevention of asthma symptoms and by signaling, counselling or management of children who are at a high

  3. Implementation of municipal health promoting projects in primary schools: teachers perspective

    DEFF Research Database (Denmark)

    Nordin, Lone Lindegard

    2013-01-01

    . The project is funded by the Danish Ministry of Science, University of Aarhus and Silkeborg municipality, and involves 5 primary schools, 23 teachers and 233 pupils from 7th to 9 class. The project is positioned within the critical approach to school health education and health promotion, developed......Implementation of municipally health promoting projects' in primary schools: teachers perspective Research question This paper discusses the findings from a qualitative research, that aimed to investigate how teachers in primary schools implemented municipal health promoting projects focusing...... that there is a “gap” between policy and practice according to aim, content and methods, and that teachers practice can be explained as coping mechanism. The key findings include: • Teachers practice is closer to traditional health education than critical health education. • Teachers priorities the mandatory teaching...

  4. 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.

  5. Lay health workers perceptions of an anemia control intervention in Karnataka, India: a qualitative study.

    Science.gov (United States)

    Shet, Arun S; Rao, Abha; Jebaraj, Paul; Mascarenhas, Maya; Zwarenstein, Merrick; Galanti, Maria Rosaria; Atkins, Salla

    2017-09-18

    Lay health workers (LHWs) are increasingly used to complement health services internationally. Their perceptions of the interventions they implement and their experiences in delivering community based interventions in India have been infrequently studied. We developed a novel LHW led intervention to improve anemia cure rates in rural community dwelling children attending village day care centers in South India. Since the intervention is delivered by the village day care center LHW, we sought to understand participating LHWs' acceptance of and perspectives regarding the intervention, particularly in relation to factors affecting daily implementation. We conducted a qualitative study alongside a cluster randomized controlled trial evaluating a complex community intervention for childhood anemia control in Karnataka, South India. Focus group discussions (FGDs) were conducted with trained LHWs assigned to deliver the educational intervention. These were complemented by non-participant observations of LHWs delivering the intervention. Transcripts of the FGDs were translated and analyzed using the framework analysis method. Several factors made the intervention acceptable to the LHWs and facilitated its implementation including pre-implementation training modules, intervention simplicity, and ability to incorporate the intervention into the routine work schedule. LHWs felt that the intervention impacted negatively on their preexisting workload. Fluctuating relationships with mothers weakened the LHWs position as providers of the intervention and hampered efficient implementation, despite the LHWs' highly valued position in the community. Modifiable barriers to the successful implementation of this intervention were seen at two levels. At a broader contextual level, hindering factors included the LHW being overburdened, inadequately reimbursed, and receiving insufficient employer support. At the health system level, lack of streamlining of LHW duties, inability of LHWs to

  6. Qualitative environmental health research: an analysis of the literature, 1991-2008.

    Science.gov (United States)

    Scammell, Madeleine Kangsen

    2011-10-01

    Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. In this analysis, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. A primary search for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. This analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.

  7. Application of Qualitative Methods in Health Research: An Overview

    OpenAIRE

    Dongre, AR; Deshmukh, PR; Kalaiselvan, G; Upadhyaya, S

    2010-01-01

    Qualitative research is type of formative research that includes specialized techniques for obtaining in-depth responses about what people think and how they feel. It is seen as the research that seeks answer to the questions in the real world. Qualitative researchers gather what they see, hear, read from people and places, from events and activities, with the purpose to learn about the community and to generate new understanding that can be used by the social world. Qualitative research have...

  8. Retention of health workers in Malawi: perspectives of health workers and district management

    Directory of Open Access Journals (Sweden)

    MacLachlan Malcolm

    2009-07-01

    Full Text Available Abstract Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource

  9. Retention of health workers in Malawi: perspectives of health workers and district management.

    Science.gov (United States)

    Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles

    2009-07-28

    Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the

  10. Indian students' perspectives on obesity and school-based obesity prevention: a qualitative examination.

    Science.gov (United States)

    Riggs, Nathaniel; Tewari, Abha; Stigler, Melissa; Rodrigues, Lindsay; Arora, Monika; Khubchandani, Jagdish; Simmons, Rob; Pentz, Mary Ann

    2013-11-01

    Childhood obesity has recently been reported as a growing problem in low- and middle-income countries. One potential prevention strategy is to apply effective obesity prevention approaches from the United States and/or other Western countries into programs that can be implemented in developing countries such as India. The purpose of this study was to explore Indian students' perceptions of social-contextual factors related to obesity and whether they perceived a role for school-based obesity prevention. This study was conducted as a first step in a model to translate interventions from one culture to another. A total of 183 fourth- and fifth-grade students of middle socioeconomic status participated in focus group discussions. Analyses were guided by the essential principles of qualitative research and informed by social cognitive and social ecological theories. Results yielded five relevant themes: (a) student health behavior knowledge, (b) parental influence on health behavior, (c) school influence on health behavior, (d) media influence on health behavior, and (e) contexts for health promotion intervention. We found that students had moderate knowledge related to health behaviors (i.e., food intake and physical activity); that parents, schools, and the media are all important contributors to healthy and unhealthy behavior; and that schools can play an important role in the prevention of obesity. Results suggest that Indian middle socioeconomic status students are already moderately aware of the health benefits to nutritious food intake and physical activity, but parents, schools, and the media can influence unhealthy behaviors.

  11. Exploring Managers' Perspectives on MNCH Program in Pakistan: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Mariyam Sarfraz

    Full Text Available Pakistan's Maternal, Newborn and Child Health (MNCH Program is faced with multiple challenges in service delivery, financial and logistic management, training and deployment of human resources, and integration within the existing health system. There is a lack of evidence on managerial aspects of the MNCH program management and implementation.This study used qualitative methods to explore the challenges national, provincial and district program managers have faced in implementing a community midwifery program in province of Punjab while also exploring future directions for the program under a devolved health system. While the program had been designed in earnest, the planning lacked critical elements of involving relevant stakeholders in design and implementation, socio-demographic context and capacity of the existing health system. Financial limitations, weak leadership and lack of a political commitment to the problem of maternal health have also had an impact on program implementation.Our study results suggest that there is a need to re-structure the program while ensuring sustainability and collaboration within the health sector to increase uptake of skilled birth attendance and improve maternal health care in Pakistan.

  12. Health risks in perspective: Judging health risks of energy technologies

    Energy Technology Data Exchange (ETDEWEB)

    Rowe, M.D.

    1992-09-18

    Almost daily, Americans receive reports from the mass news media about some new and frightening risk to health and welfare. Most such reports emphasize the newsworthiness of the risks -- the possibility of a crisis, disagreements among experts, how things happened, who is responsible for fixing them, how much will it cost, conflict among parties involved, etc. As a rule, the magnitudes of the risks, or the difficulty of estimating those magnitudes, have limited newsworthiness, and so they are not mentioned. Because of this emphasis in the news media, most people outside the risk assessment community must judge the relative significance of the various risks to which we all are exposed with only that information deemed newsworthy by reporters. This information is biased and shows risks in isolation. There is no basis for understanding and comparing the relative importance of risks among themselves, or for comparing one risk, perhaps a new or newly-discovered one, in the field of all risks. The purpose of this report is to provide perspective on the various risks to which we are routinely exposed. It serves as a basis for understanding the meaning of quantitative risk estimates and for comparing new or newly-discovered risks with other, better-understood risks. Specific emphasis is placed on health risks of energy technologies.

  13. Health care reform: can a communitarian perspective be salvaged?

    Science.gov (United States)

    Callahan, Daniel

    2011-10-01

    The United States is culturally oriented more toward individual rights and values than to communitarian values. That proclivity has made it hard to develop a common good, or solidarity-based, perspective on health care. Too many people believe they have no obligation to support the health care of others and resist a strong role for government, higher taxation, or reduced health benefits. I argue that we need to build a communitarian perspective on the concept of solidarity, which has been the concept underlying European health care systems, by focusing not on individual needs, but rather, on those of different age groups--that is, what people need at different stages of life.

  14. Young adults' perspectives on living with kidney failure: a systematic review and thematic synthesis of qualitative studies.

    Science.gov (United States)

    Bailey, Phillippa K; Hamilton, Alexander J; Clissold, Rhian L; Inward, Carol D; Caskey, Fergus J; Ben-Shlomo, Yoav; Owen-Smith, Amanda

    2018-01-10

    Young adults fare worse than younger adolescents or older adults on a broad range of health indicators. Those with a chronic illness such as renal failure are a particularly vulnerable group, who experience poor outcomes compared with both children and older adults. Understanding how being in receipt of renal replacement therapy (RRT) affects the lives of young adults might help us to better prepare and support these individuals for and on RRT, and improve outcomes. This study aimed to synthesise research describing young adults' experiences of the psychosocial impact of kidney failure and RRT. A systematic literature review identified qualitative research reporting the perspectives of people aged 16-30 years receiving RRT on the psychosocial impact of renal failure. Electronic databases (including Medline/EMBASE/PsycINFO/ASSIA) were searched to November 2017 for full-text papers. The transparency of reporting of each study was assessed using the Consolidated Criteria for Reporting Qualitative Health Research (COREQ) framework. Quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. An inductive thematic synthesis was undertaken. Seven studies from five different countries were included, comprising 123 young adults receiving RRT. Comprehensiveness of reporting was variable: studies reported 9-22 of the 32 COREQ-checklist items.Three global themes about the impact of kidney failure on young adults were identified: (1) difference desiring normality, (2) thwarted or moderated dreams and ambitions, and (3) uncertainty and liminality. These reflected five organising themes: (1) physical appearance and body image, (2) activity and participation, (3) educational disruption and underachievement, (4) career ambitions and employment difficulties, and (5) social isolation and intimate relationships. Across different countries and different healthcare settings, young adults on RRT experience difference and liminality, even after

  15. A qualitative study into the impact of fasting within a large tertiary hospital in Australia--the patients' perspective.

    Science.gov (United States)

    Carey, Sharon K; Conchin, Simone; Bloomfield-Stone, Susan

    2015-07-01

    This qualitative study aims to explore the physical and emotional impact of fasting from the patients' perspective. Fasting patients in hospital is common practice and generally viewed as necessary for symptom management or for safety of healthcare provision. Negative impacts of repeated or prolonged fasting on nutritional status have been well researched, but little is documented as to how fasting impacts an individual patient's psyche. Qualitative descriptive design within a tertiary hospital in Sydney, Australia. Twelve patients having had prolonged periods of continuous or intermittent fasting were invited to participate in a semi-structured interview between January-September 2012. Questions for interview explored each patient's experience of fasting, including physical and emotional impacts, interpretation of communication regarding fasting and the process of recommencing on fluids or foods. An inductive thematic analysis approach was used. Analyses showed six main themes: physical impacts; emotional impacts; food as structure; nil by mouth as jargon; fear of food re-introduction; and dissatisfaction regarding unnecessary fasting. Overwhelmingly, thirst was reported as the worst physical effect of fasting. In the first few days of fasting, patients became emotionally fixated on food. This quickly dissipated leading to a lack of appetite and fear of starting to eat again. Discomfort experienced by patients coupled with lack of appetite resulting from prolonged fasting and difficulty with food re-introduction strengthens the argument for reducing fasting times in hospital. When patients are fasted, proper hydration and establishing alternate routes of medication administration should be a priority. It is well recognised that fasting for prolonged periods is detrimental to health outcomes, but this study also shows the distress that fasting can cause. Inadequate hospital systems and out-dated practices need to be replaced with evidence-based, patient

  16. Qualitative environmental health research: an analysis of the literature, 1991-2008.

    Science.gov (United States)

    Scammell, Madeleine Kangsen

    2010-08-01

    Recent articles have advocated for the use of qualitative methods in environmental health research. Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. In this analysis of the literature, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. A primary search on ISI Web of Knowledge/Web of Science for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Inclusion and exclusion criteria are described. Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. Ninety-one articles met inclusion criteria. These articles were published in 58 different journals, with a maximum of eight for a single journal. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health, with most studies relying on one-on-one interviews. Details of the analyses were absent from a large number of studies. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. Qualitative data are published in traditionally quantitative environmental health studies to a limited extent. However, this analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.

  17. Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions.

    LENUS (Irish Health Repository)

    McGowan, Yvonne

    2013-03-11

    BACKGROUND: Hospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations. OBJECTIVE: This article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times. DESIGN: A qualitative methodology was chosen. METHODS: Semi-structured in-depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software. RESULTS: Dominant themes included the following: (1) unrealistic workloads: characterised by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep-deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings. CONCLUSION: Respondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several \\'red flags\\

  18. What Physical Health Means to Me: Perspectives of People with Mental Illness.

    Science.gov (United States)

    Happell, Brenda; Ewart, Stephanie B; Platania-Phung, Chris; Bocking, Julia; Scholz, Brett; Stanton, Robert

    2016-12-01

    There are significant inequalities in physical health and life expectancy between people with and without a mental illness. Understanding perspectives of people with mental illness on personal meanings of physical health is essential to ensuring health services are aligned with consumer understandings, needs, and values. A qualitative exploratory study was undertaken involving focus groups with 31 consumers in The Australian Capital Territory, Australia. Participants were asked: "What does physical health mean to you?" Thematic analysis was applied to interview transcripts. Five themes are discussed, representing different emphases in the meaning of physical health: (1) physical and mental are interconnected, (2) absence of disease, (3) moving the body, (4) struggling for healthy diet, and (5) functioning and participation. Physical pain was a difficulty that arose across these themes. Mental health consumers see physical health as always connected with well-being. Nurses would benefit from been informed by consumer understandings of physical health. In addition, there should be more attention to quality of life measures of people with mental illness as these are more congruent with consumer perspectives on physical health than biomedical measures.

