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Sample records for identify barriers perceived

  1. Identifying real and perceived barriers to therapeutic education programs for individuals with inflammatory arthritis.

    Science.gov (United States)

    Bain, Lorna; Sangrar, Ruheena; Bornstein, Carolyn; Lukmanji, Sara; Hapuhennedige, Sandani; Thorne, Carter; Beattie, Karen A

    2016-09-01

    Therapeutic Education Programs (TEPs) grounded in self-management principles have been shown to improve quality of life of patients with chronic conditions and reduce patient-related healthcare costs. Though these programs are becoming more readily available, patients often experience barriers in participating. This study sought to identify barriers faced by inflammatory arthritis (IA) patients in attending a TEP and understand how patients overcame perceived barriers. A mixed-method study design was used. Questionnaires were distributed to individuals with IA who were invited to attend a TEP between 2010 and 2013. Respondents were those that chose not to attend (group A), individuals who attended ≤4 of 10 sessions (group B), individuals who attended ≥5 of 10 sessions prior to May 2013 (group C), and individuals who attended ≥5 of 10 sessions from June 2013 to November 2013 (group D). Individuals in group D were also invited to participate in focus groups to discuss how they had overcome perceived barriers. Real barriers identified by individuals in groups A and B included time, distance, and cost associated with attendance. Individuals who overcame perceived barriers (groups C and D) discussed strategies they used to do so. Aspects of the overall program experience and access to clinic and program also contributed to patients being able to overcome barriers. Time, distance, and cost are external barriers that prevented individuals from utilizing self-management education opportunities. These barriers were overcome if and when individuals had resources available to them. Readiness for behavior change also influenced commitment to participate in the program.

  2. Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline.

    Science.gov (United States)

    van der Wees, Philip J; Zagers, Cor A M; de Die, Sara E; Hendriks, Erik J M; Nijhuis-van der Sanden, Maria W G; de Bie, Rob A

    2013-05-01

    Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation planning. This study aimed at developing a questionnaire to identify perceived barriers for implementing the Dutch COPD guideline for physical therapists and its recommended measurement instruments. An overall questionnaire, based on two existing questionnaires, was constructed to identify barriers and facilitators for implementing the COPD guideline. The construct of the questionnaire was assessed in a cross-sectional study among 246 chest physical therapists. Factor analysis was conducted to explore underlying dimensions. Psychometric properties were analyzed using Cronbach's alpha. Barriers and facilitators were assessed using descriptive statistics. Some 139 physical therapists (57%) responded. Factor analysis revealed 4-factor and 5-factor solutions with an explained variance of 36% and 39% respectively. Cronbach's alpha of the overall questionnaire was 0.90, and varied from 0.66 to 0.92 for the different factors. Underlying domains of the 5-factor solution were characterized as: attitude towards using measurement instruments, knowledge and skills of the physical therapist, applicability of the COPD guideline, required investment of time & money, and patient characteristics. Physical therapists showed a positive attitude toward using the COPD guideline. Main barriers for implementation were required time investment and financial constraints. The construct of the questionnaire revealed relevant underlying domains for the identification of barriers and facilitators for implementing the COPD guideline. The questionnaire allowed for tailoring to the target group and may be used across health care professionals as basis for in-depth analysis of barriers to specific recommendations in

  3. Developing a questionnaire to identify perceived barriers for implementing the Dutch physical therapy COPD clinical practice guideline

    NARCIS (Netherlands)

    Wees, P.J. van der; Zagers, C.A.; Die, S.E. de; Hendriks, E.J.; Nijhuis-Van der Sanden, M.W.G.; Bie, R.A. de

    2013-01-01

    BACKGROUND: Clinical practice guidelines have been developed to assist healthcare practitioners in clinical decision making. Publication of clinical practice guidelines does not automatically lead to their uptake and barrier identification has been recognized as an important step in implementation

  4. Perceived benefits and barriers to physical exercise participation of ...

    African Journals Online (AJOL)

    Regular participation in exercise is associated with disease prevention and provides many benefits. Physical exercise plays a key role in the promotion of good health. However, very few young people participate in physical exercise. The purpose of this study was to identify the perceived benefits and barriers to participation ...

  5. Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations.

    Science.gov (United States)

    Jensen, Jakob D; Ratcliff, Chelsea; Weaver, Jeremy; Krakow, Melinda M; Payton, William; Loewen, Sherrie

    2015-11-01

    In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion's perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40-74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.

  6. Perceived barriers to physical activity among Polish adolescents.

    Science.gov (United States)

    Jodkowska, Maria; Mazur, Joanna; Oblacińska, Anna

    2015-01-01

    To identify barriers to physical activity (PA) for adolescents according to the gender and age and examine the association between these barriers and youths' physical activity. 3346 students aged 10-16 years (1759 girls) took part in the cross-sectional, nationally representative study. For this paper the dataset was created from adolescents who reported perceived barriers to PA, N = 2300, (1259 girls), range 13-16 years. Barriers and physical activity (MVPA) were analysed for all participants, as well as by gender, age group and place of residence. Multiple regression analysis was used to examine the relationships between perceived barriers and physical inactivity for all and than separately for boys and girls. Lack of energy, lack of time and lack of support were three of the five barriers reported by more than 40% of adolescents, statistically more likely by girls than boys and older youth than younger. For boys - lack of time (OR = 2.56; CI = 1.66-3.96), lack of skills (OR = 2.35; CI = 1.94-3.95), lack of willpower (OR = 1.71, CI = 1.05-2.80) and lack of support (OR = 1.64, CI = 1.11-2.41) were the predictors contributing to low level of PA. For girls lack of skills (OR = 3.16, CI = 1.62-6.18), lack of energy (OR = 1.84, CI = 1.14-2.96), lack of support (OR = 1.64, CI = 1.07-2.54) and lack of time (OR = 1.61,CI = 1.00-2.60) were positively and statistically significant associated with physical inactivity. 1. Perceived barriers to physical activity among adolescents have strong negative impact on recommended PA level. For girls lack of skills is the strongest predictor of low PA, for boys - lack of time. 2. Identification more precisely barriers to physical activity among adolescents will enable to developed more effective interventions in high-risk populations.

  7. Perceived Online Education Barriers of Administrators and Faculty at a U.S. University in Lebanon

    Science.gov (United States)

    El Turk, Sahar; Cherney, Isabelle D.

    2016-01-01

    The purpose of this quantitative study was to identify the perceived barriers obstructing the implementation of online education by administrators and faculty at the School of Arts and Sciences of a U.S. university located in Lebanon. The aim of this study was to offer a solution to the most important perceived barriers to online education that…

  8. Perceived barriers to online education by radiologic science educators.

    Science.gov (United States)

    Kowalczyk, Nina K

    2014-01-01

    Radiologic science programs continue to adopt the use of blended online education in their curricula, with an increase in the use of online courses since 2009. However, perceived barriers to the use of online education formats persist in the radiologic science education community. An electronic survey was conducted to explore the current status of online education in the radiologic sciences and to identify barriers to providing online courses. A random sample of 373 educators from radiography, radiation therapy, and nuclear medicine technology educational programs accredited by the Joint Review Committee on Education in Radiologic Technology and Joint Review Committee on Educational Programs in Nuclear Medicine Technology was chosen to participate in this study. A qualitative analysis of self-identified barriers to online teaching was conducted. Three common themes emerged: information technology (IT) training and support barriers, student-related barriers, and institutional barriers. Online education is not prevalent in the radiologic sciences, in part because of the need for the clinical application of radiologic science course content, but online course activity has increased substantially in radiologic science education, and blended or hybrid course designs can effectively provide opportunities for student-centered learning. Further development is needed to increase faculty IT self-efficacy and to educate faculty regarding pedagogical methods appropriate for online course delivery. To create an excellent online learning environment, educators must move beyond technology issues and focus on providing quality educational experiences for students.

  9. Perceived gender-based barriers to careers in academic surgery.

    Science.gov (United States)

    Cochran, Amalia; Hauschild, Tricia; Elder, William B; Neumayer, Leigh A; Brasel, Karen J; Crandall, Marie L

    2013-08-01

    Women represent roughly 50% of US medical students and one third of US surgery residents. Within academic surgery departments, however, women are disproportionately underrepresented, particularly at senior levels. The aim of this study was to test the hypothesis that female surgeons perceive different barriers to academic careers relative to their male colleagues. A modified version of the Career Barriers Inventory-Revised was administered to senior surgical residents and early-career surgical faculty members at 8 academic medical centers using an online survey tool. Likert-type scales were used to measure respondents' agreement with each survey item. Fisher's exact test was used to identify significant differences on the basis of gender. Respondents included 70 women (44 residents, 26 faculty members) and 84 men (41 residents, 43 faculty members). Women anticipated or perceived active discrimination in the form of being treated differently and experiencing negative comments about their sex, findings that differed notably from those for male counterparts. Sex-based negative attitudes inhibited the career aspirations of female surgeons. The presence of overt and implicit bias resulted in a sense that sex is a barrier to female surgeons' career development in academic surgery. No differences were observed between male and female respondents with regard to career preparation or structural barriers. Female academic surgeons experience challenges that are perceived to differ from their male counterparts. Women who participated in this study reported feeling excluded from the dominant culture in departments of surgery. This study may help guide transformative initiatives within academic surgery departments. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Nurses' attitude and perceived barriers to pressure ulcer prevention.

    Science.gov (United States)

    Etafa, Werku; Argaw, Zeleke; Gemechu, Endalew; Melese, Belachew

    2018-01-01

    The presence or absence of pressure ulcers has been generally regarded as a performance measure of quality nursing care and overall patient health. The aim of this study- wasto explorenurses' attitude about pressure ulcer prevention'and to identify staff nurses' perceived barriers to pressure ulcer prevention public hospitals in Addis Ababa, Ethiopia. A self-reported multi-center institutional based cross sectional study design was employed to collect data from staff nurses ( N  = 222) working in six (6) selected public hospitals in Addis Ababa, from April 01-28/2015. Majority of the nurses had ( n  = 116, 52.2%) negative attitude towards pressure ulcer prevention. The mean scores of the test for all participants was 3.09out of 11(SD =0.92, range = 1-5). Similarly, the study revealed several barriers need to be resolved to put in to practice the strategies of pressure ulcer prevention; Heavy workload and inadequate staff (lack of tie) (83.1%), shortage of resources/equipment (67.7%) and inadequate training (63.2%) were among the major barriers identified in the study. The study finding suggests that Addis Ababa nurses have negative attitude to pressure ulcer prevention. Also several barriers exist for implementing pressure ulcer prevention protocols in public hospitals in Addis Ababa, Ethiopia. Suggestion for improving this situation is attractive.

  11. Measuring Perceived Barriers to Physical Activity in Adolescents.

    Science.gov (United States)

    Gunnell, Katie E; Brunet, Jennifer; Wing, Erin K; Bélanger, Mathieu

    2015-05-01

    Perceived barriers to moderate-to-vigorous physical activity (PA) may contribute to the low rates of moderate-to-vigorous PA in adolescents. We examined the psychometric properties of scores from the perceived barriers to moderate-to-vigorous PA scale (PB-MVPA) by examining composite reliability and validity evidence based on the internal structure of the PB-MVPA and relations with other variables. This study was a cross-sectional analysis of data collected in 2013 from adolescents (N = 507; Mage = 12.40, SD = .62) via self-report scales. Using exploratory and confirmatory factor analyses, we found that perceived barriers were best represented as two factors representing internal (e.g., "I am not interested in physical activity") and external (e.g., "I need equipment I don't have") dimensions. Composite reliability was over .80. Using multiple regression to examine the relationship between perceived barriers and moderate-to-vigorous PA, we found that perceived internal barriers were inversely related to moderate-to-vigorous PA (β = -.32, p barriers (p > .26). The PB-MVPA scale demonstrated evidence of score reliability and validity. To improve the understanding of the impact of perceived barriers on moderate-to- vigorous PA in adolescents, researchers should examine internal and external barriers separately.

  12. Iranian entrepreneur nurses' perceived barriers to entrepreneurship: A qualitative study.

    Science.gov (United States)

    Jahani, Simin; Abedi, Heidarali; Elahi, Nasrin; Fallahi-Khoshknab, Masoud

    2016-01-01

    To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses' perceived barriers to entrepreneurship, in order to identify the existing barriers. This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.

  13. Iranian entrepreneur nurses’ perceived barriers to entrepreneurship: A qualitative study

    Science.gov (United States)

    Jahani, Simin; Abedi, Heidarali; Elahi, Nasrin; Fallahi-Khoshknab, Masoud

    2016-01-01

    Background: To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses’ perceived barriers to entrepreneurship, in order to identify the existing barriers. Materials and Methods: This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. Results: As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. Conclusions: The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity. PMID:26985222

  14. Perceived adherence barriers among patients failing second-line ...

    African Journals Online (AJOL)

    Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa. W Barnett, G Patten, B Kerschberger, K Conradie, DB Garone, G van Cutsem, CJ Colvin ...

  15. Cervical cancer screening and psychosocial barriers perceived by patients. A systematic review.

    Science.gov (United States)

    Bukowska-Durawa, Alicja; Luszczynska, Aleksandra

    2014-01-01

    This study aimed at integrating research discussing the role of perceived psychosocial barriers in cervical cancer screening (CCS) uptake. In particular, we analyzed the evidence for the associations between CCS uptake and perceived psychosocial barriers and frequency of psychosocial barriers identified by women. A systematic search of peer-reviewed papers published until 2011 in 8 databases yielded 48 original studies, analyzing data obtained from 155 954 women. The majority of studies (k = 43) applied correlational design, while 5 had experimental design. Experimental research indicated a positive effect of 75% of psychosocial interventions targeting barriers. The interventions resulted in a significant increase of CCS uptake. Overall 100% of correlational studies indicated that perceiving lower levels of barriers significantly predicted higher CCS uptake. 53 psychosocial barriers were listed in at least 2 original correlational studies: 9.5% of barriers were related to CCS facilities/environment, 67.9% dealt with personal characteristics of the patient, and 22.6% addressed social factors. As many as 35.9% of perceived barriers referred to negative emotions related to CCS examination procedures and collecting CCS results, whereas 25.7% of barriers referred to prior contacts with health professionals. Leaflets or discussion on psychosocial barriers between patients and health professionals involved in CCS might increase CCS uptake and thus reduce cervical cancer mortality rates. Communication skills training for health professionals conducting CCS might focus on the most frequently reported barriers, referring to emotions related to CCS examination and collecting CCS results.

  16. Measuring Perceived Benefits and Perceived Barriers for Physical Activity

    Science.gov (United States)

    Brown, Seth A.

    2005-01-01

    Objectives: To evaluate the psychometric properties and relationship to physical activity levels of the Exercise Benefits/Barriers Scale (EBBS) among college students. Methods: A total of 398 college students completed the EBBS and a measure of self-efficacy, the Physical Exercise Self-Efficacy Scale. In addition, a subsample of 275 students also…

  17. Emergency nurses' knowledge of perceived barriers in pain management in Taiwan.

    Science.gov (United States)

    Tsai, Feng-Ching; Tsai, Yun-Fang; Chien, Chih-Cheng; Lin, Chia-Chin

    2007-11-01

    To explore knowledge of and perceived barriers to pain management among emergency nurses in Taiwan. Pain is the most common patient complaint in emergency departments. Quality care of these patients depends on the pain knowledge and pain management skills of emergency nurses. However, no studies have explored emergency nurses' knowledge of and perceived barriers to pain management in Taiwan. Nurse subjects (n = 249) were recruited from nine hospitals chosen by stratified sampling across Taiwan. Data were collected using the Nurses' Knowledge and Attitudes Survey-Taiwanese version, a scale to assess perceived barriers to pain management and a background information form. The overall average correct response rate for the knowledge scale was 49.2%, with a range of 4.8-89.2% for each survey question. The top barrier to managing pain was identified by these nurses as 'the responsibility of caring for other acutely ill patients in addition to a patient with pain. Knowledge of pain management had a significant, negative relationship with perceived barriers to pain management and a significant, positive relationship with extent of clinical care experience and total hours of prior pain management education. In addition, scores for knowledge and perceived barriers differed significantly by the nursing clinical ladder. Perceived barriers also differed significantly by hospital accreditation category. Our results indicate an urgent need to strengthen pain education for emergency nurses in Taiwan. The pain education should target knowledge deficits and barriers to changing pain management approaches for Taiwanese emergency nurses.

  18. Perceived Barriers To Sport And Recreation Participation In Botswana

    African Journals Online (AJOL)

    In order to determine perceived barriers to sport and recreation participation in Botswana the modified Crawford, Jackson and Godbey\\'s (1991) constraint assessment questionnaire which focused on five barrier categories, i.e. aptitude, socio-economic, socio-cultural, facility-awareness and facility constraint, was used.

  19. Differences in perceived communication barriers among nurses and elderly patients in China.

    Science.gov (United States)

    Ruan, Jing; Lambert, Vickie A

    2008-06-01

    In China, limited information exists about nurses' and elderly patients' perceptions of barriers to the communication process. Therefore, the purposes of this study were to identify the major communication barriers (nurse-related, patient-related, and environment-related) perceived both by nurses and elderly patients and to determine the perceived differences in the level of importance of the communication barriers between nurses and elderly patients. The sample consisted of 84 nurses and 75 elderly patients who completed a demographic questionnaire and a communication barriers questionnaire. The findings suggested that the nurses and elderly patients often selected similar barriers related to the communication process. The nurses tended to assign higher values to the communication barriers that were found to be significantly different from those of the elderly patients. The study findings provide information about which type of barriers nurses need to address so as to facilitate effective communication with elderly patients.