  19. Laying the Foundations of Lifelong Health at the Beginning of Life: Islamic Perspective.

    Science.gov (United States)

    Alimohammadi, Nasrollah; Jafari-Mianaei, Soheila; Bankipoor-Fard, Amir-Hossein; Hasanpour, Marzieh

    2017-08-23

    In this systematic literature review, all the Shiite-Islamic documents (Quran and Hadith) without any time limitation were surveyed, analyzed and synthesized for the purpose of determining the foundations of lifelong health. The data were analyzed and combined using inductive qualitative content analysis method. Two main categories were emerged from the analysis: "prevention of health problems" and "health maintenance and promotion." In conclusion based on Islamic perspective, the foundations of comprehensive health of a person, i.e., health in all physical, mental, social, and spiritual dimensions, are begun to form at four stages: the time of marriage of his parents, the moment of their conception, when he is unborn in his mother womb, and during infancy period. Observing religion instructions in this regard is not the sufficient condition for being completely healthy; however, such instructions can provide a base for being a healthy person.

  20. What Is Career Success for Academic Hospitalists? A Qualitative Analysis of Early-Career Faculty Perspectives.

    Science.gov (United States)

    Cumbler, Ethan; Yirdaw, Essey; Kneeland, Patrick; Pierce, Read; Rendon, Patrick; Herzke, Carrie; Jones, Christine D

    2018-06-01

    Understanding the concept of career success is critical for hospital medicine groups seeking to create sustainably rewarding faculty positions. Conceptual models of career success describe both extrinsic (compensation and advancement) and intrinsic (career satisfaction and job satisfaction) domains. How hospitalists define career success for themselves is not well understood. In this study, we qualitatively explore perspectives on how early-career clinician-educators define career success. We developed a semistructured interview tool of open-ended questions validated by using cognitive interviewing. Transcribed interviews were conducted with 17 early-career academic hospitalists from 3 medical centers to thematic saturation. A mixed deductiveinductive, qualitative, analytic approach was used to code and map themes to the theoretical framework. The single most dominant theme participants described was "excitement about daily work," which mapped to the job satisfaction organizing theme. Participants frequently expressed the importance of "being respected and recognized" and "dissemination of work," which were within the career satisfaction organizing theme. The extrinsic organizing themes of advancement and compensation were described as less important contributors to an individual's sense of career success. Ambivalence toward the "academic value of clinical work," "scholarship," and especially "promotion" represented unexpected themes. The future of academic hospital medicine is predicated upon faculty finding career success. Clinician-educator hospitalists view some traditional markers of career advancement as relevant to success. However, early-career faculty question the importance of some traditional external markers to their personal definitions of success. This work suggests that the selfconcept of career success is complex and may not be captured by traditional academic metrics and milestones. © 2018 Society of Hospital Medicine

  1. The perspectives of adults living with peritoneal dialysis: thematic synthesis of qualitative studies.

    Science.gov (United States)

    Tong, Allison; Lesmana, Brian; Johnson, David W; Wong, Germaine; Campbell, Denise; Craig, Jonathan C

    2013-06-01

    Most patients with end-stage renal disease require dialysis to survive because they are unable to access kidney transplantation. Peritoneal dialysis (PD) is recommended by some clinical practice guidelines as the dialysis treatment of choice for adults without significant comorbid conditions or those with residual kidney function. This study aims to synthesize published qualitative studies of patients' experiences, beliefs, and attitudes about PD. We conducted a systematic review and thematic synthesis of qualitative studies of adult perspectives of living with PD. Databases (MEDLINE, Embase, PsycINFO, and CINAHL), theses, and reference lists were searched to November 2011. 39 studies involving 387 participants were included. We identified 7 themes: resilience and confidence (determination and overcoming vicissitudes), support structures (strong family relationship, peer support, professional dedication, social abandonment, and desire for holistic care), overwhelming responsibility (disruptive intrusion, family burden, and onerous treatment regimen), control (gaining bodily awareness, achieving independence and self-efficacy, and information seeking), freedom (flexibility and autonomy, retaining social functioning, and ability to travel), sick identity (damage to self-esteem and invisible suffering), and disablement (physical incapacitation and social loss and devaluation). PD can offer patients a sense of control, independence, self-efficacy, and freedom. However, holistic and multidisciplinary care is needed to mitigate the risks of impaired self-esteem, physical incapacitation, reduced social functioning, and poor sense of self-worth. Strategies that aim to strengthen social support and promote resilience and confidence in patients are integral to achieving positive adjustment, improved psychosocial outcomes, and treatment satisfaction. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  2. Teaching methods in Hawler College of Medicine in Iraq: A qualitative assessment from teachers' perspectives

    Directory of Open Access Journals (Sweden)

    Saleh Abubakir M

    2012-07-01

    Full Text Available Abstract Background Medical education in Iraq is poorly assessed and there is a general lack of documented knowledge about the challenges facing this field and the needs for its development. This study aimed to assess the existing teaching methods in the Hawler College of Medicine, Iraq from teaching staff perspectives and assess the knowledge of the teaching staff about student-centred learning. Methods A qualitative study based on a self-administered questionnaire survey of a purposive sample of 83 teaching staff in Hawler Medical University was conducted. The questionnaire addressed the participants’ view on the positive aspects and problems of the current teaching methods and priorities to change it. The qualitative data analysis comprised thematic analysis. Results The study revealed significant problems facing the existing teaching methods including having large number of students in the lecture hall (45.0 %, having focus on teacher-centred teaching (45.0 % and lack of infrastructures and facilities suitable for proper teaching (26.7 %. The priorities for improving the quality of teaching methods included adoption of small group teaching strategy in all study years (34.6 %, improving the infrastructure and facilities for teaching in the college (34.6 % and provision of continuous academic development programs for the teaching staff (24.3 %. Conclusions The existing medical education system face significant problems and it needs important and comprehensive improvements in different areas. There is a need for further research in this field to explore the identified problems in a more in-depth manner in order to better understand of the problems and needs of this important area of education.

  3. Teaching methods in Hawler College of Medicine in Iraq: a qualitative assessment from teachers' perspectives.

    Science.gov (United States)

    Saleh, Abubakir M; Al-Tawil, Namir G; Al-Hadithi, Tariq S

    2012-07-27

    Medical education in Iraq is poorly assessed and there is a general lack of documented knowledge about the challenges facing this field and the needs for its development. This study aimed to assess the existing teaching methods in the Hawler College of Medicine, Iraq from teaching staff perspectives and assess the knowledge of the teaching staff about student-centred learning. A qualitative study based on a self-administered questionnaire survey of a purposive sample of 83 teaching staff in Hawler Medical University was conducted. The questionnaire addressed the participants' view on the positive aspects and problems of the current teaching methods and priorities to change it. The qualitative data analysis comprised thematic analysis. The study revealed significant problems facing the existing teaching methods including having large number of students in the lecture hall (45.0 %), having focus on teacher-centred teaching (45.0 %) and lack of infrastructures and facilities suitable for proper teaching (26.7 %). The priorities for improving the quality of teaching methods included adoption of small group teaching strategy in all study years (34.6 %), improving the infrastructure and facilities for teaching in the college (34.6 %) and provision of continuous academic development programs for the teaching staff (24.3 %). The existing medical education system face significant problems and it needs important and comprehensive improvements in different areas. There is a need for further research in this field to explore the identified problems in a more in-depth manner in order to better understand of the problems and needs of this important area of education.

  4. Cannabis use in a Swiss male prison: qualitative study exploring detainees' and staffs' perspectives.

    Science.gov (United States)

    Ritter, Catherine; Broers, Barbara; Elger, Bernice S

    2013-11-01

    Several studies suggest a high prevalence of cannabis use before and during imprisonment, but subjective perspectives of detainees and staff towards its use in prison are lacking. This issue was explored in the framework of an observational study addressing tobacco use in three Swiss prisons in 2009 and 2010 that involved multiple strands (quantitative and qualitative components). This article presents qualitative data on cannabis use collected in one of the settings. We used in-depth semi-structured interviews with both detainees and staff to explore their attitudes towards cannabis in one post-trial male Swiss prison. We performed specific coding and thematic analysis for cannabis with the support of ATLAS.ti, compared detainees' and staff's opinions, and considered the results with regard to drug policy in prison in general. 58 participants (31 male offenders, mean age 35 years, and 27 prison staff, mean age 46 years, 33% female) were interviewed. Detainees estimated the current use of cannabis use to be as high as 80%, and staff 50%. Participants showed similar opinions on effects of cannabis use that were described both at individual and institutional levels: analgesic, calming, self-help to go through the prison experience, relieve stress, facilitate sleep, prevent violence, and social pacifier. They also mentioned negative consequences of cannabis use (sleepiness, decreased perception of danger and social isolation), and dissatisfaction regarding the ongoing ambiguous situation where cannabis is forbidden but detection in the urine was not sanctioned. However, the introduction of a more restrictive regulation induced fear of violence, increased trafficking and a shift to other drug use. Although illegal, cannabis use is clearly involved in daily life in prison. A clearer and comprehensive policy addressing cannabis is needed, including appropriate measures tailored to individual users. To sustain a calm and safe environment in prison, means other than

  5. A qualitative cancer screening study with childhood sexual abuse survivors: experiences, perspectives and compassionate care.

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    Gesink, Dionne; Nattel, Lilian

    2015-08-05

    The childhood sexual abuse (CSA) survivor population is substantial and survivors have been identified as part of the population who were under-screened or never-screened for breast, cervical and colon cancer. Our objective was to learn CSA survivor perspectives on, and experiences with, breast, cervical and colon cancer screening with the intention of generating recommendations to help healthcare providers improve cancer screening participation. A pragmatic constructivist qualitative study involving individual, semistructured, in-depth interviews was conducted in January 2014. Thematic analysis was used to describe CSA survivor perspectives on cancer screening and identify potential facilitators for screening. A diverse purposive sample of adult female CSA survivors was recruited. The inclusion criteria were: being a CSA survivor, being in a stable living situation, where stable meant able to meet one's financial needs independently, able to maintain supportive relationships, having participated in therapy to recover from past abuse, and living in a safe environment. 12 survivors were interviewed whose ages ranged from the early 40s to mid-70s. Descriptive saturation was reached after 10 interviews. Interviews were conducted over the phone or Internet. CSA survivors were primarily from urban and rural Ontario, but some resided elsewhere in Canada and the USA. The core concept that emerged was that compassionate care at every level of the healthcare experience could improve cancer screening participation. Main themes included: desire for holistic care; unique needs of patients with dissociative identity disorder; the patient-healthcare provider relationship; appointment interactions; the cancer screening environment; and provider assumptions about patients. Compassionate care can be delivered by: building a relationship; practising respect; focusing attention on the patient; not rushing the appointment; keeping the environment positive and comfortable; maintaining

  6. Outpatients’ Perspectives on Problems and Needs Related to Female Genital Mutilation/Cutting: A Qualitative Study from Somaliland

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    Sarah Fried

    2013-01-01

    Full Text Available Aim. To explore female outpatients’ perspectives on problems related to female genital mutilation/cutting (FGM/C and their views on information, care, and counseling. Setting. An FGM/C support center at a maternity clinic in Hargeisa, Somaliland. Methods. A qualitative, descriptive study, using content analysis of seven semistructured interviews with female outpatients. Results. All participants had been ignorant of the etiology of their FGM/C-related complications and hesitant to seek care. All had undergone infibulation but did not wish the same for their daughters. In recent years they had learnt through religious leaders and media campaigns that infibulation was unapproved by Islam. A less severe FGM/C type, “Sunna,” was more accepted; however, few could define what “Sunna” meant. Condemning and ridiculing attitudes against uncircumcised women prevailed in their community. Conclusions. New ideas and concepts related to FGM/C enter the common discourse in the Somali society while traditional norms and values still prevail. Religion was shown to have a strong impact on FGM/C practices and beliefs. Interventions aiming to raise awareness of health consequences of all types of FGM/C, as well as where to seek care for complications, are needed in Somaliland. Involvement of religious leaders in anti-FGM/C programs is essential.

  7. The Effects of Men's Bipolar Mood Disorder Type II on Marital Relationships from the Spouse's Perspective: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    مصطفی عرب ورنوسفادرانی

    2017-12-01

    Full Text Available The aim of this study was to determine the effects of males’ bipolar disorder type II on marital relationship from their wives’ perspective. This study was conducted with a qualitative research approach and thematic analysis. Data were collected through unstructured interviews with a purposive sampling of a husband with bipolar disorder and his wife and continued until data saturation (10 couples. Data analysis and comparison was performed continuously and synchronized with data collection and sampling. During the data analysis process, there were four main themes (escape balance, irritability, insecurity and management weakness. These themes show the effects of bipolar disorder on marital relationships. According to the results, the effects of bipolar disorder on marital relationships lead to crisis and serious harm in the family. Therefore, the knowledge of the effects of bipolar disorder with the theories expressed from the experiences of the spouse can be used in the treatment, care, counseling and education programs for the patient and family by specialists in the field of health, treatment, family, nursing, as well as by counselors and psychologists.

  8. Reasons for middle-aged women in Taiwan to choose hysterectomy: a qualitative study using the bounded rationality perspective.

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    Wu, Shu-Mei; Lee, Hui-Ling; Yeh, Mei-Yu; Che, Hui-Lian

    2014-12-01

    To explore women's perspectives on deciding to undergo hysterectomy for benign conditions based on physicians' recommendations and the women's own judgement. Hysterectomy is the second most common surgical procedure worldwide. Although most hysterectomies are elective, physicians may recommend treatment that involves a loss of sexuality or ovary removal, creating a difficult choice for women. Qualitative, in-depth interview A purposive sample of 17 women was recruited. The women had decided to undergo hysterectomy after the diagnosis of uterine fibroids. All these women had already decided not to have more children. Data were collected by in-depth interviewing, and content analysis was used to analyse the data. Our study revealed five themes: release from stress, inescapable fate, positive support, hoping for peace of mind and sense of trust. The participants felt that mental and physical health were the most important considerations, noting that when women no longer want children, a uterus is useless. The women believed that they retained their womanhood, even without a uterus, and were satisfied with the outcomes of their hysterectomy decisions. Our findings might serve as educational and counselling reference materials for healthcare providers, ensuring that women receive appropriate care quality and have their needs met. Healthcare providers can then maximise women's empowerment, deepen their awareness of body image and their concept of self-care and help them to clearly perceive their own concerns and needs so that they can make suitable decisions. © 2014 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Roberts, Emily; Struckmeyer, Kristopher M.

    2018-01-01

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

  10. Success factors for strategic change initiatives: a qualitative study of healthcare administrators' perspectives.

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    Kash, Bita Arbab; Spaulding, Aaron; Johnson, Christopher E; Gamm, Larry

    2014-01-01

    Success factors related to the implementation of change initiatives are well documented and discussed in the management literature, but they are seldom studied in healthcare organizations engaged in multiple strategic change initiatives. The purpose of this study was to identify key success factors related to implementation of change initiatives based on rich qualitative data gathered from health leader interviews at two large health systems implementing multiple change initiatives. In-depth personal interviews with 61 healthcare leaders in the two large systems were conducted and inductive qualitative analysis was employed to identify success factors associated with 13 change initiatives. Results from this analysis were compared to success factors identified in the literature, and generalizations were drawn that add significantly to the management literature, especially to that in the healthcare sector. Ten specific success factors were identified for the implementation of change initiatives. The top three success factors were (1) culture and values, (2) business processes, and (3) people and engagement. Two of the identified success factors are unique to the healthcare sector and not found in the literature on change models: service quality and client satisfaction (ranked fourth of 10) and access to information (ranked ninth). Results demonstrate the importance of human resource functions, alignment of culture and values with change, and business processes that facilitate effective communication and access to information to achieve many change initiatives. The responses also suggest opportunities for leaders of healthcare organizations to more formally recognize the degree to which various change initiatives are dependent on one another.

  11. Qualitative Comparison of Women's Perspectives on the Functions and Benefits of Group and Individual Prenatal Care.

    Science.gov (United States)

    Heberlein, Emily C; Picklesimer, Amy H; Billings, Deborah L; Covington-Kolb, Sarah; Farber, Naomi; Frongillo, Edward A

    2016-01-01

    Women's definitions and experiences of the functions and benefits of their routine prenatal care are largely absent from research and public discourse on prenatal care outcomes. This qualitative study aimed to develop a framework of women's prenatal care experiences by comparing the experiences of women in individual and group prenatal care. We conducted serial qualitative interviews with racially diverse low-income women receiving individual prenatal care (n = 14) or group prenatal care (n = 15) through pregnancy and the early postpartum period. We completed 42 second-trimester, 48 third-trimester, and 44 postpartum interviews. Using grounded theory, the semistructured interviews were coded for themes, and the themes were integrated into an explanatory framework of prenatal care functions and benefits. Individual and group participants described similar benefits in 3 prenatal care functions: confirming health, preventing and monitoring medical complications, and building supportive provider relationships. For the fourth function, educating and preparing, group care participants experienced more benefits and different benefits. The benefits for group participants were enhanced by the supportive group environment. Group participants described greater positive influences on stress, confidence, knowledge, motivation, informed decision making, and health care engagement. Whereas pregnant women want to maximize their probability of having a healthy newborn, other prenatal care outcomes are also important: reducing pregnancy-related stress; developing confidence and knowledge for improving health; preparing for labor, birth, and newborn care; and having supportive relationships. Group prenatal care may be more effective in attaining these outcomes. Achieving these outcomes is increasingly relevant in health care systems prioritizing woman-centered care and improved birth outcomes. How to achieve them should be part of policy development and research. © 2016 by the

  12. Considering axiological integrity: a methodological analysis of qualitative evidence syntheses, and its implications for health professions education.

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    Kelly, Martina; Ellaway, Rachel H; Reid, Helen; Ganshorn, Heather; Yardley, Sarah; Bennett, Deirdre; Dornan, Tim

    2018-05-14

    Qualitative evidence synthesis (QES) is a suite of methodologies that combine qualitative techniques with the synthesis of qualitative knowledge. They are particularly suited to medical education as these approaches pool findings from original qualitative studies, whilst paying attention to context and theoretical development. Although increasingly sophisticated use is being made of qualitative primary research methodologies in health professions education (HPE) the use of secondary qualitative reviews in HPE remains underdeveloped. This study examined QES methods applied to clinical humanism in healthcare as a way of advancing thinking around the use of QES in HPE in general. A systematic search strategy identified 49 reviews that fulfilled the inclusion criteria. Meta-study was used to develop an analytic summary of methodological characteristics, the role of theory, and the synthetic processes used in QES reviews. Fifteen reviews used a defined methodology, and 17 clearly explained the processes that led from data extraction to synthesis. Eight reviews adopted a specific theoretical perspective. Authors rarely described their reflexive relationship with their data. Epistemological positions tended to be implied rather than explicit. Twenty-five reviews included some form of quality appraisal, although it was often unclear how authors acted on its results. Reviewers under-reported qualitative approaches in their review methodologies, and tended to focus on elements such as systematicity and checklist quality appraisal that were more germane to quantitative evidence synthesis. A core concern was that the axiological (value) dimensions of the source materials were rarely considered let alone accommodated in the synthesis techniques used. QES can be used in HPE research but only with careful attention to maintaining axiological integrity.

  13. Seniors' perspectives on care: a case study of the Alex Seniors health clinic, Calgary.

    Science.gov (United States)

    Shaw, Marta; Rypien, Candace; Drummond, Neil; Harasym, Patricia; Nixon, Lara

    2015-02-25

    Primary care initiatives face an imperative to not only reduce barriers to care for their patients but also to uniquely accommodate the complex needs of at-risk patient populations. Patient-centered multidisciplinary care team models for primary care, like the Alex Seniors Clinic, are one approach for providing comprehensive care for marginalized seniors. The purpose of this qualitative study was to explore patient perspectives on the responsiveness of the Alex Seniors Clinic to their stated health needs. Themes reflected participants' perspectives on factors impacting their health needs as vulnerable seniors as well as on the measures that the Alex Seniors Clinic has taken to meet those needs. Factors impacting health included: the nature of their relationships to the physical environment in which they lived, the nature of the relationships they had to others in that environment, and independence and autonomy. Participants identified accessibility, respect and support, and advocacy as the ways in which the clinic was working to address those health needs. While respect and support, as well as advocacy, effectively addressed some patient needs, participants felt that accessibility problems continue to be health-related barriers for clinic patients. This may be due to the fact that issues of accessibility reflect larger community and social problems. Nevertheless, it is only through engaging the patient community for input on clinic approaches that an understanding can be gained of how closely a clinic's care goals are currently aligning with patient perspectives of the care and services they receive.

  14. Improving the production of applied health research findings: insights from a qualitative study of operational research.

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    Crowe, Sonya; Turner, Simon; Utley, Martin; Fulop, Naomi J

    2017-09-08

    Knowledge produced through applied health research is often of a form not readily accessible to or actionable by policymakers and practitioners, which hinders its implementation. Our aim was to identify research activities that can support the production of knowledge tailored to inform policy and practice. To do this, we studied an operational research approach to improving the production of applied health research findings. A 2-year qualitative study was conducted of the operational research contribution to a multidisciplinary applied health research project that was successful in rapidly informing national policy. Semi-structured interviews (n = 20) were conducted with all members of the project's research team and advisory group (patient and health professional representatives and academics). These were augmented by participant (> 150 h) and non-participant (> 15 h) observations focusing on the process and experience of attempting to support knowledge production. Data were analysed thematically using QSR NVivo software. Operational research performed a knowledge mediation role shaped by a problem-focused approach and an intent to perform those tasks necessary to producing readily implementable knowledge but outwith the remit of other disciplinary strands of the project. Three characteristics of the role were found to support this: engaging and incorporating different perspectives to improve services by capturing a range of health professional and patient views alongside quantitative and qualitative research evidence; rendering data meaningful by creating and presenting evidence in forms that are accessible to and engage different audiences, enabling them to make sense of it for practical use; and maintaining perceived objectivity and rigour by establishing credibility, perceived neutrality and confidence in the robustness of the research in order to unite diverse professionals in thinking creatively about system-wide service improvement. Our study

  15. Hormone therapy after the Women's Health Initiative: a qualitative study

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    Holtrop Jodi S

    2006-10-01

    Full Text Available Abstract Background Publication of results from the Women's Health Initiative study in July 2002 was a landmark event in biomedical science related to postmenopausal women. The purpose of this study was to describe the impact of new hormone therapy recommendations on patients' attitudes and decision-making in a primary care practice. Methods A questionnaire including structured and open-ended questions was administered in a family practice office waiting room from August through October 2003. Rationale for taking or not taking hormone therapy was specifically sought. Women 50–70 years old attending for office visits were invited to participate. Data were analyzed qualitatively and with descriptive statistics. Chart review provided medication use rates for the entire practice cohort of which the sample was a subset. Results Respondents (n = 127 were predominantly white and well educated, and were taking hormone therapy at a higher rate (38% than the overall rate (26% for women of the same age range in this practice. Belief patterns about hormone therapy were, in order of frequency, 'use is risky', 'vindication or prior beliefs', 'benefit to me outweighs risk', and 'unaware of new recommendations'. Twenty-eight out of 78 women continued hormones use after July 2002. Of 50 women who initially stopped hormone therapy after July 2002, 12 resumed use. Women who had stopped hormone therapy were a highly symptomatic group. Responses with emotional overtones such as worry, confusion, anger, and grief were common. Conclusion Strategies for decision support about hormone therapy should explicitly take into account women's preferences about symptom relief and the trade-offs among relevant risks. Some women may need emotional support during transitions in hormone therapy use.

  16. Factors influencing workplace health promotion intervention: a qualitative systematic review.

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    Rojatz, Daniela; Merchant, Almas; Nitsch, Martina

    2017-10-01

    Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity

    Science.gov (United States)

    Grundberg, Åke; Ebbeskog, Britt; Gustafsson, Sanna Aila; Religa, Dorota

    2014-01-01

    Mental health promotion needs to be studied more deeply within the context of primary care, because persons with multiple chronic conditions are at risk of developing poor mental health. In order to make progress in the understanding of mental health promotion, the aim of this study was to describe the experiences of health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity – what these seniors believe is important for achieving a dialogue that may promote their mental health. Seven interviews with six women and one man, aged 83–96 years, were analyzed using qualitative content analysis. The results were summarized into nine subcategories and three categories. The underlying meaning of the text was formulated into an overarching theme that embraced every category, “perceived and well-managed as a unique individual”. These seniors with multimorbidity missed someone to talk to about their mental health, and needed partners that were accessible for health dialogues that could promote mental health. The participants missed friends and relatives to talk to and they (crucially) lacked health care or social service providers for health-promoting dialogues that may promote mental health. An optimal level of care can be achieved through involvement, continuity, and by providing a health-promoting dialogue based on seniors’ needs and wishes, with the remembrance that general health promotion also may promote mental health. Implications for clinical practice and further research are discussed. PMID:24812516

  18. Sexual Health Promotion Programme: Participants' Perspectives on Capacity Building

    Science.gov (United States)

    Keogh, Brian; Daly, Louise; Sharek, Danika; De Vries, Jan; McCann, Edward; Higgins, Agnes

    2016-01-01

    Objectives: The aim of this study was to evaluate a Health Service Executive (HSE) Foundation Programme in Sexual Health Promotion (FPSHP) with a specific emphasis on capacity building. Design: A mixed-method design using both quantitative and qualitative methods was used to collect the data. Setting: The FPSHP was delivered to staff working in…

  19. Physical Education and Health: Global Perspectives and Best Practice

    Science.gov (United States)

    Chin, Ming-Kai, Ed.; Edginton, Christopher R.