  20. A systematic review of perceived barriers and motivators to physical activity after stroke.

    Science.gov (United States)

    Nicholson, Sarah; Sniehotta, Falko F; van Wijck, Frederike; Greig, Carolyn A; Johnston, Marie; McMurdo, Marion E T; Dennis, Martin; Mead, Gillian E

    2013-07-01

    Physical fitness is impaired after stroke, may contribute to disability, yet is amenable to improvement through regular physical activity. To facilitate uptake and maintenance of physical activity, it is essential to understand stroke survivors' perceived barriers and motivators. Therefore, we undertook a systematic review of perceived barriers and motivators to physical activity after stroke. Electronic searches of EMBASE, Medline, CINAHL, and PsychInfo were performed. We included peer-reviewed journal articles, in English, between 1 January 1966 and 30 August 2010 reporting stroke survivors' perceived barriers and motivators to physical activity. Searches identified 73,807 citations of which 57 full articles were retrieved. Six articles were included, providing data on 174 stroke survivors (range 10 to 83 per article). Two reported barriers and motivators, two reported only motivators, and two reported only barriers. Five were qualitative articles and one was quantitative. The most commonly reported barriers were lack of motivation, environmental factors (e.g. transport), health concerns, and stroke impairments. The most commonly reported motivators were social support and the need to be able to perform daily tasks. This review has furthered our understanding of the perceived barriers and motivators to physical activity after a stroke. This review will enable the development of tailored interventions to target barriers, while building upon perceived motivators to increase and maintain stroke survivors' physical activity. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  1. Identifying and overcoming barriers to technology implementation

    International Nuclear Information System (INIS)

    Bailey, M.; Warren, S.; McCune, M.

    1996-01-01

    In a recent General Accounting Office report, the Department of Energy's (DOE) Office of Environmental Management was found to be ineffective in integrating their environmental technology development efforts with the cleanup actions. As a result of these findings, a study of remediation documents was performed by the Technology Applications Team within DOE's Office of Environmental Restoration (EM-40) to validate this finding and to understand why it was occurring. A second initiative built on the foundation of the remediation document study and evaluated solutions to the ineffective implementation of improved technologies. The Technology Applications Team examined over 50 remediation documents (17 projects) which included nearly 600 proposed remediation technologies. It was determined that very few technologies are reaching the Records of Decision documents. In fact, most are eliminated in the early stages of consideration. These observations stem from regulators' and stakeholders' uncertainties in cost and performance of the technology and the inability of the technology to meet site specific conditions. The Technology Applications Team also set out to identify and evaluate solutions to barriers to implementing innovative technology into the DOE's environmental management activities. Through the combined efforts of DOE and the Hazardous Waste Action Coalition (HWAC), a full day workshop was conducted at the annual HWAC meeting in June 1995 to solve barriers to innovative technology implementation. Three barriers were identified as widespread throughout the DOE complex and industry. Identified barriers included a lack of verified or certified cost and performance data for innovative technologies; risk of failure to reach cleanup goals using innovative technologies; and communication barriers that are present at virtually every stage of the characterization/remediation process from development through implementation

  2. Do stigma and other perceived barriers to mental health care differ across Armed Forces?

    Science.gov (United States)

    Gould, Matthew; Adler, Amy; Zamorski, Mark; Castro, Carl; Hanily, Natalie; Steele, Nicole; Kearney, Steve; Greenberg, Neil

    2010-01-01

    Summary Objectives Military organizations are keen to address barriers to mental health care yet stigma and barriers to care remain little understood, especially potential cultural differences between Armed Forces. The aim of this study was to compare data collected by the US, UK, Australian, New Zealand and Canadian militaries using Hoge et al.'s perceived stigma and barriers to care measure (Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. New Engl J Med 2004;351:13–22). Design Each member country identified data sources that had enquired about Hoge et al.'s perceived stigma and perceived barriers to care items in the re-deployment or immediate post-deployment period. Five relevant statements were included in the study. Setting US, UK Australian, New Zealand and Canadian Armed Forces. Results Concerns about stigma and barriers to care tended to be more prominent among personnel who met criteria for a mental health problem. The pattern of reported stigma and barriers to care was similar across the Armed Forces of all five nations. Conclusions Barriers to care continue to be a major issue for service personnel within Western military forces. Although there are policy, procedural and cultural differences between Armed Forces, the nations studied appear to share some similarities in terms of perceived stigma and barriers to psychological care. Further research to understand patterns of reporting and subgroup differences is required. PMID:20382906

  3. Perceived barriers to physical activity among Nigerian stroke survivors.

    Science.gov (United States)

    Idowu, Opeyemi Ayodiipo; Adeniyi, Ade Fatai; Ogwumike, Omoyemi Olubunmi; Fawole, Henrietta Oluwafunmilola; Akinrolie, Olayinka

    2015-01-01

    Benefits of physical activity in the prevention and management of stroke are well documented in the literature. There is increasing evidence that stroke survivors in South-West Nigeria are physically inactive. Data on barriers to the achievement of the recommended physical activity levels including its differences along socio-demographic characteristics among stroke survivors in South-West Nigeria are needed. The Exercise Benefits and Barrier Scale and the International Physical Activity Questionnaire were administered on 121 stroke survivors to determine their perceived barriers to physical activity and physical activity levels respectively. Information on socio-demographic data and clinical variables were also collected. The sample included 70.2% males, with majority of the participants reporting low physical activity levels (80.2%) and high perceived barriers (Mean = 48.13, SD = 7.88). The four most reported common barriers among stroke survivors were access to exercise facilities (95.0%), being embarrassed to exercise (94.2%), economic cost demands of exercise (94.2%) and notion that people in exercise clothes look funny (94.2%) respectively. There were no significant differences found in barriers to physical activity between gender (U = 1471.00, P = 0.74) and across each of: occupational status (H = 4.37, P = 0.22), age group (H = 0.82, P = 0.84) and educational levels (H = 4.56, P = 0.33). Significant difference however existed in perceived barriers across marital status categories (H = 12.87, P = 0.05). Stroke survivors indicated high perceived barriers to physical activity and these barriers were associated with marital status.

  4. Perceived barriers, benefits, and motives for physical activity: two primary-care physical activity prescription programs.

    Science.gov (United States)

    Patel, Asmita; Schofield, Grant M; Kolt, Gregory S; Keogh J, W L

    2013-01-01

    This study examined whether perceived barriers, benefits, and motives for physical activity differed based on allocation to 2 different types of primary-care activity-prescription programs (pedometer-based vs. time-based Green Prescription). Eighty participants from the Healthy Steps study completed a questionnaire that assessed their perceived barriers, benefits, and motives for physical activity. Factor analysis was carried out to identify common themes of barriers, benefits, and motives for physical activity. Factor scores were then used to explore between-groups differences for perceived barriers, benefits, and motives based on group allocation and demographic variables. No significant differences were found in factor scores based on allocation. Demographic variables relating to the existence of chronic health conditions, weight status, and older age were found to significantly influence perceived barriers, benefits, and motives for physical activity. Findings suggest that the addition of a pedometer to the standard Green Prescription does not appear to increase perceived motives or benefits or decrease perceived barriers for physical activity in low-active older adults.

  5. Perceived exercise benefits and barriers among power wheelchair soccer players.

    Science.gov (United States)

    Barfield, J P; Malone, Laurie A

    2013-01-01

    Lack of exercise is a major risk factor for secondary conditions among persons dependent upon motorized wheelchairs. Power wheelchair soccer is a unique exercise opportunity for this population, and understanding factors that influence exercise decision-making is necessary for clinicians to help those in motorized chairs reduce their secondary risk. Therefore, this study examined differences in perceived benefits and barriers to exercise among power wheelchair soccer players using a mixed-methods analysis. The most common perceived benefit to exercise was "Exercising lets me have contact with friends and persons I enjoy." Post hoc comparisons of quantitative data indicated that persons with muscular dystrophy perceived exercise to be significantly less important than did other disability groups (p Exercise is hard work for me," "Exercise tires me," and "There are too few places for me to exercise" were the most common perceived barriers. These findings can assist with development of exercise opportunities for power wheelchair users.

  6. Perceived barriers and facilitators for general practitioner-patient communication in palliative care: a systematic review.

    Science.gov (United States)

    Slort, W; Schweitzer, B P M; Blankenstein, A H; Abarshi, E A; Riphagen, I I; Echteld, M A; Aaronson, N K; van der Horst, He; Deliens, L

    2011-09-01

    While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic review seven computerized databases were searched to find empirical studies on GP-patient communication in palliative care. Fifteen qualitative studies and seven quantitative questionnaire studies were included. The main perceived barriers were GPs' lack of availability, and patients' and GPs' ambivalence to discuss 'bad prognosis'. Main perceived facilitators were GPs being available, initiating discussion about several end-of-life issues and anticipating various scenarios. Lack of availability and failure to discuss former mistakes appear to be blind spots of GPs. GPs should be more forthcoming to initiate discussions with palliative care patients about prognosis and end-of-life issues. Empirical studies are needed to investigate the effectiveness of the perceived barriers and facilitators.

  7. Communication Barriers Perceived by Nurses and Patients.

    Science.gov (United States)

    Norouzinia, Roohangiz; Aghabarari, Maryam; Shiri, Maryam; Karimi, Mehrdad; Samami, Elham

    2015-09-28

    Communication, as a key element in providing high-quality health care services, leads to patient satisfaction and health. The present Cross sectional, descriptive analytic study was conducted on 70 nurses and 50 patients in two hospitals affiliated to Alborz University of Medical Sciences, in 2012. Two separate questionnaires were used for nurses and patients, and the reliability and validity of the questionnaires were assessed. In both groups of nurses and patients, nurse-related factors (mean scores of 2.45 and 2.15, respectively) and common factors between nurses and patients (mean scores of 1.85 and 1.96, respectively) were considered the most and least significant factors, respectively. Also, a significant difference was observed between the mean scores of nurses and patients regarding patient-related (p=0.001), nurse-related (p=0.012), and environmental factors (p=0.019). Despite the attention of nurses and patients to communication, there are some barriers, which can be removed through raising the awareness of nurses and patients along with creating a desirable environment. We recommend that nurses be effectively trained in communication skills and be encouraged by constant monitoring of the obtained skills.

  8. Predictors of Perceived Barriers to Mammography in Korean Women

    Directory of Open Access Journals (Sweden)

    Jung-Hee Kim, RN, PhD

    2008-06-01

    Conclusion: Nurses who work with Korean women for breast cancer screening need to assess these predictive factors, including health motivation and breast cancer fear. Further extensive research will be needed to demonstrate the relationship between breast cancer fatalism and perceived barriers to mammography.

  9. Adolescent Girls' Perceived Barriers to Participation in Physical Activity

    Science.gov (United States)

    Dwyer, John J. M.; Allison, Kenneth R.; Goldenberg, Ellie R.; Fein, Allan J.; Yoshida, Karen K.; Boutilier, Marie A.

    2006-01-01

    Research shows a decline in physical activity levels during adolescence, particularly among girls. This study explored perceived barriers to participation in moderate and vigorous physical activity among adolescent girls who live in a large ethnoracially and socioeconomically diverse city. A total of 73 adolescent girls in Toronto participated in…

  10. Sexuality education in Malaysia: perceived issues and barriers by professionals.

    Science.gov (United States)

    Khalaf, Zahra Fazli; Low, Wah Yun; Merghati-Khoei, Effat; Ghorbani, Behzad

    2014-07-01

    This research explored the perspectives of Malaysian professionals on the issues and barriers affecting the implementation of sexuality education in Malaysia. This qualitative study involved in-depth interviews with 15 key professionals working in the field of sexuality and reproductive health in Malaysia. Thematic analysis was selected to analyze data. Barriers to sexuality education were perceived from 5 aspects: feasibility, acceptability, accountability, strategies, and community unawareness. Respondents believed that implementing national sexuality education is a time-consuming project. They regarded Malaysian multicultural society as a barrier to national sexuality education, and they believed that school-based sexuality education is not easily accomplished in Malaysia; also abstinence-only policy restricts the access of young people to accurate information. Lack of community involvement was perceived as a key concern to sexuality education. Campaigning to promote awareness of families, teachers, community leaders, and policy makers are recommended to help establishing national sexuality education in Malaysia. © 2014 APJPH.

  11. Internal Medicine Hospitalists' Perceived Barriers and Recommendations for Optimizing Secondary Prevention of Osteoporotic Hip Fractures.

    Science.gov (United States)

    Tan, Eng Keong; Loh, Kah Poh; Goff, Sarah L

    2017-12-01

    Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center. The interviews were analyzed with directed content analysis. Internal medicine hospitalists consider secondary osteoporotic hip fracture prevention as the responsibility of outpatient physicians. Identified barriers were stratified based on themes including physicians' perception, patients' characteristics, risks and benefits of osteoporosis treatment, healthcare delivery system, and patient care transition from the inpatient to the outpatient setting. Some of the recommendations include building an integrated system that involves a multidisciplinary team such as the fracture liaison service, initiating a change to the hospital policy to facilitate inpatient care and management of osteoporosis, and creating a smooth patient care transition to the outpatient setting. Our study highlighted how internal medicine hospitalists perceive their role in the secondary prevention of osteoporotic hip fractures and what they perceive as barriers to initiating preventive measures in the hospital. Inconsistency in patient care transition and the fragmented nature of the existing healthcare system were identified as major barriers. A fracture liaison service could remove some of these barriers.

  12. Biological and Sociocultural Differences in Perceived Barriers to Physical Activity among 5th–7th Grade Urban Girls

    Science.gov (United States)

    Vermeesch, Amber L.; Ling, Jiying; Voskuil, Vicki R.; Bakhoya, Marion; Wesolek, Stacey M.; Bourne, Kelly A.; Pfeiffer, Karin A.; Robbins, Lorraine B.

    2015-01-01

    Background Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined. Objectives The threefold purpose of this study was to: (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index (BMI), recreational screen time, sedentary activity, and PA; and (c) identify girls’ top-rated perceived barriers to PA. Methods Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous physical activity (MVPA), and light plus MVPA. Results Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p barriers were negatively related to MVPA (r = −.10, p = .03) and light plus MVPA (r = −.11, p = .02). Girls’ top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain. Discussion Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA. PMID:26325276

  13. Biological and Sociocultural Differences in Perceived Barriers to Physical Activity Among Fifth- to Seventh-Grade Urban Girls.

    Science.gov (United States)

    Vermeesch, Amber L; Ling, Jiying; Voskuil, Vicki R; Bakhoya, Marion; Wesolek, Stacey M; Bourne, Kelly A; Pfeiffer, Karin A; Robbins, Lorraine B

    2015-01-01

    Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined. The threefold purpose of this study was to (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index, recreational screen time, sedentary activity, and PA; and (c) identify girls' top-rated perceived barriers to PA. Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous PA (MVPA), and light plus MVPA. Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p barriers were negatively related to MVPA (r = -.10, p = .03) and light plus MVPA (r = -.11, p = .02). Girls' top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain. Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA.

  14. Cervical cancer screening and psychosocial barriers perceived by patients. A systematic review

    Science.gov (United States)

    Bukowska-Durawa, Alicja

    2014-01-01

    Aim of the study This study aimed at integrating research discussing the role of perceived psychosocial barriers in cervical cancer screening (CCS) uptake. In particular, we analyzed the evidence for the associations between CCS uptake and perceived psychosocial barriers and frequency of psychosocial barriers identified by women. Material and methods A systematic search of peer-reviewed papers published until 2011 in 8 databases yielded 48 original studies, analyzing data obtained from 155 954 women. The majority of studies (k = 43) applied correlational design, while 5 had experimental design. Results Experimental research indicated a positive effect of 75% of psychosocial interventions targeting barriers. The interventions resulted in a significant increase of CCS uptake. Overall 100% of correlational studies indicated that perceiving lower levels of barriers significantly predicted higher CCS uptake. 53 psychosocial barriers were listed in at least 2 original correlational studies: 9.5% of barriers were related to CCS facilities/environment, 67.9% dealt with personal characteristics of the patient, and 22.6% addressed social factors. As many as 35.9% of perceived barriers referred to negative emotions related to CCS examination procedures and collecting CCS results, whereas 25.7% of barriers referred to prior contacts with health professionals. Conclusions Leaflets or discussion on psychosocial barriers between patients and health professionals involved in CCS might increase CCS uptake and thus reduce cervical cancer mortality rates. Communication skills training for health professionals conducting CCS might focus on the most frequently reported barriers, referring to emotions related to CCS examination and collecting CCS results. PMID:25520573

  15. Fourth-year dental students' perceived barriers to providing tobacco intervention services.

    Science.gov (United States)

    Pendharkar, Bhagyashree; Levy, Steven M; McQuistan, Michelle R; Qian, Fang; Squier, Christopher A; Slach, Nancy A; Aquilino, Mary L

    2010-10-01

    In order to facilitate effective tobacco cessation services within dental school clinics, it is necessary to understand the perceived barriers encountered by dental students while providing these services. The aim of this study was to identify which factors fourth-year dental students perceive to be associated with barriers to providing tobacco intervention services. A written survey was developed and completed by incoming fourth-year dental students (a convenience sample of seventy students) at the University of Iowa College of Dentistry in 2008. The survey assessed the perceived barriers to providing tobacco intervention services and related factors. Descriptive, bivariate, and linear regression analyses were conducted. The response rate was 97 percent. The most frequently reported barriers were patients' resistance to tobacco intervention services (96 percent), inadequate time available for tobacco intervention services (96 percent), and forgetting to give tobacco intervention advice (91 percent). The following variables were significantly (p<0.05) related to greater perceived barriers in providing tobacco intervention services: lower "adequacy of tobacco intervention curriculum coverage of specific topics covered over the previous three years" and greater "perceived importance of incorporating objective structured clinical examination teaching method for learning tobacco intervention." Students probably could benefit from additional didactic training, but most important may be enhanced clinical experiences and faculty reinforcement to facilitate effective practical student learning and adaptation for future delivery of intervention services in private practice settings.