    2014-01-01

    "Physical Education and Health: Global Perspectives and Best Practice" draws together global scholars, researchers, and practitioners to provide a review and analysis of new directions in physical education and health worldwide. The book provides descriptive information from 40 countries regarding contemporary practices, models, and…

  20. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME in adults: a qualitative study of perspectives from professional practice

    Directory of Open Access Journals (Sweden)

    Campion Peter D

    2010-11-01

    Full Text Available Abstract Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME can cause profound and prolonged illness and disability, and poses significant problems of uncertainty for healthcare professionals in its diagnosis and management. The aim of this qualitative study was to explore the nature of professional 'best practice' in working with people with CFS/ME. Methods The views and experiences of health care practitioners (HCPs were sought, who had been judged by people with CFS/ME themselves to have been particularly helpful and effective. Qualitative semi-structured interviews following a topic guide were carried out with six health care practitioners. Interviews were audio-recorded, transcribed and subject to thematic analysis. Results Five main themes were developed: 1 Diagnosis; 2 Professional perspectives on living with CFS/ME; 3 Interventions for treatment and management; 4 Professional values and support for people with CFS/ME and their families; 5 Health professional roles and working practices. Key findings related to: the diagnostic process, especially the degree of uncertainty which may be shared by primary care physicians and patients alike; the continued denial in some quarters of the existence of CFS/ME as a condition; the variability, complexity, and serious impact of the condition on life and living; the onus on the person with CFS/ME to manage their condition, supported by HCPs; the wealth of often conflicting and confusing information on the condition and options for treatment; and the vital role of extended listening and trustful relationships with patients. Conclusions While professional frustrations were clearly expressed about the variability of services both in primary and specialist care and continuing equivocal attitudes to CFS/ME as a condition, there were also strong positive messages for people with CFS/ME where the right services are in place. Many of the findings from these practitioners seen by their

  1. The importance of service-users' perspectives: A systematic review of qualitative evidence reveals overlooked critical features of weight management programmes.

    Science.gov (United States)

    Sutcliffe, Katy; Melendez-Torres, G J; Burchett, Helen E D; Richardson, Michelle; Rees, Rebecca; Thomas, James

    2018-03-14

    Extensive research effort shows that weight management programmes (WMPs) targeting both diet and exercise are broadly effective. However, the critical features of WMPs remain unclear. To develop a deeper understanding of WMPs critical features, we undertook a systematic review of qualitative evidence. We sought to understand from a service-user perspective how programmes are experienced, and may be effective, on the ground. We identified qualitative studies from existing reviews and updated the searches of one review. We included UK studies capturing the views of adult WMP users. Thematic analysis was used inductively to code and synthesize the evidence. Service users were emphatic that supportive relationships, with service providers or WMP peers, are the most critical aspect of WMPs. Supportive relationships were described as providing an extrinsic motivator or "hook" which helped to overcome barriers such as scepticism about dietary advice or a lack confidence to engage in physical activity. The evidence revealed that service-users' understandings of the critical features of WMPs differ from the focus of health promotion guidance or descriptions of evaluated programmes which largely emphasize educational or goal setting aspects of WMPs. Existing programme guidance may not therefore fully address the needs of service users. The study illustrates that the perspectives of service users can reveal unanticipated intervention mechanisms or underemphasized critical features and underscores the value of a holistic understanding about "what happens" in complex psychosocial interventions such as WMPs. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

  2. 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.

  3. The lesser evil? Initiating a benzodiazepine prescription in general practice: a qualitative study on GPs' perspectives.

    Science.gov (United States)

    Anthierens, Sibyl; Habraken, Hilde; Petrovic, Mirko; Christiaens, Thierry

    2007-12-01

    Chronic benzodiazepine (BZD) use is widespread and linked with adverse effects. There is consensus concerning the importance of initiating BZD as a crucial moment. Nevertheless specific research in this field is lacking. This paper addresses the views of GPs on why they start prescribing BZDs to first-time users. Qualitative study with five focus groups analysed using a systematic content analysis. Regions of Ghent and Brussels in Belgium. A total of 35 general practitioners. The GPs' perspective on their initiating of BZD prescribing. GPs reported that they are cautious in initiating BZD usage. At the same time, GPs feel overwhelmed by the psychosocial problems of their patients. They show empathy by prescribing. They feel in certain situations there are no other solutions and they experience BZDs as the lesser evil. They admit to resorting to BZDs because of time restraint and lack of alternatives. GPs do not perceive the addictive nature of BZD consumption as a problem with first-time users. GPs do not specifically mention patients' demand as an element for starting. The main concern of GPs is to help the patient. GPs should be aware of the addictive nature of BZD even in low doses and a non-pharmacological approach should be seen as the best first approach. If GPs decide to prescribe a BZD they should make plain to the patient that the medication is only a "temporary" solution with clear agreements with regard to medication withdrawal.

  4. Nurses' perspectives on breaking bad news to patients and their families: a qualitative content analysis.

    Science.gov (United States)

    Abbaszadeh, Abbas; Ehsani, Seyyedeh Roghayeh; Begjani, Jamal; Kaji, Mohammad Akbari; Dopolani, Fatemeh Nemati; Nejati, Amir; Mohammadnejad, Esmaeil

    2014-01-01

    Breaking bad news is quite often not done in an effective manner in clinical settings due to the medical staff lacking the skills necessary for speaking to patients and their families. Bad news is faced with similar reactions on the part of the news receiver in all cultures and nations. The purpose of this study was to explore the perspectives of Iranian nurses on breaking bad news to patients and their families. In this research, a qualitative approach was adopted. In-depth and semi-structured interviews were conducted with 19 nurses who had at least one year work experience in the ward, and content analysis was performed to analyze the data. Five major categories emerged from data analysis, including effective communication with patients and their families, preparing the ground for delivering bad news, minimizing the negativity associated with the disease, passing the duty to physicians, and helping patients and their families make logical treatment decisions. The results of this study show that according to the participants, it is the physicians' duty to give bad news, but nurses play an important role in delivering bad news to patients and their companions and should therefore be trained in clinical and communicative skills to be able to give bad news in an appropriate and effective manner.

  5. 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.

  6. The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives.

    Science.gov (United States)

    Ridd, Matthew; Shaw, Alison; Lewis, Glyn; Salisbury, Chris

    2009-04-01

    The patient-doctor relationship is an important but poorly defined topic. In order to comprehensively assess its significance for patient care, a clearer understanding of the concept is required. To derive a conceptual framework of the factors that define patient-doctor relationships from the perspective of patients. Systematic review and thematic synthesis of qualitative studies. Medline, EMBASE, PsychINFO and Web of Science databases were searched. Studies were screened for relevance and appraised for quality. The findings were synthesised using a thematic approach. From 1985 abstracts, 11 studies from four countries were included in the final synthesis. They examined the patient-doctor relationship generally (n = 3), or in terms of loyalty (n = 3), personal care (n = 2), trust (n = 2), and continuity (n = 1). Longitudinal care (seeing the same doctor) and consultation experiences (patients' encounters with the doctor) were found to be the main processes by which patient-doctor relationships are promoted. The resulting depth of patient-doctor relationship comprises four main elements: knowledge, trust, loyalty, and regard. These elements have doctor and patient aspects to them, which may be reciprocally related. A framework is proposed that distinguishes between dynamic factors that develop or maintain the relationship, and characteristics that constitute an ongoing depth of relationship. Having identified the different elements involved, future research should examine for associations between longitudinal care, consultation experiences, and depth of patient-doctor relationship, and, in turn, their significance for patient care.

  7. Patient perspectives of maintaining dignity in Indonesian clinical care settings: A qualitative descriptive study.

    Science.gov (United States)

    Asmaningrum, Nurfika; Tsai, Yun-Fang

    2018-03-01

    To gain an understanding towards the perspectives of hospitalized inpatients in Indonesia regarding maintaining dignity during clinical care. Dignity is a basic human right that is crucial for an individual's well-being. Respect for a person as a valuable human is a concept that is comparable to treating a person with dignity. Maintaining patient's dignity is an ethical goal of nursing care. Nevertheless, the concept is highly dependent on cultural context. This issue has not been well studied in Indonesia. This study used a qualitative descriptive design. Thirty-five participants were recruited by purposive sampling from medical to surgical wards of six public hospitals in Eastern Java, Indonesia. Data were collected in 2016 through individual face-to-face semi-structured interviews. Inductive content analysis was applied to the data. Four major categories which described qualities of nursing care essential for maintaining a patient's dignity in clinical care settings were revealed: (1) responsiveness; (2) respectful nurse-patient relationships; (3) caring characteristics and (4) personalized service. Our findings provide a cultural viewpoint of dignity for care recipients in Indonesia. The findings provide empirical support for linking dignified care and person-centred care principles with regards to cultural sensitivity. Nurses must not only be clinically competent but also culturally competent. The ability to provide culturally competent care is important for nurses as a strategy to maintain patient dignity during hospitalized care. © 2017 John Wiley & Sons Ltd.

  8. Obstacles and problems of ethical leadership from the perspective of nursing leaders: a qualitative content analysis.

    Science.gov (United States)

    Barkhordari-Sharifabad, Maasoumeh; Ashktorab, Tahereh; Atashzadeh-Shoorideh, Foroozan

    2017-01-01

    In the nursing profession, leadership plays a significant role in creating motivation and thus enabling nurses to provide high quality care. Ethics is an essential component of leadership qualifications and the ethical leader can help create an ethical atmosphere, offer ethical guidance, and ensure the occupational satisfaction of personnel through prioritizing moralities. However, some issues prevent the implementation of this type of leadership by nursing leaders. The aim of this study was to identify and describe some problems and obstacles in ethical leadership faced by nursing leaders, and to help them achieve more accurate information and broader perspective in this field. The present study was conducted using a qualitative approach and content analysis. A total of 14 nursing managers and educators were selected purposefully, and deep and semi-structured interviews were conducted with them. Content analysis was performed using an inductive approach. Three main categories were obtained after data analysis: ethical, cultural and managerial problems. "Ethical problems" pertain to doubt in ethical actions, ethical conflicts and ethical distress; "cultural problems" include organizational and social culture; and "managerial problems" are connected to organizational and staff-related issues. Nursing leaders put forth various aspects of the problems associated with ethical leadership in the clinical setting. This style of leadership could be promoted by developing suitable programs and providing clear-cut strategies for removing the current obstacles and correcting the organizational structure. This can lead to ethical improvement in nursing leaders and subsequently the nurses.

  9. How Residents Learn From Patient Feedback: A Multi-Institutional Qualitative Study of Pediatrics Residents' Perspectives.

    Science.gov (United States)

    Bogetz, Alyssa L; Orlov, Nicola; Blankenburg, Rebecca; Bhavaraju, Vasudha; McQueen, Alisa; Rassbach, Caroline

    2018-04-01

    Residents may view feedback from patients and their families with greater skepticism than feedback from supervisors and peers. While discussing patient and family feedback with faculty may improve residents' acceptance of feedback and learning, specific strategies have not been identified. We explored pediatrics residents' perspectives of patient feedback and identified strategies that promote residents' reflection on and learning from feedback. In this multi-institutional, qualitative study conducted in June and July 2016, we conducted focus groups with a purposive sample of pediatrics residents after their participation in a randomized controlled trial in which they received written patient feedback and either discussed it with faculty or reviewed it independently. Focus group transcripts were audiorecorded, transcribed, and analyzed for themes using the constant comparative approach associated with grounded theory. Thirty-six of 92 (39%) residents participated in 7 focus groups. Four themes emerged: (1) residents valued patient feedback but felt it may lack the specificity they desire; (2) discussing feedback with a trusted faculty member was helpful for self-reflection; (3) residents identified 5 strategies faculty used to facilitate their openness to and acceptance of patient feedback (eg, help resident overcome emotional responses to feedback and situate feedback in the context of lifelong learning); and (4) residents' perceptions of feedback credibility improved when faculty observed patient encounters and solicited feedback on the resident's behalf prior to discussions. Discussing patient feedback with faculty provided important scaffolding to enhance residents' openness to and reflection on patient feedback.

  10. Sickness certification in the general practice consultation: the patients' perspective, a qualitative study.

    Science.gov (United States)

    O'Brien, Kathryn; Cadbury, Naomi; Rollnick, Stephen; Wood, Fiona

    2008-02-01

    Up to a third of general practice consultations involve issuing sickness certificates. Recent research has looked at the GPs' perspective of sickness certification but there has been no in-depth research exploring patients' views of these consultations. To explore patients' views of sickness certification within general practice consultations, and how these could be improved. A qualitative study was carried out with 12 general practices in South Wales; interview study of 19 patients who had recently received a sick note from a GP. Patients rarely attended just for a sick note, more often wanting advice or an opportunity to ask questions. Patients valued continuity of care, a good doctor-patient relationship, adequate consultation time and discussion about their illness, social situation and work-related issues when consulting with their GP for a sick note. Many patients felt doctors did not have enough time or knowledge of the patient to the able to address this issue adequately and this increased feelings of anxiety. Patients did not feel that being questioned by their GP or discussing return to work threatened the doctor-patient relationship. GPs who simply give out sick notes without question or discussion are not necessarily giving the patient what they want. More time should be spent discussing work and illness-related issues. Policy makers should recognize that continuity of care a good doctor-patient relationship and adequate consultation time are important to patients and any initiatives aimed at GPs to improve return to work rates should take these into consideration.

  11. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran.

    Science.gov (United States)

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2016-02-01

    There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran.

  12. Understanding institutional stakeholders’ perspectives on multidrug-resistant bacterial organism at the end of life: a qualitative study

    Directory of Open Access Journals (Sweden)

    Heckel M

    2017-10-01

    Full Text Available Maria Heckel,1 Franziska A Herbst,2 Thomas Adelhardt,3 Johanna M Tiedtke,4 Alexander Sturm,5 Stephanie Stiel,2 Christoph Ostgathe1 1Department of Palliative Medicine, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU, Universitätsklinikum Erlangen, Bavaria, Germany; 2Institute for General Practice, Hannover Medical School, Hannover, Germany; 3Division of Health Management, School of Business and Economics, Institute of Management (IFM, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU, Bavaria, Germany; 4Institute of Psychogerontology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU, Bavaria, Germany; 5Department of General Internal and Geriatric Medicine, Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU, Hospital of the Order of St John of God Regensburg, Bavaria, Germany Background: Information lacks about institutional stakeholders’ perspectives on management approaches of multidrug-resistant bacterial organism in end-of-life situations. The term “institutional stakeholder” includes persons in leading positions with responsibility in hospitals’ multidrug-resistant bacterial organism management. They have great influence on how strategies on multidrug-resistant bacterial organism management approaches in institutions of the public health system are designed. This study targeted institutional stakeholders’ individual perspectives on multidrug-resistant bacterial organism colonization or infection and isolation measures at the end of life. Methods: Between March and December 2014, institutional stakeholders of two study centers, a German palliative care unit and a geriatric ward, were queried in semistructured interviews. Interviews were audiotaped, transcribed verbatim, and analyzed qualitatively with the aid of the software MAXQDA for qualitative data analysis using principles of Grounded Theory. In addition, two external

  13. A qualitative investigation of the health economic impacts of bariatric surgery for obesity and implications for improved practice in health economics.

    Science.gov (United States)

    Campbell, Julie A; Ezzy, Douglas; Neil, Amanda; Hensher, Martin; Venn, Alison; Sharman, Melanie J; Palmer, Andrew J

    2018-06-01

    Obesity is an economic problem. Bariatric surgery is cost-effective for severe and resistant obesity. Most economic evaluations of bariatric surgery use administrative data and narrowly defined direct medical costs in their quantitative analyses. Demand far outstrips supply for bariatric surgery. Further allocation of health care resources to bariatric surgery (particularly public) could be stimulated by new health economic evidence that supports the provision of bariatric surgery. We postulated that qualitative research methods would elicit important health economic dimensions of bariatric surgery that would typically be omitted from the current economic evaluation framework, nor be reported and therefore not considered by policymakers with sufficient priority. We listened to patients: Focus group data were analysed thematically with software assistance. Key themes were identified inductively through a dialogue between the qualitative data and pre-existing economic theory (perspective, externalities, and emotional capital). We identified the concept of emotional capital where participants described life-changing desires to be productive and participate in their communities postoperatively. After self-funding bariatric surgery, some participants experienced financial distress. We recommend a mixed-methods approach to the economic evaluation of bariatric surgery. This could be operationalised in health economic model conceptualisation and construction, through to the separate reporting of qualitative results to supplement quantitative results. Copyright © 2018 John Wiley & Sons, Ltd.

  14. Using secondary analysis of qualitative data of patient experiences of health care to inform health services research and policy.

    Science.gov (United States)

    Ziebland, Sue; Hunt, Kate

    2014-07-01

    Qualitative research is recognized as an important method for including patients' voices and experiences in health services research and policy-making, yet the considerable potential to analyse existing qualitative data to inform health policy and practice has been little realized. This failure may partly be explained by: a lack of awareness amongst health policy makers of the increasing wealth of qualitative data available; and around 15 years of internal debates among qualitative researchers on the strengths, limitations and validity of re-use of qualitative data. Whilst acknowledging the challenges of qualitative secondary data analysis, we argue that there is a growing imperative to be pragmatic and to undertake analysis of existing qualitative data collections where they have the potential to contribute to health policy formulation. Time pressures are inherent in the policy-making process and in many circumstances it is not possible to seek funding, conduct and analyse new qualitative studies of patients' experiences in time to inform a specific policy. The danger then is that the patient voice, and the experiences of relatives and carers, is either excluded or included in a way that is easily dismissed as 'unrepresentative'. We argue that secondary analysis of qualitative data collections may sometimes be an effective means to enable patient experiences to inform policy decision-making. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. A qualitative study on the role of cultural background in patients' perspectives on rehabilitation.

    Science.gov (United States)

    Scheermesser, Mandy; Bachmann, Stefan; Schämann, Astrid; Oesch, Peter; Kool, Jan

    2012-01-23

    Low back pain (LBP) is one of the major concerns in health care. In Switzerland, musculoskeletal problems represent the third largest illness group with 9.4 million consultations per year. The return to work rate is increased by an active treatment program and saves societal costs. However, results after rehabilitation are generally poorer in patients with a Southeast European cultural background than in other patients. This qualitative research about the rehabilitation of patients with LBP and a Southeast European cultural background, therefore, explores possible barriers to successful rehabilitation. We used a triangulation of methods combining three qualitative methods of data collection: 13 semi-structured in-depth interviews with patients who have a Southeast European cultural background and live in Switzerland, five semi-structured in-depth interviews and two focus groups with health professionals, and a literature review. Between June and December 2008, we recruited participants at a Rehabilitation Centre in the German-speaking part of Switzerland. To cope with pain, patients prefer passive strategies, which are not in line with recommended coping strategies. Moreover, the families of patients tend to support passive behaviour and reduce the autonomy of patients. Health professionals and researchers propagate active strategies including activity in the presence of pain, yet patients do not consider psychological factors contributing to LBP. The views of physicians and health professionals are in line with research evidence demonstrating the importance of psychosocial factors for LBP. Treatment goals focusing on increasing daily activities and return to work are not well understood by patients partly due to communication problems, which is something that patients and health professionals are aware of. Additional barriers to returning to work are caused by poor job satisfaction and other work-related factors. LBP rehabilitation can be improved by addressing

  16. A qualitative study on the role of cultural background in patients' perspectives on rehabilitation

    Directory of Open Access Journals (Sweden)

    Scheermesser Mandy

    2012-01-01

    Full Text Available Abstract Background Low back pain (LBP is one of the major concerns in health care. In Switzerland, musculoskeletal problems represent the third largest illness group with 9.4 million consultations per year. The return to work rate is increased by an active treatment program and saves societal costs. However, results after rehabilitation are generally poorer in patients with a Southeast European cultural background than in other patients. This qualitative research about the rehabilitation of patients with LBP and a Southeast European cultural background, therefore, explores possible barriers to successful rehabilitation. Methods We used a triangulation of methods combining three qualitative methods of data collection: 13 semi-structured in-depth interviews with patients who have a Southeast European cultural background and live in Switzerland, five semi-structured in-depth interviews and two focus groups with health professionals, and a literature review. Between June and December 2008, we recruited participants at a Rehabilitation Centre in the German-speaking part of Switzerland. Results To cope with pain, patients prefer passive strategies, which are not in line with recommended coping strategies. Moreover, the families of patients tend to support passive behaviour and reduce the autonomy of patients. Health professionals and researchers propagate active strategies including activity in the presence of pain, yet patients do not consider psychological factors contributing to LBP. The views of physicians and health professionals are in line with research evidence demonstrating the importance of psychosocial factors for LBP. Treatment goals focusing on increasing daily activities and return to work are not well understood by patients partly due to communication problems, which is something that patients and health professionals are aware of. Additional barriers to returning to work are caused by poor job satisfaction and other work

  17. Perceptions of Patient Engagement Applications During Pregnancy: A Qualitative Assessment of the Patient's Perspective.

    Science.gov (United States)

    Goetz, Maren; Müller, Mitho; Matthies, Lina Maria; Hansen, Jenny; Doster, Anne; Szabo, Akos; Pauluschke-Fröhlich, Jan; Abele, Harald; Sohn, Christof; Wallwiener, Markus; Wallwiener, Stephanie

    2017-05-26

    With growing demand for medical information and health applications in pregnancy, the potential of electronic health (eHealth) and mobile health (mHealth) solutions in clinical care is increasingly unfolding. However, we still do not know how pregnant women engage with mobile apps, how such apps impact routine medical care, and whether benefit expectations are met. Whereas recent research has raised the subject of user distribution and analyzed the content of pregnancy applications, there is still a significant knowledge gap regarding what pregnant women like and dislike about pregnancy tools, along with how such interventions could be improved. The aim of the study was to examine the perceptions and expectations of mobile and Web-based patient-engagement pregnancy applications. We assessed usability requirements, general acceptance of eHealth, and the impact of eHealth and mHealth pregnancy applications on the doctor-patient interaction and daily clinical routine. A qualitative study was conducted at the maternity department of a major German university hospital. The sample included 30 women with low- to medium-risk pregnancies. Half of the patients were seen during outpatient care and half were hospitalized for several days. The extent and frequency of Web- and mobile phone app usage were assessed. Semistructured interviews were conducted and analyzed using systematic thematic analysis. Patients had a high demand for Web-based pregnancy applications. Study findings suggested a strong request for personalization, monitoring, and accessibility for frequent use as main themes derived from the interviews. Fostering patient empowerment in the doctor-patient relationship was also highly valued for a pregnancy app. Participants favored further integration of medical apps in their daily routine and pregnancy care. However, concerns were raised about content quality, trustworthiness of Web sources, and individual data security. eHealth and mHealth applications are a

  18. The Promise of Qualitative Research to Inform Theory to Address Health Equity

    Science.gov (United States)

    Shelton, Rachel C.; Griffith, Derek M.; Kegler, Michelle C.

    2017-01-01

    Most public health researchers and practitioners agree that we need to accelerate our efforts to eliminate health disparities and promote health equity. The past two decades of research have provided a wealth of descriptive studies, both qualitative and quantitative, that describe the size, scale, and scope of health disparities, as well as the…

  19. A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

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    Agudelo-Suárez Andrés A

    2012-12-01

    Full Text Available Abstract Background Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011. Methods A systematic review was conducted for Qualitative research papers (English/Spanish published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2% were carried out in the U.S and 11 studies (42.3% dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to

  20. Descriptions of sampling practices within five approaches to qualitative research in education and the health sciences

    OpenAIRE

    Guetterman, Timothy C.

    2015-01-01

    Although recommendations exist for determining qualitative sample sizes, the literature appears to contain few instances of research on the topic. Practical guidance is needed for determining sample sizes to conduct rigorous qualitative research, to develop proposals, and to budget resources. The purpose of this article is to describe qualitative sample size and sampling practices within published studies in education and the health sciences by research design: case study, ethnography, ground...

  1. Effective heart disease prevention: lessons from a qualitative study of user perspectives in Bangladeshi, Indian and Pakistani communities.

    Science.gov (United States)

    Netto, G; McCloughan, L; Bhatnagar, A

    2007-03-01

    Coronary heart disease (CHD) has a high mortality, incidence and prevalence among Indian, Pakistani and Bangladeshi communities in the UK, indicating the need for effective heart disease prevention initiatives for these communities. This paper considers how service user perspectives can be used to develop effective, culturally focused CHD prevention interventions for these target groups by addressing identified barriers, including deeply held cultural beliefs. A qualitative research study, using a longitudinal action research approach. This was a community-based study in Edinburgh. Six focus group discussions--two for each community--were organized with participants from these communities at the beginning of the project. A further six focus group discussions for the same communities were organized six months later. Over the period examined, participants reported varying changes in levels of knowledge relating to the nature, causes and symptoms of CHD. Some participants reported taking slight to significant steps to reduce or prevent heart disease, while others did not. The project was viewed as helpful in increasing knowledge about CHD and preventive measures and encouraging healthier lifestyles. However, persistent barriers to change were also identified, requiring changes to the project that involved not only matching intervention materials and messages to observable, superficial characteristics of the target population, but more fundamental changes that address the cultural, social, historical, environmental and psychological forces that influence health behaviour. CHD prevention initiatives need to identify and respond to deep-rooted influences on health-behaviour in 'at-risk' groups, in addition to superficial characteristics of the target populations. It is important for specific prevention initiatives to be linked into wider CHD frameworks to ensure transferability of learning and integration within wider service provision.

  2. 'I feel stronger and younger all the time'-perspectives of elderly kidney transplant recipients: thematic synthesis of qualitative research.