  16. Perceived barriers in the use of ultrasound in developing countries.

    Science.gov (United States)

    Shah, Sachita; Bellows, Blaise A; Adedipe, Adeyinka A; Totten, Jodie E; Backlund, Brandon H; Sajed, Dana

    2015-12-01

    Access to ultrasound has increased significantly in resource-limited settings, including the developing world; however, there remains a lack of sonography education and ultrasound-trained physician support in developing countries. To further investigate this potential knowledge gap, our primary objective was to assess perceived barriers to ultrasound use in resource-limited settings by surveying care providers who practice in low- and middle-income settings. A 25-question online survey was made available to health care providers who work with an ultrasound machine in low- and middle-income countries (LMICs), including doctors, nurses, technicians, and clinical officers. This was a convenience sample obtained from list-serves of ultrasound and radiologic societies. The survey was analyzed, and descriptive results were obtained. One hundred and thirty-eight respondents representing 44 LMICs including countries from the continents of Africa, South America, and Asia completed the survey, with a response rate of 9.6 %. Ninety-one percent of the respondents were doctors, and 9 % were nurses or other providers. Applications for ultrasound were diverse, including obstetrics (75 %), DVT evaluation (51 %), abscess evaluation (54 %), cardiac evaluation (64 %), inferior vena cava (IVC) assessment (49 %), Focused Assessment Sonography for Trauma (FAST) exam (64 %), biliary tree assessment (54 %), and other applications. The respondents identified the following barriers to use of ultrasound: lack of training (60 %), lack of equipment (45 %), ultrasound machine malfunction (37 %), and lack of ultrasound maintenance capability (47 %). Seventy-four percent of the respondents wished to have further training in ultrasound, and 82 % were open to receiving distance learning or telesonography training. Subjects used communication tools including Skype, Dropbox, emailed photos, and picture archiving and communication system (PACS) as ways to communicate and receive feedback

  17. Young adult males' motivators and perceived barrier towards eating healthily and being active: A qualitative study

    Science.gov (United States)

    There is a lack of understanding of young men's perspectives in obesity-related research. This study aims to: (1) identify young men's perceived motivators and barriers in adopting healthy eating and physical activity behaviors, and (2) explore any differences in responses by weight status categorie...

  18. Exploratory Study of Perceived Barriers to Learning in an Urban Educational Opportunity Center

    Science.gov (United States)

    Lee, Jung Min

    2017-01-01

    The purpose of this study was to identify the perceived barriers of adult learners to program in the State University of New York (SUNY) Manhattan Educational Opportunity Center (MEOC) from the perspectives of students and teachers. The study also sought to determine teachers' insights regarding means of motivating adult students to continue…

  19. Perceived barriers to communication between hospital and nursing home at time of patient transfer.

    Science.gov (United States)

    Shah, Faraaz; Burack, Orah; Boockvar, Kenneth S

    2010-05-01

    To identify perceived barriers to communication between hospital and nursing home at the time of patient transfer and examine associations between perceived barriers and hospital and nursing home characteristics. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Respondents rated the importance as a barrier to hospital-nursing home communication of (1) hospital providers' attitude, time, effort, training, payment, and familiarity with nursing home patients; (2) unplanned and off-hours transfers; (3) HIPAA privacy regulations; and (4) lost or failed information transmission. Associations were determined between barriers and the following organizational characteristics: (1) hospital-nursing home affiliations, pharmacy or laboratory agreements, cross-site staff visits, and cross-site physician care; (2) hospital size, teaching status, and frequency of geriatrics specialty care; (3) nursing home size, location, type, staffing, and Medicare quality indicators; and (4) hospital-to-nursing home communication, consistency of hospital care with health care goals, and communication quality improvement efforts. Of 647 questionnaires sent, 229 were returned (35.4%). The most frequently reported perceived barriers to communication were sudden or unplanned transfers (44.4%), transfers that occur at night or on the weekend (41.4%), and hospital providers' lack of effort (51.0%), lack of familiarity with patients (45.0%), and lack of time (43.5%). Increased hospital size, teaching hospitals, and urban nursing home location were associated with greater perceived importance of these barriers, and cross-site staff visits and hospital provision of laboratory and pharmacy services to the nursing home were associated with lower perceived importance of these barriers. Hospital and nursing home characteristics and interorganizational relationships were associated with nursing home

  20. Perceived barriers to consumption of fish among Norwegian women

    DEFF Research Database (Denmark)

    Trondsen, Torbjørn; Scholderer, Joachim; Lund, Eiliv

    2003-01-01

    with consumption levels among those who would like to eat more fish. Higher education and income were associated with increased dissatisfaction about fish consumption, but also with reduced perception of most barriers. It is concluded that improvements in the supply of high-quality fresh and processed fish......This study aimed to characterize constraints on consumption of fish perceived by consumers in Norway. A random sample of Norwegian women aged 45-69 years answered a self-administered mail questionnaire in 1996 about eating habits, perceived barriers to fish consumption, socioeconomic status...... weight are dissatisfied with the range of products offered in the marketplace. Satisfaction with quality and availability of wild lean codfish, especially in inland regions, is lower than for aqua-cultured fat salmon. Neither income nor education or health factors were significantly associated...

  1. Participation of chronic patients in medical consultations: patients' perceived efficacy, barriers and interest in support

    NARCIS (Netherlands)

    Henselmans, Inge; Heijmans, Monique; Rademakers, Jany; van Dulmen, Sandra

    2015-01-01

    Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and barriers,

  2. Perceived barriers to leisure-time physical activity and associated factors in adolescents.

    Science.gov (United States)

    Dias, Douglas Fernando; Loch, Mathias Roberto; Ronque, Enio Ricardo Vaz

    2015-11-01

    The objective of this study was to identify the prevalence of perceived barriers to leisure-time physical activity in teenagers and to examine the possible association of these barriers with leisure-time physical inactivity. This cross-sectional study was conducted in 2011 and a representative sample of 1,409 high school students from public schools in the city of Londrina/Paraná was selected through multistage sampling. For data collection, the adolescents completed a questionnaire. The relationship between leisure-time physical inactivity (barriers was analyzed by calculating the prevalence ratio (PR) in Poisson regression models. "Lack of friends company" was the most prevalent barrier for both girls (75.8%) and boys (58.7%). "Feel lazy" for girls (PR: 1.21; CI 95%: 1.08 to 1.36) and "prefer to do other things" for the boys (PR: 1.48; CI 95%: 1.01 to 2.15) were the barriers most strongly associated with leisure-time physical inactivity. For both genders, a strong dose-response relationship was observed between the number of perceived barriers and leisure-time physical inactivity. The perception of barriers was associated with a higher prevalence of leisure-time physical inactivity in adolescents and should therefore be considered in actions for promoting physical activity in this population.The objective of this study was to identify the prevalence of perceived barriers to leisure-time physical activity in teenagers and to examine the possible association of these barriers with leisure-time physical inactivity. This cross-sectional study was conducted in 2011 and a representative sample of 1,409 high school students from public schools in the city of Londrina/Paraná was selected through multistage sampling. For data collection, the adolescents completed a questionnaire. The relationship between leisure-time physical inactivity (barriers was analyzed by calculating the prevalence ratio (PR) in Poisson regression models. "Lack of friends company" was the most

  3. Identifying barriers to emergency care services.

    Science.gov (United States)

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

    This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

  4. Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs.

    Science.gov (United States)

    Hyshka, Elaine; Anderson, Jalene Tayler; Wild, T Cameron

    2017-05-01

    Research on perceived unmet need for care for mental health and substance use problems focuses on general populations to the detriment of hidden populations. This study describes prevalence and correlates of perceived unmet need for care in a community-based sample of street-involved people who use illicit drugs and identifies barriers to care. A sample of 320 street-involved people who use drugs participated in a structured, interviewer-assisted survey in Edmonton, Canada. The survey included the Perceived Need for Care Questionnaire, which assessed unmet need for care for mental health and substance use problems across seven service types. Logistic regression examined the associations between perceived unmet need, extent of socioeconomic marginalisation and problem severity. Barriers underlying unmet service needs were also examined. Most (82%) participants reported unmet need for one or more services during the past year. Odds of reporting one or more unmet needs were elevated amongst participants reporting substantial housing instability (adjusted odds ratio = 2.37; 95% confidence interval 1.19-4.28) and amongst participants meeting criteria for drug dependence (adjusted odds ratio = 1.22; 95% confidence interval 1.03-1.50), even after adjustment for sociodemographic covariates. Structural, rather than motivational barriers were the most commonly reported reasons underlying unmet service needs. Street-involved people who use drugs experience very high rates of perceived unmet need for care for mental health and substance use problems. General population studies on perceived unmet need are insufficient for understanding needs and barriers to care in hidden populations.[Hyshka E, Anderson JT, Wild TC. Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs. Drug Alcohol Rev 2017;36:295-304]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  5. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review

    Directory of Open Access Journals (Sweden)

    Griffiths Kathleen M

    2010-12-01

    Full Text Available Abstract Background Adolescents and young adults frequently experience mental disorders, yet tend not to seek help. This systematic review aims to summarise reported barriers and facilitators of help-seeking in young people using both qualitative research from surveys, focus groups, and interviews and quantitative data from published surveys. It extends previous reviews through its systematic research methodology and by the inclusion of published studies describing what young people themselves perceive are the barriers and facilitators to help-seeking for common mental health problems. Methods Twenty two published studies of perceived barriers or facilitators in adolescents or young adults were identified through searches of PubMed, PsycInfo, and the Cochrane database. A thematic analysis was undertaken on the results reported in the qualitative literature and quantitative literature. Results Fifteen qualitative and seven quantitative studies were identified. Young people perceived stigma and embarrassment, problems recognising symptoms (poor mental health literacy, and a preference for self-reliance as the most important barriers to help-seeking. Facilitators were comparatively under-researched. However, there was evidence that young people perceived positive past experiences, and social support and encouragement from others as aids to the help-seeking process. Conclusions Strategies for improving help-seeking by adolescents and young adults should focus on improving mental health literacy, reducing stigma, and taking into account the desire of young people for self-reliance.

  6. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review.

    Science.gov (United States)

    Gulliver, Amelia; Griffiths, Kathleen M; Christensen, Helen

    2010-12-30

    Adolescents and young adults frequently experience mental disorders, yet tend not to seek help. This systematic review aims to summarise reported barriers and facilitators of help-seeking in young people using both qualitative research from surveys, focus groups, and interviews and quantitative data from published surveys. It extends previous reviews through its systematic research methodology and by the inclusion of published studies describing what young people themselves perceive are the barriers and facilitators to help-seeking for common mental health problems. Twenty two published studies of perceived barriers or facilitators in adolescents or young adults were identified through searches of PubMed, PsycInfo, and the Cochrane database. A thematic analysis was undertaken on the results reported in the qualitative literature and quantitative literature. Fifteen qualitative and seven quantitative studies were identified. Young people perceived stigma and embarrassment, problems recognising symptoms (poor mental health literacy), and a preference for self-reliance as the most important barriers to help-seeking. Facilitators were comparatively under-researched. However, there was evidence that young people perceived positive past experiences, and social support and encouragement from others as aids to the help-seeking process. Strategies for improving help-seeking by adolescents and young adults should focus on improving mental health literacy, reducing stigma, and taking into account the desire of young people for self-reliance.

  7. Perceived barriers to effective job performance among nursing assistants in long-term care.

    Science.gov (United States)

    Parmelee, Patricia A; Laszlo, Mary C; Taylor, Jo A

    2009-10-01

    This research explored perceived barriers to job performance among a national sample of nursing assistants (NAs). Specific objectives were (1) to clarify which of the problems identified by previous research are most troublesome for NAs, (2) to develop a reliable quantitative measure of perceived barriers to job performance, and (3) to test construct validity of the measure vis-à-vis work-related psychological empowerment and job satisfaction. Nursing assistants attending the 2006 national conference of the National Association of Health Care Assistants completed a paper-and-pencil survey including 33 barriers to job performance and standardized measures of empowerment and job satisfaction. The barriers were also rated by a small sample of NAs at a single Georgia nursing home. Factor analysis of barriers items yielded a 30-item Nursing Assistants Barriers Scale (NABS) comprising 6 subscales: Teamwork, Exclusion, Respect, Workload, Work Stress, and New NAs. Lack of teamwork and exclusion from communication processes were rated as most problematic by both samples. The 6 NABS subscales were significantly and independently associated with empowerment and satisfaction; different barriers predicted the 2 constructs. This study is a first step toward quantitative assessment of NAs' perceptions of barriers to doing their jobs. Primary limitations are the select sample and use of a job satisfaction measure that may have artificially inflated correlations with the NABS. Nonetheless, results confirm the validity of the new scale as an operationalization of the barriers construct. The concept of barriers to job performance is a unique construct from work empowerment and satisfaction with one's job. Nursing assistants clearly differentiate various barriers, converging on workload and lack of teamwork as most problematic. Further work is needed to substantiate validity and reliability of the NABS, particularly with respect to NAs' actual job performance, intent to stay on the

  8. Efficacy and flexibility impact perceived adherence barriers in pediatric kidney post-transplantation.

    Science.gov (United States)

    Guilfoyle, Shanna M; Goebel, Jens W; Pai, Ahna L H

    2011-03-01

    The alarming rates of medication nonadherence and its detrimental effect on long-term graft survival in pediatric kidney transplantation has called attention to identifying modifiable factors that promote better adherence and subsequent transplant outcomes. In a sample of 45 adolescent kidney transplant recipients (14.7 ± 3.3 years, 77.8% Caucasian, 39.5% female) and their primary caregivers, study aims included: 1) identifying sociodemographic and medical correlates of both caregiver- and patient-reported general family functioning (i.e., efficacy, flexibility, and communication) and 2) determining the unique contributions of these family functioning indices to perceived posttransplant adherence barriers. During a routine clinic visit, caregivers completed a sociodemographic form and questionnaire on general family functioning. Both caregivers and the adolescents completed a measure on perceived medication adherence barriers. Data identified household income and family structure as persistent correlates of family functioning. Familial efficacy and flexibility contributed significant variance to perceived adherence barriers. Family-based interventions enhancing modifiable family factors, such as flexibility and efficacy, in overcoming medication adherence barriers would likely promote more optimal health outcomes in the pediatric kidney transplant population. (c) 2011 APA, all rights reserved

  9. Regulatory Monitoring of Fortified Foods: Identifying Barriers and Good Practices

    Science.gov (United States)

    Rowe, Laura A; Vossenaar, Marieke; Garrett, Greg S

    2015-01-01

    While fortification of staple foods and condiments has gained enormous global traction, poor performance persists throughout many aspects of implementation, most notably around the critical element of regulatory monitoring, which is essential for ensuring foods meet national fortification standards. Where coverage of fortified foods is high, limited nutritional impact of fortification programs largely exists due to regulatory monitoring that insufficiently identifies and holds producers accountable for underfortified products. Based on quality assurance data from 20 national fortification programs in 12 countries, we estimate that less than half of the samples are adequately fortified against relevant national standards. In this paper, we outline key findings from a literature review, key informant interviews with 11 fortification experts, and semi-quantitative surveys with 39 individuals from regulatory agencies and the food fortification industry in 17 countries on the perceived effectiveness of regulatory monitoring systems and barriers to compliance against national fortification standards. Findings highlight that regulatory agencies and industry disagree on the value that enforcement mechanisms have in ensuring compliance against standards. Perceived political risk of enforcement and poorly resourced inspectorate capacity appear to adversely reinforce each other within an environment of unclear legislation to create a major hurdle for improving overall compliance of fortification programs against national standards. Budget constraints affect the ability of regulatory agencies to create a well-trained inspector cadre and improve the detection and enforcement of non-compliant and underfortified products. Recommendations to improve fortification compliance include improving technical capacity; ensuring sustained leadership, accountability, and funding in both the private and the public sectors; and removing political barriers to ensure consistent detection of

  10. Promoting Early Brain and Child Development: Perceived Barriers and the Utilization of Resources to Address Them.

    Science.gov (United States)

    Garner, Andrew S; Storfer-Isser, Amy; Szilagyi, Moira; Stein, Ruth E K; Green, Cori M; Kerker, Bonnie D; O'Connor, Karen G; Hoagwood, Kimberly E; McCue Horwitz, Sarah

    Efforts to promote early brain and child development (EBCD) include initiatives to support healthy parent-child relationships, tools to identify family social-emotional risk factors, and referrals to community programs to address family risk factors. We sought to examine if pediatricians perceive barriers to implementing these activities, and if they utilize resources to address those barriers. Data were analyzed from 304 nontrainee pediatricians who practice general pediatrics and completed a 2013 American Academy of Pediatrics Periodic Survey. Sample weights were used to decrease nonresponse bias. Bivariate comparisons and multivariable regression analyses were conducted. At least half of the pediatricians agreed that barriers to promoting EBCD include: a lack of tools to promote healthy parent-child relationships, a lack of tools to assess the family environment for social-emotional risk factors, and a lack of local resources to address family risks. Endorsing a lack of tools to assess the family environment as a barrier was associated with using fewer screening tools and community resources. Endorsing a lack of local resources as a barrier was associated with using fewer community resources and fewer initiatives to promote parent-child relationships. Interest in pediatric mental health was associated with using more initiatives to promote healthy parent-child relationships, screening tools, and community resources. Although the majority of pediatricians perceive barriers to promoting EBCD, few are routinely using available resources to address these barriers. Addressing pediatricians' perceived barriers and encouraging interest in pediatric mental health may increase resource utilization and enhance efforts to promote EBCD. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. Barriers to Participation in Parenting Programs: The Relationship between Parenting Stress, Perceived Barriers, and Program Completion.

    Science.gov (United States)

    Rostad, Whitney L; Moreland, Angela D; Valle, Linda Anne; Chaffin, Mark J

    2018-04-01

    Families experiencing child maltreatment or risk factors for child maltreatment often receive referrals to interventions focused on changing parenting practices. Compliance with specific parenting programs can be challenging as many of the stressors that place families at-risk may also interfere with program participation. Because families may receive limited benefit from programs they do not fully receive, it is critical to understand the relationship between parenting stress and barriers to program completion. We used structural equation modeling to examine the relationship among parenting stress, perceived barriers to program participation, and program completion in two datasets involving low-income parents. Data were collected at two time points from a sample of parents involved with child welfare services and a sample of parents considered at-risk of future involvement (total study n = 803). Direct paths from parenting stress at time 1 to barriers to participation and parenting stress at time 2, and from parenting stress at time 2 to program completion were significant. Interestingly, increased barriers to participation were related to increased parenting stress at time 2, and greater parenting stress was related to increased program completion. Results suggest that with increasing levels of parenting stress, parents have an increased likelihood of completing the program. Assessing and addressing the influence of perceived barriers and parenting stress on program participation may decrease the likelihood of treatment attrition.

  12. Perceived barriers to consumption of fish among Norwegian women.

    Science.gov (United States)

    Trondsen, Torbjørn; Scholderer, Joachim; Lund, Eiliv; Eggen, Anne E

    2003-12-01

    This study aimed to characterize constraints on consumption of fish perceived by consumers in Norway. A random sample of Norwegian women aged 45-69 years answered a self-administered mail questionnaire in 1996 about eating habits, perceived barriers to fish consumption, socioeconomic status, and questions related to health. Altogether, 9407 women answered the questionnaire (response rate: 52.5%). Data were analyzed by means of logistic regression. Limited supply of fish products that satisfy children's wishes reduce at-home fish consumption. People with health problems and those who wish to lose weight are dissatisfied with the range of products offered in the marketplace. Satisfaction with quality and availability of wild lean codfish, especially in inland regions, is lower than for aqua-cultured fat salmon. Neither income nor education or health factors were significantly associated with consumption levels among those who would like to eat more fish. Higher education and income were associated with increased dissatisfaction about fish consumption, but also with reduced perception of most barriers. It is concluded that improvements in the supply of high-quality fresh and processed fish products that satisfy (a) children's wishes, (b) health-oriented family members, and (c) convenience-oriented consumers, will significantly increase at-home consumption of fish.

  13. A cross-cultural survey of residents' perceived barriers in questioning/challenging authority.

    Science.gov (United States)

    Kobayashi, H; Pian-Smith, M; Sato, M; Sawa, R; Takeshita, T; Raemer, D

    2006-08-01

    To identify perceived barriers to residents' questioning or challenging their seniors, to determine how these barriers affect decisions, and to assess how these barriers differ across cultures. A written questionnaire was administered to residents in teaching hospitals in the US and Japan to assess factors affecting residents' willingness to question or challenge their superiors. The responses were analyzed for statistical significance of differences between the two cultures and to determine the importance of issues affecting decisions. Questionnaires were completed by 175 US and 65 Japanese residents, with an overall response rate of 71%. Trainees from both countries believe that questioning and challenging contribute to safety. The perceived importance of specific beliefs about the workplace differed across cultures in seven out of 22 questions. Residents' decisions to make a challenge were related to the relationships and perceived response of the superiors. There was no statistical difference between the US and Japanese residents in terms of the threshold for challenging their seniors. We have identified attributes of residents' beliefs of communication, including several cross-cultural differences in the importance of values and issues affecting one's decision to question or challenge. In contrast, there was no difference in the threshold for challenging seniors by the Japanese and US residents studied. Changes in organizational and professional culture may be as important, if not more so, than national culture to encourage "speaking up". Residents should be encouraged to overcome barriers to challenging, and training programs should foster improved relationships and communication between trainers and trainees.

  14. Perceived exercise barriers explain exercise participation in Australian women treated for breast cancer better than perceived exercise benefits.

    Science.gov (United States)

    Gho, Sheridan A; Munro, Bridget J; Jones, Sandra C; Steele, Julie R

    2014-12-01

    This study aimed to determine the effect of perceived exercise benefits and barriers on exercise levels among women who have been treated for breast cancer and have not participated in a formal exercise intervention. This was an anonymous, national, online cross-sectional survey study. Four hundred thirty-two women treated for breast cancer completed an online survey covering their treatment and demographic background, current exercise levels, and perceived exercise benefits and barriers. Each perceived benefit and barrier was considered in a binary logistic regression against reported exercise levels to ascertain significant relationships and associative values (odds ratio [OR]). Agreement with 16 out of 19 exercise barriers was significantly related to being more likely to report insufficient exercise levels, whereas agreement with 6 out of 15 exercise benefits was significantly related to being less likely to report insufficient levels of exercise. Feeling too weak, lacking self-discipline, and not making exercise a priority were the barriers with the largest association to insufficient exercise levels (OR=10.97, 95% confidence interval [CI]=3.90, 30.86; OR=8.12, 95% CI=4.73, 13.93; and OR=7.43, 95% CI=3.72, 14.83, respectively). Conversely, exercise enjoyment, improved feelings of well-being, and decreased feelings of stress and tension were the top 3 benefits associated with being less likely to have insufficient exercise levels (OR=0.21, 95% CI=0.11, 0.39; OR=0.21, 95% CI=0.07, 0.63; and OR=0.31, 95% CI=0.15, 0.63, respectively). Self-reported data measures were used to collect exercise data. Targeting exercise barriers specific to women treated for breast cancer may improve exercise participation levels in this cohort. Awareness of the impact of exercise barriers identified in the present study will enable physical therapists to better plan exercise interventions that support all women treated for breast cancer. © 2014 American Physical Therapy Association.

  15. Perceived barriers and difficulties of intermittent catheterization: In Korean patients with spinal dysraphism and their parents.

    Science.gov (United States)

    Lim, Seoung-Wha; Lee, Hahn-Ey; Davis, Monica; Park, Kwanjin

    2016-03-01

    Integrating regular intermittent catheterization (IC) into daily life is essential for good medical outcomes in patients with neurogenic bladders. The goal is to identify long-term IC-related barriers, or difficulties in Korean patients with spinal dysraphism and their parents. The data were prospectively collected using questionnaires from spinal dysraphism patients from two sources: an online community, and those visiting the outpatient clinic of Seoul National university hospital. The questions included were barriers in general and school life, respectively. Also, an open question was included regarding suggestions for school managers or the government in order to overcome identified IC related difficulties. A total of 20 patients and 40 parents answered the questionnaire. Common barriers found in general life were related to lack of places, time, or helpers to perform IC. Substantial numbers of adolescent patients also complained that IC could not be adequately performed due to problems related to privacy or lack of understanding at school. However, the number and nature of barriers varied according to the developmental stage and school environments. Almost all IC barriers seemed to be significant in adolescence. Some parents requested that the government provide space and broaden insurance coverage of catheters in order to facilitate IC. Various perceived barriers were identified in those who need IC and differences were demonstrated over time. Both dedicated space and time are issues. In addition, patients may benefit from emotional support and enhanced communication with community agencies and government to resolve the problems related with privacy. © 2014 Wiley Periodicals, Inc.

  16. Overweight men's motivations and perceived barriers towards weight loss

    DEFF Research Database (Denmark)

    Sabinsky, Marianne; Toft, U. N.; Raben, A.

    2007-01-01

    motive for losing weight was a strong desire to become more effective and a greater asset for one's workplace. Overweight subjects were considered less effective and attractive for the labour market. Conclusion: This study indicates that if men from lower socioeconomic backgrounds are to be motivated......Objective: To explore motivation and perceived barriers towards weight loss among Danish men. Design: The study was of an explorative nature, using qualitative focus group interviews as a method. Setting: Copenhagen, Denmark. Subjects: Twenty-two overweight men, at the age of 25-44 years...... and motivated for weight loss, were recruited and distributed into four focus groups. The men were primarily unskilled workers. Overall 13 men participated and each group contained three or four participants. Intervention: The interview guide was partly structured, partly unstructured and the themes...

  17. Participation of chronic patients in medical consultations: patients’ perceived efficacy, barriers and interest in support.

    NARCIS (Netherlands)

    Henselmans, I.; Heijmans, M.; Rademakers, J.; Dulmen, S. van

    2015-01-01

    Aims: Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and

  18. Municipal Officials’ Perceived Barriers to Consideration of Physical Activity in Community Design Decision Making

    Science.gov (United States)

    Goins, Karin Valentine; Schneider, Kristin L.; Brownson, Ross; Carnoske, Cheryl; Evenson, Kelly; Eyler, Amy; Heinrich, Katie; Litt, Jill; Lyn, Rodney; Maddock, Jay; Reed, Hannah; Tompkins, Nancy O’Hara; Lemon, Stephenie C.

    2016-01-01

    Context Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to consideration of physical activity in decision making. Objective This study aimed to 1) identify barriers to the consideration of physical activity in community design and planning decisions among municipal decision makers and 2) explore differences in these barriers among a wide range of job functions and departments in a geographically diverse sample. Design A web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50,000 residents in eight states. Participants 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures responded to the survey. Main Outcome Measures Five barriers to consideration of physical activity in community design and layout were assessed. Results The most common barriers included lack of political will (23.5%), limited staff (20.4%) and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Compared to other professionals, public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments. They were also more likely to report lack of political will compared to city managers or mayors and municipal legislators. Conclusions Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will

  19. Common Perceived Barriers and Facilitators for Reducing Sedentary Behaviour among Office Workers.

    Science.gov (United States)

    Nooijen, Carla F J; Kallings, Lena V; Blom, Victoria; Ekblom, Örjan; Forsell, Yvonne; Ekblom, Maria M

    2018-04-18

    Qualitative studies identified barriers and facilitators associated with work-related sedentary behaviour. The objective of this study was to determine common perceived barriers and facilitators among office workers, assess subgroup differences, and describe sedentary behaviour. From two Swedish companies, 547 office workers (41 years (IQR = 35–48), 65% women, 66% highly educated) completed questionnaires on perceived barriers and facilitators, for which subgroup differences in age, gender, education, and workplace sedentary behaviour were assessed. Sedentary behaviour was measured using inclinometers ( n = 311). The most frequently reported barrier was sitting is a habit (67%), which was reported more among women than men (Χ² = 5.14, p = 0.03) and more among highly sedentary office workers (Χ² = 9.26, p < 0.01). The two other most reported barriers were that standing is uncomfortable (29%) and standing is tiring (24%). Facilitators with the most support were the introduction of either standing- or walking-meetings (respectively 33% and 29%) and more possibilities or reminders for breaks (31%). The proportion spent sedentary was 64% at the workplace, 61% on working days, and 57% on non-working days. This study provides a detailed understanding of office workers’ ideas about sitting and means to reduce sitting. We advise to include the supported facilitators and individualized support in interventions to work towards more effective strategies to reduce sedentary behaviour.

  20. The effect of a walking program on perceived benefits and barriers to exercise in postmenopausal African American women.

    Science.gov (United States)

    Williams, Bernadette R; Bezner, Janet; Chesbro, Steven B; Leavitt, Ronnie

    2006-01-01

    Rates of exercise participation among African Americans is low. Identifying and overcoming perceived benefits/ barriers unique to African American women (AAW) may increase their exercise participation. The purpose of this study was to describe perceived benefits/barriers to exercise in AAW before and after participation in a walking program. Thirty-five postmenopausal AAW participated in a 7-week structured walking program with 2 walking goals. Perceived benefits and barriers to exercise were assessed using the Exercise Benefits/Barriers Scale at the beginning and end of the program. Participants engaged in a postintervention interview to further assess benefits/barriers to exercise participation. Perceived benefits/barriers to exercise did not change significantly with participation in a walking program. Lack of time due to work and family responsibilities affected achievement of the brisk walking goal. Postmenopausal AAW in this study strongly believed in the benefits of exercising and had increased levels of participation in a walking program when lack of time was not a barrier. Overcoming this barrier is the true challenge to health care professionals.

  1. Moving Towards Sustainable Food Consumption : Identifying Barriers to Sustainable Student Diets

    OpenAIRE

    Ede, James; Graine, Sophia; Rhodes, Chris

    2011-01-01

    Adopting more sustainable consumption habits has been identified as a necessary step in the progression towards a sustainable society. In the area of sustainable consumption, personal food behaviour represents a strong leverage point. University students have been identified as a strategic audience; habits established during this transformative period can track forward into later life. This study seeks to identify the barriers inhibiting students from eating more sustainably. Perceived benefi...

  2. Baccalaureate Minority Nursing Students Perceived Barriers and Facilitators to Clinical Education Practices: An Integrative Review.

    Science.gov (United States)

    Graham, Crystal L; Phillips, Shannon M; Newman, Susan D; Atz, Teresa W

    2016-01-01

    This integrative review synthesized baccalaureate minority nursing students' perceptions of their clinical experiences. The diversity of the nursing workforce does not mirror the United States population. Attrition rates of minority nursing students remain higher than rates for White students. Literature examining facilitators and barriers to minority student success predominantly focuses on academic factors, excluding those relevant to clinical education. An integrative review using literature from nursing and education. Three common perceived barriers were identified: discrimination from faculty, peers, nursing staff, and patients; bias in faculty grading practices; and isolation. Although little is known about the relationship between clinical failures and overall attrition, this review provides evidence that minority students encounter significant barriers in clinical education. To increase the diversity of the nursing workforce, faculty must address these issues and make modifications to ensure an equal opportunity at a quality education for all students.

  3. Identifying Food Safety Concerns when Communication Barriers Exist

    Science.gov (United States)

    Neal, Jack A.; Dawson, Mary; Madera, Juan M.

    2011-01-01

    Abstract: Students must be prepared to lead a diverse workforce. The objective of this study was to establish a teaching method that helps students identify barriers to food safety while working in a simulated environment with communication barriers. This study employed a perspective taking exercise based upon the principles of social learning…

  4. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mazza Danielle

    2013-01-01

    Full Text Available Abstract Background Despite strong evidence of the benefits of preconception interventions for improving pregnancy outcomes, the delivery and uptake of preconception care and periconceptional folate supplementation remain low. General practitioners play a central role in the delivery of preconception care. Understanding general practitioners’ perceptions of the barriers and enablers to implementing preconception care allows for more appropriate targeting of quality improvement interventions. Consequently, the aim of this study was to examine the barriers and enablers to the delivery and uptake of preconception care guidelines from general practitioners’ perspective using theoretical domains related to behaviour change. Methods We conducted a qualitative study using focus groups consisting of 22 general practitioners who were recruited from three regional general practice support organisations. Questions were based on the theoretical domain framework, which describes 12 domains related to behaviour change. General practitioners’ responses were classified into predefined themes using a deductive process of thematic analysis. Results Beliefs about capabilities, motivations and goals, environmental context and resources, and memory, attention and decision making were the key domains identified in the barrier analysis. Some of the perceived barriers identified by general practitioners were time constraints, the lack of women presenting at the preconception stage, the numerous competing preventive priorities within the general practice setting, issues relating to the cost of and access to preconception care, and the lack of resources for assisting in the delivery of preconception care guidelines. Perceived enablers identified by general practitioners included the availability of preconception care checklists and patient brochures, handouts, and waiting room posters outlining the benefits and availability of preconception care consultations

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

    Science.gov (United States)

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

    2007-01-01

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

  6. Comparison of perceived barriers to entrepreneurship in Eastern and Western European countries

    NARCIS (Netherlands)

    Iakovleva, T.A.; Kolvereid, L.; M.J. Gorgievski-Duijvesteijn (Marjan); Sørhaug, Ø

    2014-01-01

    textabstractThis qualitative study among 591 business students from four European countries investigated cross-country differences in the kind of barriers people perceive to business start-up. In line with institutional theory, the most important perceived barriers in all countries related to

  7. Perceived benefits and barriers of physical activity: A social marketing formative study.

    Science.gov (United States)

    Rundle-Thiele, Sharyn; Kubacki, Krzysztof; Gruneklee, Naomi

    2016-01-01

    The aim of this study was to gain formative research insights that can be used to design social marketing campaigns. One thousand four hundred fifty-nine people participated in an online survey. Factor analysis was undertaken to establish perceived benefits and barriers, and indexes were created for barriers, benefits, and healthy living knowledge. Four attitude groups were formed and analysis of variance was undertaken to explore group differences. Consumers with high perceived barriers report less physical activity than consumers with low perceived barriers to exercise. The current study provides evidence to suggest that exchange theory can offer important insights to inform social marketing intervention planning.