    Science.gov (United States)

    Pinter, Jule; Hanson, Camilla S; Craig, Jonathan C; Chapman, Jeremy R; Budde, Klemens; Halleck, Fabian; Tong, Allison

    2016-09-01

    Kidney transplantation offers improved survival and quality of life to an increasing number of elderly patients with end-stage kidney disease. However, elderly kidney transplant recipients may face unique challenges due to a higher burden of comorbidity, greater cumulative risk of immunosuppression-related complications and increasing frailty. We aimed to describe the perspectives of elderly kidney transplant recipients. Electronic databases were searched to April 2015. Qualitative studies were eligible if they reported views from elderly kidney transplant recipients (≥60 years). Thematic synthesis was used to analyse the findings. Twenty-one studies involving >116 recipients were included. We identified seven themes. 'Regaining strength and vitality' meant valuing the physical and psychosocial improvements in daily functioning and life participation. 'Extending life' was the willingness to accept any organ, including extended criteria kidneys, to prolong survival. 'Debt of gratitude' entailed conscious appreciation toward their donor while knowing they were unable to repay their sacrifice. 'Moral responsibility to maintain health' motivated adherence to medication and lifestyle recommendations out of an ethical duty to protect their gift for graft survival. 'Unabating and worsening forgetfulness' hindered self-management. 'Disillusionment with side effects and complications' reflected disappointment and exasperation with the unintended consequences of medications. 'Finality of treatment option' was an acute awareness that the current transplant may be their last. Kidney transplantation was perceived to slow and even reverse the experience of aging among elderly recipients, especially compared with dialysis. However, some were frustrated over persistent limitations after transplant, struggled with the burden of medication side effects and worried about a possible return to dialysis if the transplant failed. Clarifying patient expectations of transplantation

  3. Patient attitudes about the clinical use of placebo: qualitative perspectives from a telephone survey.

    Science.gov (United States)

    Ortiz, Robin; Chandros Hull, Sara; Colloca, Luana

    2016-04-04

    To examine qualitative responses regarding the use of placebo treatments in medical care in a sample of US patients.Survey studies suggest a deliberate clinical use of placebos by physicians, and prior research has found that although most US patients find placebo use acceptable, the rationale for these beliefs is largely unknown. Members of the Outpatient Clinic at the Kaiser Permanente Northern California interviewed research participants who had been seen for a chronic health problem at least once in the prior 6 months. 853 women (61%) and men, white (58%) and non-white participants aged 18-75 years. Qualitative responses on perceptions of placebo use from one-time telephone surveys were analysed for common themes and associations with demographic variables. Prior results indicated that a majority of respondents felt it acceptable for doctors to recommend placebo treatments. Our study found that a lack of harm (n=291, 46.1%) and potential benefit (n=250, 39.6%) were the most common themes to justify acceptability of placebo use. Responses citing potential benefit were associated with higher education (r=0.787; pright to know and power of the mind. Older age was associated with likelihood to cite overall physician, as opposed to treatment, related themes (r=0.753; prights-and-licensing/

  4. Choosing health: qualitative evidence from the experiences of personal health budget holders.

    Science.gov (United States)

    Davidson, Jacqueline; Baxter, Kate; Glendinning, Caroline; Irvine, Annie

    2013-10-01

    Personal health budgets were piloted in the English National Health Service between 2009 and 2012. Semi-structured interviews with a sub-sample of early budget holders aimed to explore their experiences of receiving and using a budget. Over 2000 people from 20 pilot sites were recruited to a multi-method evaluation of the personal health budget pilots. A sub-sample of 58 people was selected for qualitative interviews three months after the offer of a budget; 52 were re-interviewed six months later. The purposively selected sample reflected a range of health conditions, locality, age and gender. Personal health budgets were reported to have positive impacts on health, health care and relatives/family. Benefits often extended beyond the condition for which the budget had been awarded. However, interviewees rarely knew the level of their budget; some reported difficulty in agreeing acceptable uses for their budget; and delays could occur in procuring chosen services or equipment. Patients' experiences offer valuable insights for the roll-out of personal health budgets beyond the pilot phase. Flexibility in how budgets are used may allow maximum benefits to be derived. Clear information about what budgets can and cannot be used for, with suggestions offered, will be useful. People with newly diagnosed or recent sudden onset conditions may need more help to plan their support, but all budget holders are likely to benefit from regular contact with staff for reassurance and continued motivation.

  5. The ethics in qualitative health research: special considerations.

    Science.gov (United States)

    Peter, Elizabeth

    2015-09-01

    A sound knowledge of the nature of qualitative research, along with an appreciation of some special ethical considerations, is needed for rigorous reviews to be conducted. The overall character of qualitative research is described with an emphasis on the tendency of qualitative researchers to explore sensitive topics using theoretically informed methods. A number of specific features of qualitative that require additional ethical attention and awareness are also examined including the following: 1) participants are frequently quite vulnerable and require protection because the data collection methods, such as in-depth interviews, can delve into personally and politically charged matters; 2) naturalistic observation can raise concerns regarding privacy and consent; 3) the potential for the identifiability of the results of this research may require extra efforts to maintain confidentiality. Ultimately, Reseach Ethics Committee members must be knowledgeable about qualitative approaches to be able to assess the potential harms and benefits in a protocol carefully. Without this knowledge gaining ethics approval can be overly difficult for researchers and the best practices for protecting human participants can be overlooked.

  6. The ethics in qualitative health research: special considerations

    Directory of Open Access Journals (Sweden)

    Elizabeth Peter

    2015-09-01

    Full Text Available Abstract A sound knowledge of the nature of qualitative research, along with an appreciation of some special ethical considerations, is needed for rigorous reviews to be conducted. The overall character of qualitative research is described with an emphasis on the tendency of qualitative researchers to explore sensitive topics using theoretically informed methods. A number of specific features of qualitative that require additional ethical attention and awareness are also examined including the following: 1 participants are frequently quite vulnerable and require protection because the data collection methods, such as in-depth interviews, can delve into personally and politically charged matters; 2 naturalistic observation can raise concerns regarding privacy and consent; 3 the potential for the identifiability of the results of this research may require extra efforts to maintain confidentiality. Ultimately, Reseach Ethics Committee members must be knowledgeable about qualitative approaches to be able to assess the potential harms and benefits in a protocol carefully. Without this knowledge gaining ethics approval can be overly difficult for researchers and the best practices for protecting human participants can be overlooked.

  7. Occupational Safety And Health (Osh From Islamic Perspective: A Conceptual Study

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    Afifah Binti Ismail

    2018-05-01

    Full Text Available ABSTRACT This paper illustrates occupational safety and health (OSH based on Islamic perspective in human resource management. This paper has been written based on the following objectives; ato state the duty of employer to provide safety workplace and to concern on employee health; bto list out the management system of OSH based on Islamic perspective as preventive measure. A purely qualitative approach of literature review was done and Islamic OSH is derived from Islamic principles which are guide by Al-Quran and sunnah. The responsibility to preserve safety and health of employee does not only relies to the employer solely but involved all workers, the government and the authority bodies as the runner for the Occupational safety and Health Act  OSHA 1994, Islamic order’s and policy to be implemented in the organization. The Occupational Safety and Health Master Plan (OSHMP 2020 is a tremendous incentive by the Ministry of Human Resource to cope and minimize the number of accident and injuries in Malaysia.   Keywords: Islamic occupational safety and health, employee safety and health, Islamic management system of OSH

  8. Situating mobile health: a qualitative study of mHealth expectations in the rural health district of Nouna, Burkina Faso.

    Science.gov (United States)

    Duclos, Vincent; Yé, Maurice; Moubassira, Kagoné; Sanou, Hamidou; Sawadogo, N Hélène; Bibeau, Gilles; Sié, Ali

    2017-07-12

    The implementation of mobile health (mHealth) projects in low- and middle-income countries raises high and well-documented expectations among development agencies, policymakers and researchers. By contrast, the expectations of direct and indirect mHealth users are not often examined. In preparation for a proposed intervention in the Nouna Health District, in rural Burkina Faso, this study investigates the expected benefits, challenges and limitations associated with mHealth, approaching these expectations as a form of situated knowledge, inseparable from local conditions, practices and experiences. The study was conducted within the Nouna Health District. We used a qualitative approach, and conducted individual semi-structured interviews and group interviews (n = 10). Participants included healthcare workers (n = 19), godmothers (n = 24), pregnant women (n = 19), women with children aged 12-24 months (n = 33), and women of childbearing age (n = 92). Thematic and content qualitative analyses were conducted. Participants expect mHealth to help retrieve patients lost to follow-up, improve maternal care monitoring, and build stronger relationships between pregnant women and primary health centres. Expected benefits are not reducible to a technological realisation (sending messages), but rather point towards a wider network of support. mHealth implementation is expected to present considerable challenges, including technological barriers, organisational challenges, gender issues, confidentiality concerns and unplanned aftereffects. mHealth is also expected to come with intrinsic limitations, to be found as obstacles to maternal care access with which pregnant women are confronted and on which mHealth is not expected to have any significant impact. mHealth expectations appear as situated knowledges, inseparable from local health-related experiences, practices and constraints. This problematises universalistic approaches to mHealth knowledge, while nevertheless hinting at

  9. Perspectives on condom breakage: a qualitative study of female sex workers in Bangalore, India.

    Science.gov (United States)

    Gurav, Kaveri; Bradley, Janet; Chandrashekhar Gowda, G; Alary, Michel

    2014-01-01

    A qualitative study was conducted to obtain a detailed understanding of two key determinants of condom breakage - 'rough sex' and poor condom fit - identified in a recent telephone survey of female sex workers, in Bangalore, India. Transcripts from six focus-group discussions involving 35 female sex workers who reported condom breakage during the telephone survey were analysed. Rough sex in different forms, from over-exuberance to violence, was often described by sex workers as a result of clients' inebriation and use of sexual stimulants, which, they report, cause tumescence, excessive thrusting and sex that lasts longer than usual, thereby increasing the risk of condom breakage. Condom breakage in this setting is the result of a complex set of social situations involving client behaviours and power dynamics that has the potential to put the health and personal lives of sex workers at risk. These findings and their implications for programme development are discussed.

  10. Perspectives of LGBTQ Older Adults on Aging in Place: A Qualitative Investigation.

    Science.gov (United States)

    Boggs, Jennifer M; Dickman Portz, Jennifer; King, Diane K; Wright, Leslie A; Helander, Kenneth; Retrum, Jessica H; Gozansky, Wendolyn S

    2017-01-01

    This qualitative study conducted by a community-research partnership used multiple types of data collection to examine variables relevant for LGBTQ older adults who wished to age in place in their urban Denver neighborhood. Focus groups, interviews, and a town hall meeting were used to identify barriers and supports to aging in place. Participants (N = 73) identified primarily as lesbian or gay, aged 50-69, and lived with a partner. Ageism, heterosexism, and cisgenderism emerged as cross-cutting themes that negatively impact access to health care, housing, social support, home assistance, and legal services. Resilience from weathering a lifetime of discrimination was identified as a strength to handle aging challenges. Recommendations for establishing an aging in place model included establishing welcoming communities and resource centers and increasing cultural competence of service providers. This study provides a unique contribution to understanding the psychosocial, medical, and legal barriers for successfully aging in place.

  11. Understanding healthful eating from a salutogenic perspective

    OpenAIRE

    Swan, E.C.

    2016-01-01

    The biomedical model of health orients towards pathogenesis, the study of disease origins and causes. The starting point is to understand determinants of ill-health, and health is defined in this model as the absence of disease. When applied to nutrition research, the underlying assumption is that eating is a physiological act, and that eating supports physical health. This risk-oriented, pathogenic view also underlies the search for determinants of unhealthful eating. However, there is such ...

  12. Understanding healthful eating from a salutogenic perspective

    NARCIS (Netherlands)

    Swan, E.C.

    2016-01-01

    The biomedical model of health orients towards pathogenesis, the study of disease origins and causes. The starting point is to understand determinants of ill-health, and health is defined in this model as the absence of disease. When applied to nutrition research, the underlying assumption is

  13. Towards a Critical Health Equity Research Stance: Why Epistemology and Methodology Matter More than Qualitative Methods

    Science.gov (United States)

    Bowleg, Lisa

    2017-01-01

    Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with…

  14. Talk to me, please!: The importance of qualitative research to games for health

    Science.gov (United States)

    This editorial provides an overview of the ways in which qualitative research can guide games for health research and its potential contributions. It also provides guidelines for conducting qualitative research, such as using open ended, non-leading questions and digitally recording the sessions....