  8. Do switching barriers of a service company moderate the relationship of perceived image and its antecedents?

    Directory of Open Access Journals (Sweden)

    Marinković Veljko

    2013-01-01

    Full Text Available The aim of the paper is to identify key antecedents of the perceived image. The paper presents a new model in which switching barriers play specific role. They have been highlighted as a potential moderator of relationship between the perceived image and its drivers. The survey was conducted on a sample of 221 respondents. The suitability of conceptual model was tested using confirmative factor analysis. When examining relations between the variables of the proposed model the main and interaction effects are determined. The paper provides useful managerial implications. Findings of the research indicate the factors that impact the perception of the image, where the intensity of the impact of each individual factor is established. The positioning of the image as dependent variable in the model gives the paper a certain specificity, since there are numerous examples of works in the field of services marketing in which authors identify the key drivers of customer satisfaction and loyalty. There are few studies which have analyzed the antecedents of the perceived image. Furthermore, the importance of the switching barriers as a potential moderator between certain variables is examined in the market of financial services, hotel and restaurant management, but so far it has not attracted greater attention of authors when it comes to the business of cable operators.

  9. Perceived Exercise Benefits and Barriers of Non-Exercising Female University Students in the United Kingdom

    Directory of Open Access Journals (Sweden)

    John K. Parker

    2010-03-01

    Full Text Available Many individuals do not engage in sufficient physical activity due to low perceived benefits and high perceived barriers to exercise. Given the increasing incidence of obesity and obesity related health disorders, this topic requires further exploration. We used the Exercise Benefits/Barriers Scale to assess perceived benefit and barrier intensities to exercise in 200 non-exercising female university students (mean age 19.3 years, SD = 1.06 in the UK. Although our participants were selected because they self reported themselves to be non-exercising, however they reported significantly higher perceived benefits from exercise than perceived barriers to exercise [t(199 = 6.18, p < 0.001], and their perceived benefit/barrier ratio was 1.33. The greatest perceived benefit from exercise was physical performance followed by the benefits of psychological outlook, preventive health, life enhancement, and then social interaction. Physical performance was rated significantly higher than all other benefits. Psychological outlook and preventive health were not rated significantly different, although both were significantly higher than life enhancement and social interaction. Life enhancement was also rated significantly higher than social interaction. The greatest perceived barrier to exercise was physical exertion, which was rated significantly higher than time expenditure, exercise milieu, and family discouragement barriers. Implications from this investigation for the design of physical activity programmes include the importance, for females, of a perception of high benefit/barrier ratio that could be conducive to participation in exercise. Applied interventions need to assist female students to ‘disengage’ from or overcome any perceived ‘unpleasantness’ of physical exertion during physical activity (decrease their perceived barriers, and to further highlight the multiple health and other benefits of regular exercising (increase their perceived

  10. Identifying barriers in the diffusion of renewable energy sources

    International Nuclear Information System (INIS)

    Eleftheriadis, Iordanis M.; Anagnostopoulou, Evgenia G.

    2015-01-01

    Rapid diffusion of renewable energy sources (RES) in the electricity power sector is crucial if the EU wants to fulfill its 2050 CO 2 reduction commitments. For this reason, identifying and alleviating all barriers that hinder the development of RES is necessary to the successful deployment of these technologies. This paper discusses the main barriers in the diffusion of wind and photovoltaic (PV) solar power in the Greek electricity sector by drawing on the literature of technological innovation systems and system functions. Furthermore, we provide an explanation of the different diffusion rates between the two technologies. Inadequate financial resources, low grid capacity, delays in the issuance of building permits, opposition from local communities to the construction of wind farms and the lack of a stable institutional framework are among the most important barriers that inhibit the diffusion of the wind and PV solar power. The nature of the barriers identified in this study calls for policy intervention. - Highlights: • Firms in the Greek wind and solar power sectors assess RES barriers. • Lack of financial resources is the most important RES barrier. • Lack of a stable institutional framework negatively affects RES deployment. • The support of the public sector is crucial to the diffusion of RES. •Wind power faces strong legitimization barriers

  11. Perceived barriers and facilitators to physical activity for children with disability: a systematic review.

    Science.gov (United States)

    Shields, Nora; Synnot, Anneliese Jane; Barr, Megan

    2012-11-01

    The aim of this systematic review was to investigate the perceived barriers and facilitators to physical activity among children with disability. 10 electronic databases were searched from the earliest time available to September 2010 to identify relevant articles. Articles were included if they examined the barriers or facilitators to physical activity for children with disability and were written in English. Articles were excluded if they included children with an acute, transient or chronic medical condition, examined sedentary leisure activities, or societal participation in general. Two reviewers independently assessed the search yields, extracted the data and assessed trial quality. Data were analysed descriptively. 14 articles met the inclusion criteria. Barriers included lack of knowledge and skills, the child's preferences, fear, parental behaviour, negative attitudes to disability, inadequate facilities, lack of transport, programmes and staff capacity, and cost. Facilitators included the child's desire to be active, practising skills, involvement of peers, family support, accessible facilities, proximity of location, better opportunities, skilled staff and information. Personal, social, environmental, and policy and programme-related barriers and facilitators influence the amount of activity children with disability undertake. The barriers to physical activity have been studied more comprehensively than the facilitators.

  12. Nurses' Perceived Barriers to Bedside Handover and Their Implication for Clinical Practice.

    Science.gov (United States)

    Tobiano, Georgia; Whitty, Jennifer A; Bucknall, Tracey; Chaboyer, Wendy

    2017-10-01

    Bedside handover during the change of shift allows nurses to visualize patients and facilitate patient participation, both purported to improve patient safety. But, bedside handover does not always occur and when it does, it may not involve the patient. To explore and understand barriers nurses perceive in undertaking bedside handover. A cross-sectional survey was administered to 200 nurses working on medical wards, recruited from two Australian hospitals, one private and one public. As part of the survey, there was one open-ended question asking about perceived barriers to bedside handover. Content analysis was used to analyze data. Barriers were assessed using a determinant framework. The open-ended question was answered by 176 (88%) participants. Three categories were identified. First, censoring the message showed nurses were concerned about patients and third-parties hearing sensitive information. In the second category, disrupting the communication flow, nurses perceived patients, family members, other nurses and external sources, interrupted the flow of handover and increased its duration. Finally, inhibiting characteristics demonstrated that individual patient and nurse views or capabilities hindered bedside handover. Barriers to bedside handover were determined to relate to individual nurse factors, patient factors, social, political and legal factors, and guideline factors. Suggestions for enhancing bedside handover include debunking nurses' misconceptions, reflecting on nurses' viewpoints, using active educational approaches, and promotion of legal requirements to heighten nurses' confidence dealing with sensitive information. Regular patient rounding, and standardized handover may enable patient involvement in handover. Finally, reviewing the local context to ensure organizational processes support bedside handover is recommended. © 2017 Sigma Theta Tau International.

  13. Assessment of common interventions and perceived barriers to pressure ulcer prevention in southwest Nigeria.

    Science.gov (United States)

    Ilesanmi, Rose Ekama; Olabisi, Prisca

    2014-01-01

    We examined the interventions used by nurses to prevent pressure ulcers in 3 hospitals in south west Nigeria and perceived barriers to effective nursing pressure ulcer prevention interventions. One hundred ninety-three nurses were purposively selected from neurological, orthopedic, intensive care, and accident and emergency units of participating hospitals. Study sites were 3 teaching hospitals in south west Nigeria (Lagos State University Teaching Hospital, Lagos; University College Hospital, Ibadan; and Obafemi Awolowo Teaching Hospital Ile-Ife). Data were collected via a structured questionnaire designed for this study. It included 3 sections: demographic information, practices used for pressure ulcer prevention, and perceived barriers to prevention. Sections of the questionnaire that queried interventions and perceived barriers to pressure ulcer prevention were evaluated for face and content validity. Reliability was evaluated via internal consistency; the split half reliability was 0.82. Similar practices regarding pressure ulcer prevention were found across the 3 hospitals. The most commonly used intervention was patient repositioning every 2 hours; the least used intervention was completion of a validated pressure ulcer risk scale. Nurses described using interventions that have not proved effective for pressure ulcer prevention such as massaging bony prominences and application of talcum powder. Nurses identified 2 principal factors that act as barriers to successful prevention of pressure ulcers: inadequate manpower and inadequate supply of linens on the wards. Nurses use a combination of evidence-based interventions, along with interventions that have not proved effective for pressure ulcer prevention. We recommend development of national standards for pressure ulcer prevention in Nigeria that are based on current best evidence and consistent with current international guidelines.

  14. Barriers to access to antiretroviral treatment in Mozambique, as perceived by patients and health workers in urban and rural settings.

    NARCIS (Netherlands)

    Posse, M.E.; Baltussen, R.M.P.M.

    2009-01-01

    This study identifies, ranks, and compares factors perceived as barriers to accessing antiretroviral treatment (ART) in urban and rural settings in Mozambique. Data were collected between March and July 2008. It consisted of 13 focus group discussions and a structured questionnaire administered to

  15. Perceived Career Barriers for Gay, Lesbian, and Bisexual Individuals

    Science.gov (United States)

    Parnell, Martha Keeton; Lease, Suzanne H.; Green, Michael L.

    2012-01-01

    This study examined career-related barriers that gay, lesbian, and bisexual (GLB) individuals had encountered in the past and anticipated in the future and the degree of hindrance associated with future barriers. Two hundred forty-one GLB participants (126 women and 115 men) completed the Career Barriers Inventory-Revised and 11 additional items…

  16. Families' perceived benefits of home visits for managing paediatric obesity outweigh the potential costs and barriers.

    Science.gov (United States)

    Gehring, Nicole D; Ball, Geoff D C; Perez, Arnaldo; Holt, Nicholas L; Neuman, Daniel; Spence, Nicholas; Mercier, Laura; Jetha, Mary

    2018-02-01

    Home visits have successfully been used to deliver various health services, but what role could they play in paediatric weight management? Low treatment initiation and high attrition prompted our multidisciplinary paediatric weight management clinic to investigate how families perceived the benefits and barriers of home visits. We focused on children with obesity aged 2-17 who were enrolled in our tertiary-level clinic in Alberta, Canada. None had received a home visit. The families were interviewed face-to-face from October 2015 to October 2016, and we used a qualitative description methodological framework and manifest content analysis. The parents were the main interviewees. Of the 56 families, 89% were interested in a home visit, 82% wanted support from a dietician and 54% from an exercise specialist. The perceived benefits of home visits included comprehensive assessment (95%), convenience (86%), tailored care (29%) and family involvement (13%), while the costs and barriers included clinicians' potential judgmental attitudes (30%), loss of privacy (19%) and distractions (10%). Some thought clinicians would find home visits inconvenient (25%), with bureaucratic challenges (14%) and sustainability issues (5%). Families felt home visits were a convenient option for managing paediatric obesity and identified important benefits and barriers that could guide such interventions. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  17. Perceived benefits and barriers to leisure-time physical activity during pregnancy in previously inactive and active women.

    Science.gov (United States)

    Da Costa, Deborah; Ireland, Kierla

    2013-01-01

    This study compared perceived benefits and barriers to leisure-time physical activity during pregnancy among women who were insufficiently active or inactive before pregnancy. Eighty-two pregnant women completed questionnaires assessing leisure-time physical activity benefits/barriers, exercise self-efficacy, social support, depressed mood, pre-pregnancy and current physical activity and fatigue. Multivariable regression analyses identified factors associated with exercise benefits/barriers for the two pre-pregnancy leisure-time physical activity groups. Both pre-pregnancy leisure-time physical activity groups reported more benefits than barriers to exercise during pregnancy. Previously inactive women reported fewer perceived benefits and greater perceived barriers to leisure-time physical activity during pregnancy. Higher self-efficacy for exercise during pregnancy was significantly associated with greater benefits of leisure-time physical activity during pregnancy for both groups. Less family support for exercise and lower self-efficacy for exercise were significantly related to greater leisure-time physical activity barriers during pregnancy for previously inactive women. Lower self-efficacy for exercise, higher depressed mood scores, and younger age were associated with greater leisure-time physical activity barriers for active women. Findings suggest that the intensities of perceived leisure-time physical activity benefits and barriers during pregnancy differ for women, depending on their pre-pregnancy leisure-time physical activity status. Consideration of pre-pregnancy leisure-time physical activity status may thus be important when tailoring strategies to overcome barriers to promote initiation and maintenance of physical activity during pregnancy.

  18. Implementing clinical guidelines in psychiatry: a qualitative study of perceived facilitators and barriers

    Directory of Open Access Journals (Sweden)

    Wistedt Anna

    2010-01-01

    Full Text Available Abstract Background Translating scientific evidence into daily practice is complex. Clinical guidelines can improve health care delivery, but there are a number of challenges in guideline adoption and implementation. Factors influencing the effective implementation of guidelines remain poorly understood. Understanding of barriers and facilitators is important for development of effective implementation strategies. The aim of this study was to determine perceived facilitators and barriers to guideline implementation and clinical compliance to guidelines for depression in psychiatric care. Methods This qualitative study was conducted at two psychiatric clinics in Stockholm, Sweden. The implementation activities at one of the clinics included local implementation teams, seminars, regular feedback and academic detailing. The other clinic served as a control and only received guidelines by post. Data were collected from three focus groups and 28 individual, semi-structured interviews. Content analysis was used to identify themes emerging from the interview data. Results The identified barriers to, and facilitators of, the implementation of guidelines could be classified into three major categories: (1 organizational resources, (2 health care professionals' individual characteristics and (3 perception of guidelines and implementation strategies. The practitioners in the implementation team and at control clinics differed in three main areas: (1 concerns about control over professional practice, (2 beliefs about evidence-based practice and (3 suspicions about financial motives for guideline introduction. Conclusions Identifying the barriers to, and facilitators of, the adoption of recommendations is an important way of achieving efficient implementation strategies. The findings of this study suggest that the adoption of guidelines may be improved if local health professionals actively participate in an ongoing implementation process and identify

  19. Physician variation in perceived barriers to personal health

    Directory of Open Access Journals (Sweden)

    Rubenfire M

    2012-01-01

    Full Text Available Adam RB Kosteva1, Brian M Salata1, Sangeetha Mahadevan Krishnan2, Michael Howe3, Alissa Weber3, Melvyn Rubenfire2,3, Elizabeth A Jackson2,31Michigan Cardiovascular Research and Reporting Program, 2Division of Cardiovascular Medicine, 3Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USAObjective: Physicians’ personal health habits are associated with their counseling habits regarding physical activity. We sought to examine physicians’ own barriers to a healthy lifestyle by level of training and gender.Methods: Physicians at a major teaching hospital were surveyed regarding their lifestyle habits and barriers to healthy habits. The frequency of reported barriers was examined by years in practice (trainees vs staff physicians and gender.Results: 183 total responses were received. Over 20% of respondents were overweight. Work schedule was cited as the greatest barrier to regular exercise in 70.5% of respondents. Trainees were more likely to cite time constraints or cost as a barrier to a healthy diet compared to staff physicians. Staff physicians were more likely to report the time to prepare healthy foods as a barrier. For both trainees and staff physicians, time was a barrier to regular exercise. For trainees work schedule was a barrier, while both work schedule and family commitments were top barriers cited by staff physicians. Women were more likely to report family commitments as a barrier than men. Respondents suggested healthier options in vending machines and the hospital cafeteria, healthy recipes, and time and/or facilities for exercise at work as options to help overcome these barriers.Conclusion: Work schedules and family commitments are frequently reported by providers as barriers to healthy lifestyle. Efforts to reduce such barriers may lead to improved health habits among providers.Keywords: diet, exercise, counseling, prevention, gender, barriers, health

  20. Perceived exercise benefits and barriers of non-exercising female university students in the United Kingdom.

    Science.gov (United States)

    Lovell, Geoff P; El Ansari, Walid; Parker, John K

    2010-03-01

    Many individuals do not engage in sufficient physical activity due to low perceived benefits and high perceived barriers to exercise. Given the increasing incidence of obesity and obesity related health disorders, this topic requires further exploration. We used the Exercise Benefits/Barriers Scale to assess perceived benefit and barrier intensities to exercise in 200 non-exercising female university students (mean age 19.3 years, SD = 1.06) in the UK. Although our participants were selected because they self reported themselves to be non-exercising, however they reported significantly higher perceived benefits from exercise than perceived barriers to exercise [t(199) = 6.18, p exercise was physical performance followed by the benefits of psychological outlook, preventive health, life enhancement, and then social interaction. Physical performance was rated significantly higher than all other benefits. Psychological outlook and preventive health were not rated significantly different, although both were significantly higher than life enhancement and social interaction. Life enhancement was also rated significantly higher than social interaction. The greatest perceived barrier to exercise was physical exertion, which was rated significantly higher than time expenditure, exercise milieu, and family discouragement barriers. Implications from this investigation for the design of physical activity programmes include the importance, for females, of a perception of high benefit/barrier ratio that could be conducive to participation in exercise. Applied interventions need to assist female students to 'disengage' from or overcome any perceived 'unpleasantness' of physical exertion during physical activity (decrease their perceived barriers), and to further highlight the multiple health and other benefits of regular exercising (increase their perceived benefits).

  1. Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa

    Directory of Open Access Journals (Sweden)

    W Barnett

    2013-11-01

    Full Text Available Background. The recent scale-up of antiretroviral therapy (ART coverage in resource-limited settings has greatly improved access to treatment. However, increasing numbers of patients are failing first- and second-line ART. Objective. To examine factors affecting adherence to second-line ART from the perspective of clinic staff and patients, assessing both individual and structural perceived barriers. Methods. Research was conducted at a large primary care tuberculosis (TB/HIV clinic in Khayelitsha, a peri-urban township in Cape Town, South Africa. Participants were drawn from a Médecins Sans Frontières-run programme to support patients failing second-line ART. A qualitative research approach was used, combining multiple methodologies including key informant interviews with staff (n=11, in-depth interviews with patients (n=10 and a Photovoice workshop (n=11. Responses and photographs were coded by content; data were transformed into variables and analysed accordingly. Results. Staff identified drinking, non-disclosure, not using condoms and pill fatigue as barriers to ART adherence, while patients identified side-effects, not using condoms and a lack of understanding concerning medication timing. With respect to service delivery, staff identified a need for continued counselling and educational support following ART initiation. Patients were concerned about missing medical records and poor staff attitudes in the clinic. Conclusion. These findings identify discrepancies between provider and patient perceptions of barriers to, and facilitators of adherence, as well as of service delivery solutions. This highlights the need for on-going counselling and education following ART initiation, improved quality of counselling, and improved methods to identify and address specific barriers concerning medication adherence.

  2. Interest, views and perceived barriers to bariatric surgery in patients with morbid obesity.

    Science.gov (United States)

    Wharton, S; Serodio, K J; Kuk, J L; Sivapalan, N; Craik, A; Aarts, M-A

    2016-04-01

    The objective of the study was to assess the interest, views and patient-perceived barriers to bariatric surgery among surgery-eligible patients. Surveys were completed at a weight management clinic and local hospital in Ontario, Canada. Patients were ≥18 years of age with a body mass index (BMI) >40 kg m(-2) or BMI > 35 kg m(-2) with ≥1 comorbidity. The sample included 105 participants, 73.3% female, with a mean BMI of 46.6 ± 7.1 kg m(-2) . Only 33.3% of participants were interested in surgery; 50.5% of participants were not interested and 16.2% had mixed feelings. Participants identified risks (69.5%) and side effects (57.1%) as significant surgical barriers. Interested participants were more likely to perceive themselves as obese, were unhappy with their current weight loss method and were less likely to fear surgery (P bariatric surgery, the majority of qualified patients are not interested in surgery mainly due to the perceived risk of surgery in general and satisfaction with current non-surgical weight loss efforts. The self-perception of obesity, as opposed to medical comorbidities, may be a stronger driver of the decision to have bariatric surgery. It is unclear if patients are aware of the effectiveness of bariatric surgery to help improve comorbidities or if bariatric surgery is perceived as being more cosmetic in nature. © 2016 World Obesity.

  3. Identifying and responding to barriers impacting women educators ...

    African Journals Online (AJOL)

    Drawing on these reflections, this article explores the notion of academic citizenship as it relates to the status and practice of these five educators who teach at various institutions of higher education in Southern Africa. The article is divided into two parts. a) Part 1 identifies the barriers impacting the participants. It draws on ...

  4. Iranian entrepreneur nurses' perceived barriers to entrepreneurship: A qualitative study

    Directory of Open Access Journals (Sweden)

    Simin Jahani

    2016-01-01

    Conclusions: The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.

  5. Perceived barriers to physical activity among Nigerian stroke survivors

    African Journals Online (AJOL)

    The four most reported common barriers among stroke survivors were access to exercise facilities (95.0 %), being embarrassed to exercise (94.2%), economic cost demands of exercise (94.2 %) and notion that people in exercise clothes look funny (94.2%) respectively. There were no significant differences found in barriers ...

  6. Perceived barriers to quitting smoking among alcohol dependent patients in treatment.

    Science.gov (United States)

    Asher, Marilyn K; Martin, Rosemarie A; Rohsenow, Damaris J; MacKinnon, Selene Varney; Traficante, Regina; Monti, Peter M

    2003-03-01

    Little is known about the perceived barriers to quitting smoking among alcohol abusers. In addition to the usual barriers perceived by smokers, alcohol dependent smokers may have a few barriers unique to their addictive lifestyle. The Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) was administered to 96 alcohol dependent smokers in residential substance abuse treatment. The BQS-SAT is designed to assess perceived barriers to quitting smoking among alcohol abusers using eleven true-false items. One open-ended item was included to gather information about potential additional barriers. The majority of respondents reported withdrawal-related barriers such as expecting to feel irritable, anxious, restless, and about half expected intolerable urges to smoke if they were to quit smoking, as most smokers do. However, concerns about effects on sobriety and needing cigarettes to cope with feeling down were also endorsed by almost half of the patients. Total number of perceived barriers was significantly related to smoking history, expected effects from smoking, and smoking temptation but was not associated with severity of alcohol use or dependence on admission. Providing corrective feedback about these barriers could be useful when addressing smoking with patients who have alcohol abuse or dependence.

  7. Muslim Scholars' Knowledge, Attitudes and Perceived Barriers Towards Polio Immunization in Pakistan.

    Science.gov (United States)

    Khan, Muhammad Umair; Ahmad, Akram; Salman, Saad; Ayub, Maria; Aqeel, Talieha; Haq, Noman-Ul; Saleem, Fahad; Khan, Muhammad Ubaid

    2017-04-01

    Pakistan is one of the two countries where polio remains endemic. Among multiple reasons of polio prevalence, false religious beliefs are accounted as major barriers towards polio immunization in Pakistan. Within this context, religious scholars are now engaged in polio immunization campaigns to dismantle the myths and battle the resurgence of polio in Pakistan. The objective of this study was to assess knowledge, attitudes and perceived barriers of Muslim scholars towards polio immunization in Pakistan. A descriptive, cross-sectional survey of Muslim scholars was conducted in Quetta and Peshawar divisions of Pakistan. From October to December 2015, a convenience sample of 770 Muslim scholars was recruited from the local mosques and religious institutions to participate in this study. Knowledge, attitudes, and perceived barriers were assessed by using self-administered, anonymous and pretested questionnaire. Descriptive and regression analyses were used to express the results with p polio with a mean score of 7.16 ± 2.12 (based on 14 questions). Knowledge gaps were identified about the transmission (32.6 %) and consequences of poliovirus (39.9 %). Overall, 527 (68.4 %) participants showed positive attitudes towards polio immunization with a mean attitude score of 27.35 ± 2.68 (based on nine statements). The majority of participants agreed on the need of depoliticizing polio immunization issues (87.1 %), while reservations were noted about their willingness to participate in future polio immunization programs (44.6 %). Security (75.8 %) and vaccine management issues (64 %) were reported by the participants as the major barriers towards polio immunization in Pakistan. The findings showed poor knowledge of Muslim scholars towards polio; however, their attitudes were positive towards polio immunization. More studies are required to assess the knowledge and attitudes of Muslim scholars at the national level to validate the findings of this study.

  8. Qatar pharmacists' understanding, attitudes, practice and perceived barriers related to providing pharmaceutical care.

    Science.gov (United States)

    El Hajj, Maguy Saffouh; Al-Saeed, Hassna Sohil; Khaja, Maryam

    2016-04-01

    Pharmaceutical care (PC) is the philosophy of practice that includes identifying and resolving medication therapy problems to improve patient outcomes. The study objectives were to examine the extent of pharmaceutical care practice and the barriers to pharmaceutical care provision as perceived by Qatar pharmacists and to assess their level of understanding of pharmaceutical care and their attitudes about pharmaceutical care provision. Setting Qatar pharmacies. A cross sectional survey of all pharmacists in Qatar was made. Consenting pharmacists were given the option to complete the survey either online using an online software or as paper by fax or by hand. 1. Extent of pharmaceutical care practice in Qatar. 2. Barriers to pharmaceutical care provision in Qatar. 3. Qatar pharmacists' level of understanding of pharmaceutical care. 4. Qatar pharmacists' attitudes toward pharmaceutical care provision. Over 8 weeks, 274 surveys were collected (34 % response rate). More than 80 % of respondents had correct understanding of the aim of PC and of the pharmacist role in PC. However, only 47 % recognized the patient role in PC and only 35 % were aware of the differences between clinical pharmacy and PC. Yet, more than 80 % believed that they could be advocates when it comes to patients' medications and health matters. Concerning their practice, respondents reported spending little time on PC activities. Offering feedback to the physician about the patient progress was always or most of the time performed by 21 % of respondents. The top perceived barriers for PC provision included inconvenient access to patient medical information (78 %) and lack of staff and time (77 and 74 % respectively). Although PC is not incorporated into pharmacy practice, Qatar pharmacists showed positive attitudes toward PC provision. Further work should focus on improving their PC understanding and on overcoming all barriers.

  9. Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

    Science.gov (United States)

    Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

    Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and

  10. Situated influences on perceived barriers to health behavior change: cultural identity and context in Kazakhstan.

    Science.gov (United States)

    Craig, Brett J; Kapysheva, Aizhan

    2017-02-23

    The objective of this study was to identify the perceived barriers to lifestyle changes citizens of Kazakhstan suffering from cardiovascular disease and type II diabetes were experiencing. 14 focus groups were conducted with patients across two regions of Kazakhstan. Topics of discussion included accessing medical care, communicating with health care providers, and following doctor's recommendations. The text of the discussions were analysed for trends and themes across the different groups. Patients identified a series of external and internal barriers to lifestyle changes, including the environment, a dependency on health care providers, a health care system they feel powerless to change, and a low level of self-efficacy. Most notable, however, was a constructed ethnic identity whose boundaries included unhealthy behaviors, specifically diet and untimely access of health care. This identity both was blamed as a cause for the patient's condition and seen as an unchangeable barrier to health behavior change. Current provider efforts to encourage lifestyle changes to manage disease are not taking into account the broader issue of ethnic identity, namely negotiating a fragile and previously suppressed identity that mostly exists alongside other ethnicities. Therefore, maintaining distinctiveness may be a greater need than modifying health behaviors. Efforts towards healthier lifestyles for the public must include not only messages regarding health but also constructions of a Kazakh identity that allows for such lifestyles to fit within the identity framework.

  11. Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study.

    Science.gov (United States)

    Shields, Nora; Synnot, Anneliese

    2016-01-19

    Children with disability engage in less physical activity compared to their typically developing peers. Our aim was to explore the barriers and facilitators to participation in physical activity for this group. Ten focus groups, involving 63 participants (23 children with disability, 20 parents of children with disability and 20 sport and recreation staff), were held to explore factors perceived as barriers and facilitators to participation in physical activity by children with disability. Data were analysed thematically by two researchers. Four themes were identified: (1) similarities and differences, (2) people make the difference, (3) one size does not fit all, and (4) communication and connections. Key facilitators identified were the need for inclusive pathways that encourage ongoing participation as children grow or as their skills develop, and for better partnerships between key stakeholders from the disability, sport, education and government sectors. Children with disabilities' need for the early attainment of motor and social skills and the integral role of their families in supporting them were considered to influence their participation in physical activity. Children with disability were thought to face additional barriers to participation compared to children with typical development including a lack of instructor skills and unwillingness to be inclusive, negative societal attitudes towards disability, and a lack of local opportunities. The perspectives gathered in this study are relevant to the many stakeholders involved in the design and implementation of effective interventions, strategies and policies to promote participation in physical activity for children with disability. We outline ten strategies for facilitating participation.

  12. A qualitative case study to identify possible barriers that limit effective elementary science education

    Science.gov (United States)

    Foster, Donald Carey

    The purpose of this case study was to identify barriers that limit the effectiveness of elementary teachers in the teaching of science. It is of the utmost urgency that barriers be first identified, so that possible solutions can be explored to bring about the improvement of elementary science education. This urgency has been imposed by the scheduled national testing of students in science by 2007, as mandated by the No Child Left Behind Act of 2001. Using qualitative case study methods, the researcher conducted interviews with 8 elementary teachers from two schools within one school district who taught 3rd, 4th, and 5th grade. These interviews were designed to gain insight into barriers these elementary teachers perceived as factors limiting their effectiveness in teaching science and preparing students for high-stakes testing. Barriers in the areas of teacher background, typical teaching day, curriculum, inservices, and legislative influences were explored. This study concluded that the barriers explored do have a substantial negative affect on the teaching and learning of science in the elementary grades. Specifically, the barriers revealed in this study include the limited science background of elementary teachers, inadequate class time devoted to science, non-comprehensive curriculum, ineffective or lack of inservice training, and pressures from legislated mandates. But it is also clear that these barriers are so intertwined that one cannot remove these barriers one at a time. It will take a collective effort from all involved, including legislators, administrators, teachers, parents, and students, to alleviate these barriers and discover effective solutions to improve elementary science education.

  13. A survey to identify barriers of implementing an antibiotic checklist.

    Science.gov (United States)

    van Daalen, F V; Geerlings, S E; Prins, J M; Hulscher, M E J L

    2016-04-01

    A checklist is an effective implementation tool, but addressing barriers that might impact on the effectiveness of its use is crucial. In this paper, we explore barriers to the uptake of an antibiotic checklist that aims to improve antibiotic use in daily hospital care. We performed an online questionnaire survey among medical specialists and residents with various professional backgrounds from nine Dutch hospitals. The questionnaire consisted of 23 statements on anticipated barriers hindering the uptake of the checklist. Furthermore, it gave the possibility to add comments. We included 219 completed questionnaires (122 medical specialists and 97 residents) in our descriptive analysis. The top six anticipated barriers included: (1) lack of expectation of improvement of antibiotic use, (2) lack of expected patients' satisfaction by checklist use, (3) lack of feasibility of the checklist, (4) negative previous experiences with other checklists, (5) the complexity of the antibiotic checklist and (6) lack of nurses' expectation of checklist use. Remarkably, 553 comments were made, mostly (436) about the content of the checklist. These insights can be used to improve the specific content of the checklist and to develop an implementation strategy that addresses the identified barriers.

  14. Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors.

    Science.gov (United States)

    Supper, I; Catala, O; Lustman, M; Chemla, C; Bourgueil, Y; Letrilliart, L

    2015-12-01

    The epidemiological transition calls for redefining the roles of the various professionals involved in primary health care towards greater collaboration. We aimed to identify facilitators of, and barriers to, interprofessional collaboration in primary health care as perceived by the actors involved, other than nurses. Systematic review using synthetic thematic analysis of qualitative research. Articles were retrieved from Medline, Web of science, Psychinfo and The Cochrane library up to July 2013. Quality and relevance of the studies were assessed according to the Dixon-Woods criteria. The following stakeholders were targeted: general practitioners, pharmacists, mental health workers, midwives, physiotherapists, social workers and receptionists. Forty-four articles were included. The principal facilitator of interprofessional collaboration in primary care was the different actors' common interest in collaboration, perceiving opportunities to improve quality of care and to develop new professional fields. The main barriers were the challenges of definition and awareness of one another's roles and competences, shared information, confidentiality and responsibility, team building and interprofessional training, long-term funding and joint monitoring. Interprofessional organization and training based on appropriate models should support collaboration development. The active participation of the patient is required to go beyond professional boundaries and hierarchies. Multidisciplinary research projects are recommended. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Assessment of primary care services and perceived barriers to care in persons with disabilities.

    Science.gov (United States)

    Harrington, Amanda L; Hirsch, Mark A; Hammond, Flora M; Norton, H James; Bockenek, William L

    2009-10-01

    To determine what percentage of persons with disabilities have a primary care provider, participate in routine screening and health maintenance examinations, and identify perceived physical or physician barriers to receiving care. A total of 344 surveys, consisting of 66 questions, were collected from adults with disabilities receiving care at an outpatient rehabilitation clinic. A total of 89.5% (95% CI 86.3%-92.8%) of participants reported having a primary care physician. Younger persons (P brain injury (P use, and safety with relationships at home ranged from 26.6% to 37.5% compared with screening for depression, diet, exercise, and smoking (64.5%-70%). Completion rates of age- and gender-appropriate health maintenance examinations ranged from 42.4% to 90%. A total of 2.67% of participants reported problems with physical access at their physician's office, and 36.4% (95% CI 30.8%-42.1%) of participants reported having to teach their primary care physician about their disability. Most persons with disabilities have a primary care physician. In general, completion rates for routine screening and health maintenance examinations were high. Perceived deficits in primary care physicians' knowledge of disability issues seem more prevalent than physical barriers to care.

  16. Perceived and real barriers for men entering nursing: implications for gender diversity.

    Science.gov (United States)

    Roth, Jay E; Coleman, Christopher Lance

    2008-01-01

    The objective of this literature review is to describe the perceived or real barriers to men seeking a career in nursing, and to suggest strategies for ameliorating barriers. A literature search exploring barriers existing for men pursuing nursing was conducted. Although the literature underscored the structure of nursing has changed substantially over the last fifty years, these changes have not always provoked a change in the public's perception of nursing. Barriers for men entering nursing still exist. Implications for gender diversity in nursing are discussed. Strategies for decreasing barriers experienced by males entering nursing are warranted.

  17. Acculturation, Enculturation, Gender, and College Environment on Perceived Career Barriers among Latino/A College Students

    Science.gov (United States)

    Holloway-Friesen, Holly

    2018-01-01

    This study examined the role culture and college environment had on the perception of ethnic and gender career barriers of 138 Latino/a college students. Specifically, background characteristics (i.e., parent education, immigration status, and sex), acculturation, enculturation, and college environment on perceived ethnic/gender barriers were…

  18. The Development and Evaluation of a Measure Assessing School Nurses' Perceived Barriers to Addressing Pediatric Obesity

    Science.gov (United States)

    Wu, Yelena P.; Steele, Ric G.

    2011-01-01

    School nurses represent an important resource for addressing pediatric obesity and weight-related health. However, school nurses perceive numerous barriers that prevent them from addressing the weight-related health of students. The current study developed and tested a new, comprehensive measure of nurses' perceptions of 10 types of barriers to…

  19. Promoting the Utilization of Science in Healthcare (PUSH) Project: A Description of the Perceived Barriers and Facilitators to Research Utilization Among Pediatric Nurses.