  15. Task sharing in rural Haiti: Qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers

    Science.gov (United States)

    McLean, Kristen E; Kaiser, Bonnie N; Hagaman, Ashley K; Wagenaar, Bradley H; Therosme, Tatiana P; Kohrt, Brandon A

    2015-01-01

    Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees’ perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery, and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased confidence regarding utilising skills, and career advancement. Qualitative findings support the added value of apprenticeship according to trainees. PMID:26190953

  16. CHALLENGES IN THE MANAGEMENT OF GLAUCOMA IN A DEVELOPING COUNTRY; A QUALITATIVE STUDY OF PROVIDERS' PERSPECTIVES.

    Science.gov (United States)

    Adekoya, B J; Adepoju, F G; Moshood, K F; Balarabe, A H

    2015-01-01

    Glaucoma management is challenging to patients as well as to the eye care providers. The study is aimed at describing the challenges faced by providers using qualitative methods. In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres offering medical and surgical glaucoma services in Lagos state, Nigeria, according to established qualitative methods. This was done using semi-structured, open ended questions to explore the providers' perspective on glaucoma burden, challenges in the management, surgery for glaucoma, acceptance of glaucoma surgery by patients, and recommendations for improving glaucoma services. The discussions were recorded with the aid of a micro-cassette recorder. Familiarisation was done to identify key ideas in the data, then, the main themes and sub-themes were identified. Quotes that reflect the themes and sub-themes were then identified in the data. In-depth interviews were conducted with a total of 11 ophthalmologists and resident doctors in training. Majority were of the opinion that glaucoma is a significant burden constituting about 35% of outpatient visits. Identified patient related challenges include; late presentation, lack of glaucoma awareness, delay in referral from optometrists, and poor compliance with medications. Shortages in needed equipment were also identified. Availability, affordability and counterfeiting of drugs were the major challenges related to medical treatment. Majority of the participants agreed that surgery should be offered to the patients as soon as the diagnosis of glaucoma is made. However, continuous monitoring of the patient on medical treatment is another line of option for them in early cases; if they are convinced the patients will be compliant. Some respondents considered the current number of glaucoma surgeries as adequate, while some think otherwise. Reasons put forward for reluctance to offer glaucoma surgery include; late presentation, lack

  17. How is Telemedicine perceived? A qualitative study of perspectives from the UK and India

    Science.gov (United States)

    2011-01-01

    Background Improvements in communication and information technologies have allowed for the globalisation of health services, especially the provision of health services from other countries, such as the use of telemedicine. This has led countries to evaluate their position on whether and to what extent they should open their health systems to trade. This often takes place from the context of multi-lateral trade agreements (under the auspices of the World Trade Organisation), which is misplaced as a significant amount of trade takes place regionally or bi-laterally. We report here the results of a qualitative study assessing stakeholders' views on the potential for a bi-lateral trade relationship between India and the UK, where India acts as an exporter and the UK as an importer of telemedicine services. Methods 19 semi-structured interviews were carried out with stakeholders from India and the UK. The themes discussed include prospects on the viability of a bi-lateral relationship between the UK and India on telemedicine, current activities and operations, barriers, benefits and risks. Results The participants in general believed there were good prospects for telemedicine trade, and that this could bring benefits to "importing" countries in terms of cost-savings and faster delivery of care and to "exporting" countries in the form of foreign exchange and quality improvement. However, there were some concerns regarding quality of care, regulation, accreditation and data security. Conclusions There is potential for trade in this type of health services to succeed and bring about important benefits to the countries involved. However, issues around data security and accreditation need to be taken into consideration. Countries may wish to consider entering bi-lateral agreements, as they provide more potential to address the concerns and capitalise on the benefits. Finally, this paper concludes that more data should be collected, both on the volume of telemedicine trade

  18. Mental health expectancy--the European perspective

    DEFF Research Database (Denmark)

    Jagger, C; Ritchie, K; Brønnum-Hansen, Henrik

    1998-01-01

    The increase in life expectancy observed over the last decade has particular relevance for mental health conditions of old age, such as dementia. Although mental disorders have been estimated to be responsible for 60% of all disabilities, until recently population health indicators such as health...... expectancies have concentrated on calculating disability-free life expectancy based on physical functioning. In 1994, a European Network for the Calculation of Health Expectancies (Euro-REVES) was established, one of its aims being the development and promotion of mental health expectancies. Such indicators...... may have an important role in monitoring future changes in the mental health of populations and predicting service needs. This article summarizes the proceedings and recommendations of the first European Conference on Mental Health Expectancy....

  19. The population health approach in historical perspective.

    Science.gov (United States)

    Szreter, Simon

    2003-03-01

    The origin of the population health approach is an historic debate over the relationship between economic growth and human health. In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued. The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a "neoliberal" agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of "global" economic growth.

  20. Nurses' lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study.

    Science.gov (United States)

    Phiri, Lindokuhle P; Draper, Catherine E; Lambert, Estelle V; Kolbe-Alexander, Tracy L

    2014-01-01

    Nurses have an increased risk for non-communicable diseases (NCDs), along with a high prevalence of obesity, poor eating habits and insufficient physical activity. The aim of this study was to determine the health concerns, health priorities and barriers to living a healthy lifestyle among nurses and hospital management staff from public hospitals in the Western Cape Metropole, South Africa. Participants were purposively sampled (n = 103), and included management personnel (n = 9), night shift (n = 57) and day-shift nurses (n = 36). Twelve focus groups (FGDs) were conducted with nursing staff to obtain insight into nurses' health concerns, lifestyle behaviours and worksite health promotion programmes (WHPPs). Seven key informant interviews (KII) were conducted with management personnel, to gain their perspective on health promotion in the worksite. Thematic analysis was used to analyse the data with the assistance of Atlas.ti Qualitative Data Analysis Software. Night shift nurses frequently identified weight gain and living with NCDs such as hypertension as their main health concerns. Being overweight was perceived to have a negative impact on work performance. All nurses identified backache and exposure to tuberculosis (TB) as occupation-related health concerns, and both management and nurses frequently reported a stressful working environment. Nurses frequently mentioned lack of time to prepare healthy meals due to long working hours and being overtired from work. The hospital environment was perceived to have a negative influence on the nurses' lifestyle behaviours, including food service that offered predominantly unhealthy foods. The most commonly delivered WHPPs included independent counselling services, an online employee wellness programme offered by the Department of Health and wellness days in which clinical measures, such as blood glucose were measured. Nurses identified a preference for WHPPs that provided access to fitness facilities or

  1. [Health education from the perspective of nursing undergraduate students].

    Science.gov (United States)

    Colomé, Juliana Silveira; de Oliveira, Dora Lucia Leidens Corrêa

    2008-09-01

    In the field of health practices, there are different models of health education. The objective of this article was to identify undergraduates' concepts of health education. This descriptive exploratory study used a qualitative approach. It was developed in the Undergraduate Nursing Courses of the Federal University of Santa Maria and Federal University of Rio Grande do Sul, Brazil. Subjects were undergraduate students of the last semester before graduation. Data were collected using a semistructured interview, and submitted to thematic content analysis. The results suggest that the undergraduate nursing students' training as health educators is permeated by concepts that are a mixture of traditional and modern assumptions on health education.

  2. Exploring health insurance services in Sudan from the perspectives of insurers.

    Science.gov (United States)

    Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

    2018-01-01

    It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social

  3. Health and Labour from the Perspective of Railway Dock workers in Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Valdecir Costa

    2015-04-01

    Full Text Available The main goal of this study is to understand and analyse the perspective of dockworkers on health and labour at the Railway Dry Port of the Municipality of Uruguaiana in the State of Rio Grande do Sul (RS, Brazil. Sixteen dockworkers participated in the study under the methodological approach of qualitative research. The fieldwork was conducted through individual interviews by applying a semi-structured research script with open-ended questions. For the data analysis, the "discourse analysis" method was adopted, leading to the definition of five thematic categories of interpretation. From the perspective of dockworkers, dock work differs in both the weight of toil, which is hard and intense, and the sense of satisfaction regarding the collaborative and collective aspect of labour, emphasising the human side of labour. Several reports on work accidents and the identification of hazards that may be avoided by implementing changes in the organisation and work conditions were also noted.

  4. Health and Labour from the Perspective of Railway Dock workers in Rio Grande do Sul, Brazil.

    Science.gov (United States)

    Costa, Valdecir; Souza, Katia Reis; Teixeira, Liliane Reis; Hedlund, Charles Jopar; Fernandes Filho, Luiz Antonio; Cardoso, Letícia Silveira

    2015-04-01

    The main goal of this study is to understand and analyse the perspective of dockworkers on health and labour at the Railway Dry Port of the Municipality of Uruguaiana in the State of Rio Grande do Sul (RS), Brazil. Sixteen dockworkers participated in the study under the methodological approach of qualitative research. The fieldwork was conducted through individual interviews by applying a semi-structured research script with open-ended questions. For the data analysis, the "discourse analysis" method was adopted, leading to the definition of five thematic categories of interpretation. From the perspective of dockworkers, dock work differs in both the weight of toil, which is hard and intense, and the sense of satisfaction regarding the collaborative and collective aspect of labour, emphasising the human side of labour. Several reports on work accidents and the identification of hazards that may be avoided by implementing changes in the organisation and work conditions were also noted.

  5. The incorporation of gender perspective into Spanish health surveys.

    Science.gov (United States)

    Rohlfs, Izabella; Borrell, Carme; Artazcoz, Lucia; Escribà-Agüir, Vicenta

    2007-12-01

    Most studies into social determinants of health conducted in Spain based on data from health surveys have focused on social class inequalities. This paper aims to review the progressive incorporation of gender perspective and sex differences into health surveys in Spain, and to suggest design, data collection and analytical proposals as well as to make policy proposals. Changes introduced into health surveys in Spain since 1995 to incorporate gender perspective are examined, and proposals for the future are made, which would permit the analysis of differences in health between women and men as a result of biology or because of gender inequalities. The introduction of gender perspective in health surveys requires the incorporation of questions related to family setting and reproductive work, workplace and society in general to detect gender differences and inequalities (for example, domestic work, intimate partner violence, discrimination, contract type or working hours). Health indicators reflecting differential morbidity and taking into account the different life cycle stages must also be incorporated. Analyses ought to be disaggregated by sex and interpretation of results must consider the complex theoretical frameworks explaining the differences in health between men and women based on sex differences and those related to gender. Analysis of survey data ought to consider the impact of social, political and cultural constructs of each society. Any significant modification in procedures for collection of data relevant to the study of gender will require systematic coordination between institutions generating the data and researchers who are trained in and sensitive to the topic.

  6. Living in Two Cultures: Chinese Canadians' Perspectives on Health.

    Science.gov (United States)

    Lu, Chunlei; McGinn, Michelle K; Xu, Xiaojian; Sylvestre, John

    2017-04-01

    Chinese people have distinctive perspectives on health and illness that are largely unrecognized in Western society. The purpose of this descriptive study was to develop a profile of Chinese immigrants' beliefs and practices related to diet, mental and social health, and sexual health. A quantitative survey with descriptive and correlational analyses was employed to examine 100 first-generation Chinese immigrants living in four urban centres across Canada (Vancouver, Toronto, Halifax, and St. Catharines). Although most Chinese immigrants preferred a Chinese diet, where they resided affected the groceries they bought and the meals they ate. Almost all participants reported their mental health was important to them and most felt comfortable discussing mental health issues with others. However, only a third would see a psychiatrist if they believed they had a mental health problem. Most participants believed social relationships were important for their health. Only a small number of participants, however, preferred making friends with mainstream Caucasian Canadians. More men than women believed sexuality contributed to health and were comfortable talking about sexual health. Chinese immigrants should be encouraged to be more engaged in the larger community in order to fully integrate themselves into Canadian society while still being encouraged to retain their healthy practices. These findings may help educators and practitioners enhance their understandings of Chinese immigrants' perspectives on health and develop culturally competent education and services in health care and health promotion.

  7. GPs' perspectives on the diagnostic work-up in patients with shoulder pain: a qualitative study.

    Science.gov (United States)

    Ottenheijm, Ramon P G; Hesselmans, Nicolle J J M; Kemper, Anouk; Moser, Albine; de Bie, Rob A; Dinant, Geert-Jan; Cals, Jochen W L

    2014-06-01

    The diagnostic work-up of patients with shoulder pain in general practice is complex. General practitioners' (GPs) guidelines advise a pragmatic diagnostic work-up in which additional imaging has a limited role. However, diagnostic ultrasounds are increasingly ordered by GPs, which seems to reflect complexity in management of shoulder pain. This study aimed to explore GPs' perspectives on the diagnostic work-up of patients with shoulder pain. This study has a qualitative exploratory design with an inductive approach and was carried out in Dutch general practice. The study population consisted of 18 Dutch GPs who were sampled purposefully with a spread in clinical experience and ordering diagnostic ultrasound. Data were gathered by means of semi-structured interviews and analysed following principles of the constant comparative method. Three main categories with subcategories emerged that captured the diagnostic work-up of shoulder pain: variety in diagnostic classifications [(non-)specific diagnosis and interdisciplinary differences], establishing strategies for diagnostic work-up (use of existing tools and motives to deviate from existing tools), and strategies dealing with diagnostic uncertainties (accepting diagnostic uncertainties, diagnostic imaging tests, and interdisciplinary consultation and referral). Despite the availability of evidence-based shoulder guidelines, GPs experience uncertainties during diagnostic work-up and apply different strategies when dealing with these uncertainties. At some point, GPs as well as patients seem to have a need for a specific diagnosis. Currently, there appears to be little agreement if, or in which phase of shoulder pain, diagnostic ultrasound is useful or indicated. © 2014 John Wiley & Sons, Ltd.