    Science.gov (United States)

    Cline, Genieveve J; Burger, Kristina J; Amankwah, Ernest K; Goldenberg, Neil A; Ghazarian, Sharon R

    The purpose of this descriptive study was to identify the perceived barriers and facilitators to research utilization and evidence-based practice among nurses employed in a tertiary care children's hospital. Results revealed seven facilitator and six barrier themes that contribute to the understanding of the problem. The themes can be utilized by nursing professional development specialists to customize organizational infrastructure and educational programs.

  20. A qualitative theory guided analysis of stroke survivors' perceived barriers and facilitators to physical activity.

    Science.gov (United States)

    Nicholson, Sarah L; Donaghy, Marie; Johnston, Marie; Sniehotta, Falko F; van Wijck, Frederike; Johnston, Derek; Greig, Carolyn; McMurdo, Marion E T; Mead, Gillian

    2014-01-01

    After stroke, physical activity and physical fitness levels are low, impacting on health, activity and participation. It is unclear how best to support stroke survivors to increase physical activity. Little is known about the barriers and facilitators to physical activity after stroke. Thus, our aim was to explore stroke survivors' perceived barriers and facilitators to physical activity. Semi-structured interviews with 13 ambulatory stroke survivors exploring perceived barriers and facilitators to physical activity post stroke were conducted in participants' homes, audio-recorded and transcribed verbatim. The Theoretical Domains Framework (TDF) informed content analysis of the interview transcripts. Data saturation was reached after interviews with 13 participants (median age of 76 years (inter-quartile range (IQR) = 69-83 years). The median time since stroke was 345 d (IQR = 316-366 d). The most commonly reported TDF domains were "beliefs about capabilities", "environmental context and resources" and "social influence". The most commonly reported perceived motivators were: social interaction, beliefs of benefits of exercise, high self-efficacy and the necessity of routine behaviours. The most commonly reported perceived barriers were: lack of professional support on discharge from hospital and follow-up, transport issues to structured classes/interventions, lack of control and negative affect. Stroke survivors perceive several different barriers and facilitators to physical activity. Stroke services need to address barriers to physical activity and to build on facilitators to promote physical activity after stroke. Physical activity post stroke can improve physical fitness and function, yet physical activity remains low among stroke survivors. Understanding stroke survivors' perceived barriers and facilitators to physical activity is essential to develop targeted interventions to increase physical activity. Beliefs about capabilities, environmental

  1. Identifying barriers to glycemic control in patients with type 2 diabetes after completion of an accredited education program.

    Science.gov (United States)

    Gildea, Chris M; Lantaff, Wendy M; Olenik, Nicole L

    The objective of this study was to identify patient-perceived barriers to achieving A1C targets after receiving instruction in an accredited diabetes education program. Qualitative research using semistructured interviews and thematic analyses. One pharmacist-run diabetes center located within an independent community pharmacy in a suburban region of southern Indiana. A total of 17 participants between the ages of 41-78 were interviewed in March and April 2016. Not applicable. Patient-perceived barriers to attaining glycemic control after completion of a pharmacist-taught diabetes self-management education (DSME) program accredited by the American Association of Diabetes Educators. Participants reported a variety of perceived barriers to glycemic control subsequent to the receipt of structured education. Seven major themes emerged: 1) health care provider factors; 2) self-identified indiscretions; 3) psychological barriers and poor social support; 4) knowledge deficits; 5) personal injury or adverse drug events; 6) time constraints and competing life demands; and 7) financial constraints. Participants reported a variety of perceived barriers to achieving A1C targets after completing DSME. Incorporation of solutions and coping mechanisms to these barriers into diabetes education programs may help patients attain glycemic control. Other factors may require individualized attention outside of DSME in follow-up episodes of diabetes care. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  2. Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

    Science.gov (United States)

    Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie

    2016-12-01

    Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Physical activity in hypertrophic cardiomyopathy: prevalence of inactivity and perceived barriers

    Science.gov (United States)

    Sweeting, Joanna; Ingles, Jodie; Timperio, Anna; Patterson, Jillian; Ball, Kylie; Semsarian, Christopher

    2016-01-01

    Objectives This study aimed to determine the prevalence of physical inactivity and perceived barriers to physical activity among individuals with hypertrophic cardiomyopathy (HCM), and to determine potential demographic, clinical and health-related factors influencing likelihood of meeting physical activity guidelines. Methods This was a cross-sectional study of consecutive patients (n=198) with HCM attending a specialist HCM centre from July 2014 to November 2015. The primary outcome measure was physical activity (minutes per day), as measured by self-report (International Physical Activity Questionnaire (IPAQ)) and objective means (ActiGraph accelerometer). For both, participants were classified as meeting guidelines if they did at least 150 min per week of physical activity. Quality of life (Short Form-36 V.2, SF-36v2), barriers to exercise and clinical–demographic data were also collected. Results In total, 54.8% of participants did not meet physical activity recommendations based on IPAQ, and 12.7% did not meet guidelines based on accelerometer data. The most commonly identified barriers to exercise were ‘pain interferes with my exercise’ (33%) and ‘I have an injury/disability that stops me’ (29%). Independent factors associated with meeting guidelines included older age (OR 0.66, 95% CI 0.51 to 0.85, p=0.002), higher education level (OR 2.31, 95% CI 1.08 to 4.93, p=0.03), better physical quality of life (OR 1.05, 95% CI 1.0 to 1.09, p=0.05) and more reported barriers (OR 0.71, 95% CI 0.56 to 0.91, p=0.01). Conclusions More than half of the patients with HCM did not meet minimum physical activity recommendations. Several barriers to exercise among individuals with HCM exist, and provide the basis for targeted interventions to promote physical activity and improve overall health in patients with HCM. PMID:27547438

  4. A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.

    Science.gov (United States)

    George, Siân; Daniels, Katy; Fioratou, Evridiki

    2018-04-03

    Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The "Health Care Access Barriers" (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre's family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB's themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals' attitudes and discrimination and the vulnerable population's lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a

  5. The role of perceived barriers and objectively measured physical activity in adults aged 65-100.

    Science.gov (United States)

    Gellert, Paul; Witham, Miles D; Crombie, Iain K; Donnan, Peter T; McMurdo, Marion E T; Sniehotta, Falko F

    2015-05-01

    to test the predictive utility of perceived barriers to objectively measured physical activity levels in a stratified sample of older adults when accounting for social-cognitive determinants proposed by the Theory of Planned Behaviour (TPB), and economic and demographic factors. data were analysed from the Physical Activity Cohort Scotland survey, a representative and stratified (65-80 and 80+ years; deprived and affluent) sample of 584 community-dwelling older people, resident in Tayside, Scotland. Physical activity was measured objectively by accelerometry. perceived barriers clustered around the areas of poor health, lack of interest, lack of safety and lack of access. Perceived poor health and lack of interest, but not lack of access or concerns about personal safety, predicted physical activity after controlling for demographic, economic and TPB variables. perceived person-related barriers (poor health and lack of interest) seem to be more strongly associated with physical activity levels than perceived environmental barriers (safety and access) in a large sample of older adults. Perceived barriers are modifiable and may be a target for future interventions. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Perceived barriers to access available health services among men ...

    African Journals Online (AJOL)

    Background: Men who have sex with men (MSM) continue to be highly affected with the HIV infection worldwide. Studies have shown that the organization of healthcare systems and how the MSM perceive it play a major role in granting or denying them access to healthcare services. Little is known in Tanzania regarding ...

  7. Perceived barriers to preventive dental care among Libyan dentists

    African Journals Online (AJOL)

    2014-04-23

    Apr 23, 2014 ... Settings and design: A cross-sectional, questionnaire-based survey was .... Table 3 reports comparison of barriers by to preventive .... and customer needs, and have less control at work, which ... needs and contributes to job satisfaction (21). .... received any funding or benefits from industry or else- where to ...

  8. Young adult males' motivators and perceived barriers towards eating healthily and being active: a qualitative study.

    Science.gov (United States)

    Ashton, Lee M; Hutchesson, Melinda J; Rollo, Megan E; Morgan, Philip J; Thompson, Debbe I; Collins, Clare E

    2015-07-15

    There is a lack of understanding of young men's perspectives in obesity-related research. This study aims to: (1) identify young men's perceived motivators and barriers in adopting healthy eating and physical activity behaviours, and (2) explore any differences in responses by weight status categories. Ten focus groups (32-63 minutes; 3-9 participants per group) were conducted with 61 young men (BMI: 25.3 ± 5.1 kg/m(2), aged: 18-25 years) from the Hunter region, New South Wales, Australia. There were 35 (57.4 %) healthy weight men and 26 (42.6 %) overweight/ obese men. Three groups were with healthy weight participants, three with overweight/obese participants and four with mixed-BMI participants. Sessions were audio-recorded and transcribed. Data analysis was conducted by an independent researcher using NVIVO10. Motivators for healthy eating grouped into four themes: physical health (e.g. to live longer), sport or performance (e.g. to support their sporting goals), physical appearance (e.g. sexual attractiveness) and social influences (e.g. societal expectations to eat healthy), while key motivators for physical activity were: physical appearance (e.g. sexual attractiveness), social inclusion (e.g. making friends), physical and mental health (e.g. relieve stress) and improvements for sport or performance (e.g. improve fitness). Themes for key barriers to eating healthy were: intrinsic (e.g. perceived effort to adopt healthy eating), logistic (e.g. cost), and social factors (e.g. peer influence), while busy lifestyles (e.g. lack of time), logistic (e.g. cost), cognitive-emotional (e.g. feelings of inferiority) and social factors (e.g. family upbringing) were key barriers for physical activity. Responses varied little by BMI status. This research emphasises the importance of consulting young men when developing healthy lifestyle programs that aim to promote healthy eating and physical activity in young men. Future research is needed to identify the most

  9. Jordanian dialysis patients' perceived exercise benefits and barriers: a correlation study.

    Science.gov (United States)

    Darawad, Muhammad W; Khalil, Amani A

    2013-01-01

    To investigate Jordanian end-stage renal disease (ESRD)patients' perceived exercise benefits and barriers, and their correlation with patients' demographic variables and dialysis measures. A descriptive correlational study was conducted using cross-sectional survey, using a convenience sample of 190 ESRD dialyzed patients who were recruited from eight hospitals in Jordan. Participants significantly perceived exercise benefits (M= 2.88/4, SD± .67) higher than barriers (M= 2.66, SD± .62). The most frequent perceived exercise benefits were preventing muscular atrophy and improving mood, whereas tiredness and lower-extremity fatigue were the most frequent exercise barriers. Finally, acceptable values of Cronbach's Alpha were revealed for perceived exercise subscale, barriers subscale, and total scale (α= .88, .81, and .70, respectively). Participants focused more on exercise benefits than barriers, and on direct exercise benefits and barriers than the indirect. The results of this study have important implications for the efforts that aim at improving ESRD patients' exercise behaviors. © 2013 Association of Rehabilitation Nurses.

  10. Regular School Teachers’ Concerns and Perceived Barriers to Implement Inclusive Education in New Delhi, India

    Directory of Open Access Journals (Sweden)

    Nisha Bhatnagar

    2014-07-01

    Full Text Available Since the passage of The Persons with Disabilities (PWD Act in 1995 and subsequent implementation of various policies and programs by the Indian government to enhance the participation of students with disabilities in regular schools, there has been a steady growth of inclusive education. Such initiatives, however, have placed new demands on schools, especially on teachers who have the major responsibility for implementing inclusion at the classroom level. Literature from other countries indicates that for inclusion to be successful, it is essential that classroom teachers’ concerns about implementing such programs be identified and systematically addressed. Unfortunately, there is a paucity of research about teacher concerns regarding inclusive education in India. This study was undertaken to identify the concerns and perceived barriers of regular school teachers in Delhi, India about the inclusion of students with disabilities. Respondents were secondary school teachers working in schools in Delhi that were involved in teaching special needs children. Two focus group interviews and 20 individual semi-structured interviews were conducted to collect data from the participants. The flexible qualitative analysis program QRS NVivo was utilized for data analysis. Three concerns and eleven barrier themes emerged

  11. Perceived barriers to implementing screening and brief intervention for alcohol consumption by adolescents in hospital emergency department in Spain.

    Science.gov (United States)

    Falcón, María; Navarro-Zaragoza, Javier; García-Rodríguez, Rosa María; Nova-López, Daniel; González-Navarro, María Dulce; Mercadal, María; García-Algar, Oscar; Luna Ruiz-Cabello, Aurelio

    2017-07-14

    Screening for alcohol consumption in adolescents is widely justified in the health care field because of the particular vulnerability of this population, which starts drinking alcohol at a very early age and frequently consumes high levels of the same. Hospital emergency departments (ED) could be a good venue to manage early detection and carry out brief intervention (BI) programmes. The aim of this study was to identify perceived barriers for medical staff of three hospitals in Spain to successfully implement a protocol for alcohol detection and BI for minors in the ED. Exploratory qualitative analysis using focus groups with semi-structured, flexible and open-ended questions to explore beliefs, attitudes, and barriers perceived by professionals to screening alcohol consumption and implementing BI in adolescents attended at the ED. The main perceived barriers by health professionals were lack of time, work overload, mistrust, lack of validated and simple screening tools, lack of training/awareness and legal concerns about informed consent and confidentiality. Barriers to screening and intervention in ED are similar to those described previously. It is necessary to improve organization of time allocated for medical consultations, avoid limiting ED resources, motivate staff and provide appropriate training.

  12. Sustainability and EMAS: Impact of Motivations and Barriers on the Perceived Benefits from the Adoption of Standards

    Directory of Open Access Journals (Sweden)

    José Álvarez-García

    2016-10-01

    Full Text Available The objective of this paper is to analyze the influence of the sources of motivation that lead companies to adopt a global standard of the Environmental Management System and the barriers found in the process, on the perceived benefits of the implementation and certification of the standard. To achieve the objectives proposed, primary data were collected using a survey questionnaire that was administered to a representative sample of companies certified as EMAS-Eco-Management and Audit Scheme of the Autonomous Community of Galicia (sample of 114 of the 255 companies. An extensive review of the academic literature published on ISO 14001 and EMAS about motivations, barriers and benefits was carried out in order to establish the working hypotheses that are analyzed using structural equation models as the statistical tool. The findings of this study show that the motivations positively affect the benefits derived from implementation, noting that the internal motivations (related to efficiency; improved performance, productivity and profitability have a stronger influence on the benefits than the external motivations (related to stakeholders’ social pressure. In addition, the motivations also affect the perceived barriers, and these affect the benefits negatively, i.e., the higher the barriers encountered, the lower the perceived benefits. The results obtained allow us to identify important implications for managers, which will help them establish management strategies in the field of environmental management.

  13. Barriers to the implementation of research perceived by nurses from Osakidetza.

    Science.gov (United States)

    Cidoncha-Moreno, M Ángeles; Ruíz de Alegría-Fernandez de Retana, Begoña

    To understand the barriers to implementing nursing research findings into practice, as perceived by the nurses working in Osakidetza and to analyze if the workplace factor and time worked affect the perception of these barriers. Cross-sectional study. BARRIERS Scale questionnaire was given to a representative sample of 1,572 Basque Health Service nurses, stratified and randomized, according to scope of work and job responsibility (response rate: 43.76%). According to the research results, the first important barrier was "insufficient time on the job to implement new ideas". Nurses have perceived the organizational factor as the most important barrier in their practice. Nurses in "Special hospital departments" perceived more barriers in the "quality of research" factor than those working in "Primary Care". Years of service showed a slight influence. The nurses stated that external factors related to the organization principally interfered in implementing results into clinical practice. They placed lack of critical reading training second. Working environment and seniority mark differences in the perception of barriers. This study may help to develop strategies for planning training programs to facilitate the use of research in clinical practice, in order to provide quality care. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. Perceived Barriers to Weight loss Programs for Overweight or Obese Women

    Directory of Open Access Journals (Sweden)

    Nasrin Sharifi

    2013-06-01

    Full Text Available Background: In order to develop appropriate obesity control and treat¬ment strategies, the key point is to understand the barriers perceived by overweight or obese people in trying to follow weight-loss programs. This study examined perceived barriers to weight-loss programs among over¬weight or obese women.Methods: In this descriptive-analytical study, 204 overweight or obese women aged 31.97± 10.62 yr, were selected randomly from the nutritional counseling centers in 2008 in Tabriz, Iran. The mean BMI was 33.83 ±5.75 kg/ m2. A structured questionnaire including questions on barriers to weight-loss diet and physical activity was filled out for each participant by face-to-face interview. Height and weight measured objectively and demo¬graphic details were obtained. Data analysis carried out using mul¬tiple re¬gression and factor analysis.Results: The most important perceived barriers to weight-loss diets were 'situational barriers', stress, depression, and food craving. High educational level was independent determinant of situational barriers (β=0.329, P=0.048. Employee women had a higher mean score on stress and de¬pres¬sion than students and housewives. Lack of time and exercising lonely were the most important items of "External barriers" and Lack of motiva¬tion was the most important item of "internal barriers" to physical activity. Employ¬ment and being student were highly associated with external bar¬riers (β=1.018, P<0.001 and β=0.541, P= 0.002. Moreover, older women who had low educational level, perceived more internal barriers. Conclusion: Weight reducing strategies should take into account the spe¬cific perceived barriers to weight-loss diets faced by overweight or obese women, particularly situational barriers, stress and depression and food craving; and lack of time and lack of motivation as barriers to physical ac¬tivity.