  8. Characteristics, determinants and perspectives of experienced medical humanitarians: a qualitative approach.

    Science.gov (United States)

    Asgary, Ramin; Lawrence, Katharine

    2014-12-08

    To explore the characteristics, motivations, ideologies, experience and perspectives of experienced medical humanitarian workers. We applied a qualitative descriptive approach and conducted in-depth semistructured interviews, containing open-ended questions with directing probes, with 44 experienced international medical aid workers from a wide range of humanitarian organisations. Interviews were coded and analysed, and themes were developed. International non-governmental organisations (INGOs) and United Nations (UN). 61% of participants were female; mean age was 41.8 years with an average of 11.8 years of humanitarian work experience with diverse major INGOs. Significant core themes included: population's rights to assistance, altruism and solidarity as motives; self-identification with the mission and directives of INGOs; shared personal and professional morals fostering collegiality; accountability towards beneficiaries in areas of programme planning and funding; burnout and emotional burdens; uncertainties in job safety and security; and uneasiness over changing humanitarian principles with increasing professionalisation of aid and shrinking humanitarian access. While dissatisfied with overall aid operations, participants were generally satisfied with their work and believed that they were well-received by, and had strong relationships with, intended beneficiaries. Despite regular use of language and ideology of rights, solidarity and concepts of accountability, tension exists between the philosophy and practical incorporation of accountability into operations. To maintain a humanitarian corps and improve aid worker retention, strategies are needed regarding management of psychosocial stresses, proactively addressing militarisation and neo-humanitarianism, and nurturing individuals' and organisations' growth with emphasis on humanitarian principles and ethical practices, and a culture of internal debate, reflection and reform. Published by the BMJ Publishing

  9. Advance care planning in motor neuron disease: A qualitative study of caregiver perspectives.

    Science.gov (United States)

    Murray, Leigh; Butow, Phyllis N; White, Kate; Kiernan, Matthew C; D'Abrew, Natalie; Herz, Helen

    2016-05-01

    Motor neuron disease is a fatal disease, characterised by progressive loss of motor function, often associated with cognitive deterioration and, in some, the development of frontotemporal dementia. Life-sustaining technologies are available (e.g. non-invasive ventilation and enteral nutrition) but may compromise quality of life for some patients. Timely commencement of 'Advance Care Planning' enables patients to participate in future care choices; however, this approach has rarely been explored in motor neuron disease. We aimed to investigate caregiver perspectives on the acceptability and impact of advance care planning, documented in a letter format, for patients with motor neuron disease and caregivers. This is a qualitative cross-sectional study. Data were analysed by a narrative synthesis approach. Structured interviews were held with 18 former caregivers of deceased patients with motor neuron disease. A total of 10 patients had created a disease-specific advanced directive, 'Letter of Future Care', and 8 had not. A total of four global themes emerged: Readiness for death, Empowerment, Connections and Clarifying decisions and choices. Many felt the letter of future care was or would be beneficial, engendering autonomy and respect for patients, easing difficult decision-making and enhancing communication within families. However, individuals' 'readiness' to accept encroaching death would influence uptake. Appropriate timing to commence advance care planning may depend on case-based clinical and personal characteristics. Advance care planning can assist patients to achieve a sense of control and 'peace of mind' and facilitates important family discussion. However, the timing and style of its introduction needs to be approached sensitively. Tools and strategies for increasing the efficacy of advance care planning for motor neuron disease should be evaluated and implemented. © The Author(s) 2016.

  10. Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study.

    Science.gov (United States)

    Schakel, Wouter; Bode, Christina; van der Aa, Hilde P A; Hulshof, Carel T J; Bosmans, Judith E; van Rens, Gerardus H M B; van Nispen, Ruth M A

    2017-08-03

    Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Two large Dutch low vision multidisciplinary rehabilitation organisations. 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. A qualitative study involving semistructured interviews. A total of four first-level codes were top-down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss. © 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.

  11. Understanding Surgical Resident and Fellow Perspectives on Their Operative Performance Feedback Needs: A Qualitative Study.

    Science.gov (United States)

    Bello, Ricardo J; Sarmiento, Samuel; Meyer, Meredith L; Rosson, Gedge D; Cooney, Damon S; Lifchez, Scott D; Cooney, Carisa M

    2018-04-20

    Operative performance feedback is essential for surgical training. We aimed to understand surgical trainees' views on their operative performance feedback needs and to characterize feedback to elucidate factors affecting its value from the resident perspective. Using a qualitative research approach, 2 research fellows conducted semistructured, one-on-one interviews with surgical trainees. We analyzed recurring themes generated during interviews related to feedback characteristics, as well as the extent to which performance rating tools can help meet trainees' operative feedback needs. Departments or divisions of general or plastic surgery at 9 US academic institutions. Surgical residents and clinical fellows in general or plastic surgery. We conducted 30 interviews with 9 junior residents, 14 senior residents, and 7 clinical fellows. Eighteen (60%) participants were in plastic and 12 (40%) were in general surgery. Twenty-four participants (80%) reported feedback as very or extremely important during surgical training. All trainees stated that verbal, face-to-face feedback is the most valuable, especially if occurring during (92%) or immediately after (65%) cases. Of those trainees using performance rating tools (74%), most (57%) expressed positive views about them but wanted the tools to complement and not replace verbal feedback in surgical education. Trainees value feedback more if received within 1 week or the case. Verbal, face-to-face feedback is very or extremely important to surgical trainees. Residents and fellows prefer to receive feedback during or immediately after a case and continue to value feedback if received within 1 week of the event. Performance rating tools can be useful for providing formative feedback and documentation but should not replace verbal, face-to-face feedback. Considering trainee views on feedback may help reduce perceived gaps in feedback demand-versus-supply in surgical training, which may be essential to overcoming current

  12. Consumer Attitudes toward Health and Health Care: A Differential Perspective.

    Science.gov (United States)

    Gould, Stephen J.

    1988-01-01

    Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)

  13. Lay involvement in the analysis of qualitative data in health services research: a descriptive study.

    Science.gov (United States)

    Garfield, S; Jheeta, S; Husson, F; Jacklin, A; Bischler, A; Norton, C; Franklin, B D

    2016-01-01

    There is a consensus that patients and the public should be involved in research in a meaningful way. However, to date, lay people have been mostly involved in developing research ideas and commenting on patient information.We previously published a paper describing our experience with lay partners conducting observations in a study of how patients in hospital are involved with their medicines. In a later part of the same study, lay partners were also involved in analysing interviews that a researcher had conducted with patients, carers and healthcare professionals about patient and carer involvement with medicines in hospital. We therefore wanted to build on our previous paper and report on our experiences with lay partners helping to conduct data analysis. We therefore interviewed the lay members and researchers involved in the analysis to find out their views.Both lay members and researchers reported that lay partners added value to the study by bringing their own perspectives and identifying further areas for the researcher to look for in the interviews. In this way researchers and lay partners were able to work together to produce a richer analysis than would have been possible from either alone. Background It is recognised that involving lay people in research in a meaningful rather than tokenistic way is both important and challenging. In this paper, we contribute to this debate by describing our experiences of lay involvement in data analysis. Methods We conducted semi-structured interviews with the lay partners and researchers involved in qualitative data analysis in a wider study of inpatient involvement in medication safety. The interviews were transcribed verbatim and coded using open thematic analysis. Results We interviewed three lay partners and the three researchers involved. These interviews demonstrated that the lay members added value to the analysis by bringing their own perspectives; these were systematically integrated into the analysis by the

  14. The nature of excellent clinicians at an academic health science center: a qualitative study.

    Science.gov (United States)

    Mahant, Sanjay; Jovcevska, Vesna; Wadhwa, Anupma

    2012-12-01

    To understand the nature of excellent clinicians at an academic health science center by exploring how and why excellent clinicians achieve high performance. From 2008 to 2010, the authors conducted a qualitative study using a grounded theory approach. Members of the Clinical Advisory Committee in the Department of Pediatrics at the University of Toronto nominated peers whom they saw as excellent clinicians. The authors then conducted in-depth interviews with the most frequently nominated clinicians. They audio-recorded and transcribed the interviews and coded the transcripts to identify emergent themes. From interviews with 13 peer-nominated, excellent clinicians, a model emerged. Dominant themes fell into three categories: (1) core philosophy, (2) deliberate activities, and (3) everyday practice. Excellent clinicians are driven by a core philosophy defined by high intrinsic motivation and passion for patient care and humility. They refine their clinical skills through two deliberate activities-reflective clinical practice and scholarship. Their high performance in everyday practice is characterized by clinical skills and cognitive ability, people skills, engagement, and adaptability. A rich theory emerged explaining how excellent clinicians, driven by a core philosophy and engaged in deliberate activities, achieve high performance in everyday practice. This theory of the nature of excellent clinicians provides a holistic perspective of individual performance, informs medical education, supports faculty career development, and promotes clinical excellence in the culture of academic medicine.

  15. Defining health-related quality of life for young wheelchair users: A qualitative health economics study.

    Directory of Open Access Journals (Sweden)

    Nathan Bray

    Full Text Available Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use.The sampling frame was children with impaired mobility (≤18 years who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life.Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1 participation and positive experiences; 2 self-worth and feeling fulfilled; 3 health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age.Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this

  16. A mismatch between supply and demand of social support in dementia care: a qualitative study on the perspectives of spousal caregivers and their social network members.

    Science.gov (United States)

    Dam, Alieske E H; Boots, Lizzy M M; van Boxtel, Martin P J; Verhey, Frans R J; de Vugt, Marjolein E

    2017-06-13

    Access to social support contributes to feelings of independence and better social health. This qualitative study aims to investigate multi-informant perspectives on informal social support in dementia care networks. Ten spousal caregivers of people with dementia (PwD) completed an ecogram, a social network card and a semi-structured interview. The ecogram aimed to trigger subjective experiences regarding social support. Subsequently, 17 network members were interviewed. The qualitative analyses identified codes, categories, and themes. Sixth themes emerged: (1) barriers to ask for support; (2) facilitators to ask for support; (3) barriers to offer support; (4) facilitators to offer support; (5) a mismatch between supply and demand of social support; and (6) openness in communication to repair the imbalance. Integrating social network perspectives resulted in a novel model identifying a mismatch between the supply and demand of social support, strengthened by a cognitive bias: caregivers reported to think for other social network members and vice versa. Openness in communication in formal and informal care systems might repair this mismatch.

  17. Learning essentials: what graduates of mental health nursing programmes need to know from an industry perspective.

    Science.gov (United States)

    McAllister, Margaret; Happell, Brenda; Flynn, Trudi

    2014-12-01

    To explore the perspectives of nursing directors in mental health in Queensland, Australia, regarding the skills and attributes of graduates of comprehensive nursing programme to provide an industry perspective and thus augment knowledge from theoretical and professional dimensions. There is a worldwide shortage of appropriately qualified nurses with the knowledge, skills and attitudes to work effectively in mental health services. Within Australia, this has been well documented since the introduction of comprehensive nursing education. The underrepresentation of mental health content in undergraduate curricula has been identified as the primary reason for nursing graduates not being adequately prepared for practice in this field. To date, this issue has primarily been addressed from the perspective of university academics, with the voice of industry relatively silent in the published literature. Qualitative exploratory. In-depth telephone interviews with Director of Nursing (Mental Health) in Queensland, Australia. The concerns of participants were expressed in six main themes: (1) foundational knowledge of mental health and disorders, (2) recovery-oriented skills, (3) physical as well as mental health skills, (4) therapeutic strategies, (5) resilience and self-development and (6) advanced knowledge and skills. The education of comprehensive nursing education needs to be reviewed as a matter of priority to ensure graduates with the attributes required to provide high-quality care for consumers of mental health services. A skilled and knowledgeable workforce is an essential component of high-quality mental health services. Research highlighting the current deficits and issues is therefore of the highest priority. © 2014 John Wiley & Sons Ltd.

  18. A qualitative study of key stakeholders' perspectives on compassion in healthcare and the development of a framework for compassionate interpersonal relations.

    Science.gov (United States)

    Kneafsey, Rosie; Brown, Sarah; Sein, Kim; Chamley, Carol; Parsons, Joanne

    2016-01-01

    To report findings from a qualitative study of key stakeholders' perspectives on 'compassion' in the health care context. To present the 'Framework for Compassionate Interpersonal Relations'. Although many research articles, health policies and health care strategies identify compassion as an underpinning value and key component of health care quality, identifying a unified definition of compassion is challenging. For Higher Education Institutions implementing 'values-based' recruitment processes, a clearer understanding of this core concept is vital. Exploratory, qualitative design. Academic staff, health care students, clinicians and service users (n = 45), participated in nine focus groups where they were asked to define compassion in the context of health care. Data were transcribed verbatim and analysed using thematic analysis. Four overarching themes were drawn from the data. The first theme centred on the participants' definitions of compassion, while the second identified compassionate behaviours. The third theme related to the barriers and threats to compassionate practice and the fourth, focused on ways to support compassion in practice. Participa