  15. The incremental role of trait emotional intelligence on perceived cervical screening barriers.

    Science.gov (United States)

    Costa, Sebastiano; Barberis, Nadia; Larcan, Rosalba; Cuzzocrea, Francesca

    2018-02-13

    Researchers have become increasingly interested in investigating the role of the psychological aspects related to the perception of cervical screening barriers. This study investigates the influence of trait EI on perceived cervical screening barriers. Furthermore, this study investigates the incremental validity of trait EI beyond the Big Five, as well as emotion regulation in the perceived barrier towards the Pap test as revealed in a sample of 206 Italian women that were undergoing cervical screening. Results have shown that trait EI is negatively related to cervical screening barriers. Furthermore, trait EI can be considered as a strong incremental predictor of a woman's perception of screening over and above the Big Five, emotion regulation, age, sexual intercourse experience and past Pap test. Detailed information on the study findings and future research directions are discussed.

  16. The effect of perceived barriers on social entrepreneurship intention in Malaysian universities: The moderating role of education

    Directory of Open Access Journals (Sweden)

    Masoumeh Shahverdi

    2018-05-01

    Full Text Available This paper attempts to identify barriers of social entrepreneurship intention by the moderating role of education amongst research universities in Malaysia. Entrepreneurship is regarded as the major factor for economic development while social entrepreneurship is considered as the alternative method of solving social problems. Entrepreneurship is not new for Malaysia as is evident from various policies and programs initiated by the government. However, social entrepreneurship is a relatively new phenomenon in Malaysian context that requires much attention. To promote entre-preneurship we need to know the barriers influencing on entrepreneurship to overcome the barriers and promote new policies and measures to create new ventures. The study used Ajzen's Theory of Planned Behavior as a framework to investigate the barriers of social entrepreneurship intention. Data was collected through questionnaire and confirmatory factor analysis was conducted by using AMOS 18. The multilevel sampling design was used with purposive sampling scheme in Malaysian research universities. The findings of this study show that overall students consider the lack of competency, lack of self-confidence and lack of resources were the barriers that affect social entrepreneurial intentions. Results also show that the social entrepreneurial education moderated the relationship between the perceived barriers and social entrepreneurial intentions of the students. This implies that teaching of social entrepreneurial can help to reduce perceived barriers. Also, the pre-sent study premises future directions that a cross country analysis between developing countries and between developed and developing countries can be done to figure out barriers of social entrepreneurship intention amongst students.

  17. How Greek nurses perceive and overcome the barriers in implementing treatment for pressure ulcers: 'against the odds'.

    Science.gov (United States)

    Kaba, E; Kelesi, M; Stavropoulou, A; Moustakas, D; Fasoi, G

    2017-09-01

    Although the occurrence of pressure ulcers (PUs) is now considered as an indicator of poor quality nursing care, questions and concerns remain regarding situations where PUs were unavoidable, irrespective of the care provided. The aim of this study was to explore Greek nurses' perceptions about the barriers involved and to identify the factors that influence care planning in PU treatment. A grounded theory approach was used and semi-structured interviews were conducted with nurses who provided pressure care to clients in a rehabilitation centre in Greece. Data were analysed using the constant comparative method. We interviewed seven nurses. Findings revealed one main category entitled 'anarchy' in delivery of care consisted of the following three subcategories: interdisciplinary conflicts; total trust in traditional knowledge; and devaluation of other's work/role and a core category 'Against the odds': the perceived value of prevention and treatment can overcome the barriers in treating PUs. This study gives an overview of the views and beliefs of nurses about the problems and barriers involved in PU prevention and treatment. The study reveals that although some barriers to good practice may exist, nurses can hold a positive attitude toward PU prevention and treatment, and their perceived value of prevention and treatment may help nurses to overcome the barriers in managing PUs.

  18. The perceived benefits and barriers to exercise participation in persons with multiple sclerosis.

    Science.gov (United States)

    Stroud, Nicole; Minahan, Clare; Sabapathy, Surendran

    2009-01-01

    The purpose of this study was to examine the perceived benefits and barriers to exercise participation in persons with multiple sclerosis (MS). A cross-sectional postal survey comprised of 93 adults with MS was conducted. Participants completed the Exercise Benefits and Barriers Scale (EBBS), Spinal Cord Injury Exercise Self-Efficacy Scale (EXSE), Multiple Sclerosis Impact Scale, Disease Steps Scale and International Physical Activity Questionnaire. Forty-three percent of the participants were classified as exercising individuals (EX group) as compared with non-exercising individuals (non-EX group). Participants in the EX group reported significantly higher scores on the EBBS and EXSE. Items related to physical performance and personal accomplishment were cited as the greatest perceived benefits to exercise participation and those items related to physical exertion as the greatest perceived barriers to both the EX and non-EX groups. When compared with previous studies conducted in the general population, the participants in the present study reported different perceived barriers to exercise participation. Furthermore, awareness of the benefits of physical activity is not sufficient to promote exercise participation in persons with MS. Perceived exercise self-efficacy is shown to play an important role in promoting exercise participation in persons with MS.

  19. Pharmacists' Attitudes and Perceived Barriers to Human Papillomavirus (HPV) Vaccination Services.

    Science.gov (United States)

    Hastings, Tessa J; Hohmann, Lindsey A; McFarland, Stuart J; Teeter, Benjamin S; Westrick, Salisa C

    2017-08-07

    Use of non-traditional settings such as community pharmacies has been suggested to increase human papillomavirus (HPV) vaccination uptake and completion rates. The objectives of this study were to explore HPV vaccination services and strategies employed by pharmacies to increase HPV vaccine uptake, pharmacists' attitudes towards the HPV vaccine, and pharmacists' perceived barriers to providing HPV vaccination services in community pharmacies. A pre-piloted mail survey was sent to 350 randomly selected community pharmacies in Alabama in 2014. Measures included types of vaccines administered and marketing/recommendation strategies, pharmacists' attitudes towards the HPV vaccine, and perceived system and parental barriers. Data analysis largely took the form of descriptive statistics. 154 pharmacists completed the survey (response rate = 44%). The majority believed vaccination is the best protection against cervical cancer (85.3%), HPV is a serious threat to health for girls (78.8%) and boys (55.6%), and children should not wait until they are sexually active to be vaccinated (80.1%). Perceived system barriers included insufficient patient demand (56.5%), insurance plans not covering vaccination cost (54.8%), and vaccine expiration before use (54.1%). Respondents also perceived parents to have inadequate education and understanding about HPV infection (86.6%) and vaccine safety (78.7%). Pharmacists have positive perceptions regarding the HPV vaccine. Barriers related to system factors and perceived parental concerns must be overcome to increase pharmacist involvement in HPV vaccinations.

  20. Disability inclusion in primary health care in Nepal: an explorative study of perceived barriers to access governmental health services.

    NARCIS (Netherlands)

    Hees, S. van; Cornielje, H.; Wagle, P.; Veldman, E.

    2014-01-01

    Purpose: Persons with disabilities face additional barriers in accessing primary healthcare services, especially in developing countries. Consequently the prevalence of secondary health conditions is higher among this population. This study aims to explore the perceived barriers to access primary

  1. Identifying barriers to aboriginal renewable energy deployment in Canada

    International Nuclear Information System (INIS)

    Krupa, Joel

    2012-01-01

    As one of the largest and wealthiest countries in the world, Canada stands well-positioned to take advantage of ongoing growth in North American demand for primary energy supply by expanding domestic delivery of renewable energy generation to internationally interconnected electric grids across the country. There are myriad benefits of adopting the renewable energy approach to development—as the province of Ontario has acknowledged through the implementation of their 2009 Green Energy Act—including drastic reductions in carbon emissions, the decommissioning of existing fossil fuel power generation that cause serious public health problems, and opportunities for sustainable development at the community level. One group in particular stands poised to shape these debates. In Canada, historically marginalized Aboriginal peoples remain one of the groups with the greatest potential for meeting these enormous renewable energy deployment needs. Aboriginal involvement in renewable energy generation in Canada has been as diverse as Canada's Aboriginal peoples and groups have already adopted a range of different solutions to meet energy supply needs. However, many significant barriers exist that prevent this diverse cultural group from reaching its full potential. The article identifies some of these shortcomings and analyzes their roots. - Highlights: ► Renewable energy is one of the most important sustainable development opportunities today. ► Aboriginal-led renewable development could dramatically increase Canadian supply. ► Surmountable barriers are identified.

  2. Maternally Perceived Barriers to and Facilitators of Establishing and Maintaining Tooth-Brushing Routines with Infants and Preschoolers

    Directory of Open Access Journals (Sweden)

    Sarah Elison

    2014-07-01

    Full Text Available Establishing effective toothbrushing routines using fluoridated toothpaste in infancy has been suggested as important to dental health throughout childhood and into adulthood. However, previous studies have revealed a number of potential barriers to, and facilitators of caregivers ability to establish early dyadic toothbrushing routines with pre-schoolers. However, as yet no qualitative research has been conducted to ascertain potential barriers and facilitators of the earliest dyadic toothbrushing in infancy, and nor has any previous research specifically focused on how novice mothers of first-born infants and preschoolers manage this task. This study therefore outlines findings from a qualitative interview study with first-time mothers of children aged 24–30 months (n = 16 exploring perceived barriers to and facilitators of early dyadic toothbrushing routines with infants and preschoolers. A number of key themes were identified from interview transcripts and an ‘ecological’ approach conceptualised maternally perceived barriers to and facilitators of dyadic toothbrushing. Proximal influences were found to be located within the caregiver-child relationship (‘micro-system’, including parental cognitions (e.g., PSE, parental behaviours (e.g., parenting practices and infant and preschooler temperament and behaviours (e.g., tantrums. Distal factors were also identified as relevant to the establishment and maintenance of these routines, such as social support (‘exosystem’ and family history of tooth-brushing (‘chronosystem’.

  3. Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence.

    Science.gov (United States)

    Coll, Carolina V N; Domingues, Marlos R; Gonçalves, Helen; Bertoldi, Andréa D

    2017-01-01

    Identify perceived barriers to leisure-time physical activity during pregnancy to inform future interventions aimed at improving physical activity levels in pregnancy. PubMed/Medline and Web of Science databases were systematically searched using a reference period between 1986 and January/2016. A comprehensive search strategy was developed combining the following keywords: (barriers OR constraints OR perceptions OR attitudes) AND (physical activity OR exercise OR motor activity) AND (pregnancy OR pregnant women OR antenatal OR prenatal). Thematic synthesis was conducted to analyze the data. A socioecological model was used to categorize the reported barriers. Twelve quantitative studies and 14 qualitative studies were included. Barriers belonging to the intrapersonal level of the socioecological model were the most reported in the studies and were categorized in five themes as follows: (1) Pregnancy-related symptoms and limitations; (2) Time constraints; (3) Perceptions of already being active, (4) Lack of motivation and (5) Mother-child safety concerns. At the interpersonal level, barriers were coded into two descriptive themes: (1) Lack of advice and information and (2) Lack of social support. Two other themes were used to summarize Environmental, Organizational and Policy barriers: (1) Adverse weather and (2) Lack of resources. A range of relevant barriers to leisure-time physical-activity engagement during pregnancy were identified in this literature review. Pregnancy-related symptoms and limitations barriers were the most reported in studies, regardless of study design. Mother-child safety concerns, lack of advice/information and lack of social support were also important emphasized pregnancy-related barriers to be targeted in future interventions. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  4. Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents.

    Science.gov (United States)

    Ng, Danny Siu-Chun; Sun, Zihan; Young, Alvin Lerrmann; Ko, Simon Tak-Chuen; Lok, Jerry Ka-Hing; Lai, Timothy Yuk-Yau; Sikder, Shameema; Tham, Clement C

    2018-01-01

    To identify residents' perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions. The ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR), using a 5-point Likert scale (1 = least and 5 = most difficulty), was conducted among residents with or without prior simulation training. Mann-Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1) higher level trainee, 2) can complete phacoemulsification most of the time (>90%) without supervisor's intervention, and 3) prior simulation training. The study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong. Of the 22 residents, 19 responded (86.3%), of which 13 (68.4%) had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by capsulorrhexis completion and nucleus rotation/manipulation. Respondents with prior simulation training had significantly lower difficulty scores on these three tasks (nucleus cracking/chopping 3.85 vs 4.75, P = 0.03; capsulorrhexis completion 3.31 vs 4.40, P = 0.02; and nucleus rotation/manipulation 3.00 vs 4.75, P = 0.01). In multivariate analyses, simulation training was significantly associated with lower difficulty scores on these three tasks. Residents who had completed Eyesi simulation training had higher

  5. Identifying Multilevel Barriers to Tobacco Intervention in Postdoctoral Dental Education.

    Science.gov (United States)

    Albert, David A; Bruzelius, Emilie; Ward, Angela; Gordon, Judith S

    2016-04-01

    The aims of this mixed-methods study were to assess tobacco treatment behaviors among residents and faculty in dental specialty postdoctoral programs and to explore factors in training and practice related to tobacco treatment education. Surveys and focus groups were conducted with a convenience sample of participants at three postdoctoral residency programs in New York City. Surveys assessed tobacco cessation training and behaviors. Focus groups explored barriers to implementing tobacco cessation treatment in educational settings. Data were collected between May and December 2013. Among the 160 faculty and residents identified as potentially eligible for the study, 60 were invited by program directors to participate, and 50 subsequently completed the survey and participated in a focus group (response rate of 31.3%). Survey results indicated high levels of asking patients about tobacco use and advising patients to quit. In contrast, specific tobacco cessation assistance and follow-up care occurred less frequently. There were statistically significant differences in tobacco cessation intervention across the specialties surveyed, but not between residents and faculty. Focus group comments were grouped into three broad areas: clinician factors, organizational support, and structural and contextual factors. Focus group results indicated that participants experienced significant organizational and structural barriers to learning about and providing tobacco treatment. Participants from each specialty indicated that multi-level barriers impeded their provision of evidence-based tobacco cessation interventions in postdoctoral educational settings. They suggested that didactic education should be reinforced by organizational- and systems-level changes to facilitate comprehensive tobacco education and effective cessation treatment in future dental practice.

  6. Primary care physicians′ knowledge and perceived barriers in the management of overweight and obesity

    Directory of Open Access Journals (Sweden)

    Abdulaziz M Sebiany

    2013-01-01

    Full Text Available Objectives: To determine the level of knowledge of primary health care physicians and the barriers perceived in the management of overweight and obesity in the Eastern Province of Saudi Arabia. Setting: Primary health care centers in Dammam and Al-Khobar cities, Saudi Arabia. Design: A cross-sectional study. Materials and Methods: One hundred and forty-nine physicians were surveyed. Data were collected with a specially made anonymous, self-administrated, structured questionnaire with a Cronbach alpha reliability of 0.85, and content validity by five experts was used to measure the knowledge and barriers from several different aspects of care provided by primary health care centers to the overweight and obese. Results: One hundred and thirty (87% physicians responded. More than two-thirds of the respondents considered themselves as key players in the management of obesity. However, only one-third believed that they were well prepared to treat obesity. Eighty-three per cent of the respondents had a negative attitude toward the concept of overweight and obesity. It was noted that 76.9% of physicians advised patients to control their weight with sport and exercise together with low calorie diet. Sixty percent of the respondents used body mass index to diagnose obesity. Seventy-two percent of respondents did not use weight reduction medications to treat obesity. Lack of training, poor administrative support, and time constraints were identified as barriers in managing overweight and obesity. Conclusion: Respondents were aware of the magnitude of overweight and obesity as a major public health problem in Saudi Arabia, and they were also aware of the correct definition of overweight and obesity, as well as its effect in increasing mortality. Better training is required to improve some areas of awareness and management of the conditions.

  7. The perceived barriers and facilitators in completing a Master’s degree in Physiotherapy

    Directory of Open Access Journals (Sweden)

    Nicolette Comley-White

    2018-05-01

    Full Text Available Background: Participating in postgraduate study is daunting and as yet there is a dearth of literature on what students’ experiences are when obtaining their Master’s degree in Physiotherapy. Objectives: The aim of this study was to gain insight into the perceived barriers and facilitators in completing a Master’s degree in Physiotherapy. Method: Semi-structured, in-depth interviews were conducted with 10 physiotherapists who had completed a Master’s degree in Physiotherapy from a university in South Africa, representative of coursework and dissertation Master’s degrees, completed within the stipulated time period as well as taking longer to complete the degree. The topics covered a range of speciality areas. The interviews were transcribed, sent for member checking and analysed thematically. Results: Within 10 interviews data saturation was reached. Two themes were identified: research environment and support, both of which were seen as either a facilitator or a barrier, depending on the participant. The theme of research environment was divided into categories of workplace and data collection. The second theme, support, was also seen as either a barrier or a facilitator. This theme encapsulated the categories of supervisor support, workplace support and a personal support network. Conclusion: The research environment and support are two major factors that can influence the experience of obtaining a master’s degree in physiotherapy, both positively and negatively. Clinical implications: With increasing numbers of physiotherapists obtaining postgraduate degrees, universities need to facilitate the process of obtaining the degree, which will ensure more physiotherapists with postgraduate degrees, thereby strengthening the profession.

  8. Barriers perceived by teachers at work, coping strategies, self-efficacy and burnout.

    Science.gov (United States)

    Doménech Betoret, Fernando; Gómez Artiga, Amparo

    2010-11-01

    This study examines the relationships among stressors, coping strategies, self-efficacy and burnout in a sample of 724 Spanish primary and secondary teachers. We understood stressors as barriers perceived by teachers that interfere with their work meeting learning objectives and which cause them stress and burnout. An analysis of teacher responses using hierarchical regression revealed that pedagogical barriers had significant positive effects on the burnout dimensions. Furthermore, the results show not only the moderator role played by coping strategies in the pedagogical barriers-burnout dimensions relationship, but also the association between self-efficacy and the coping strategies used by teachers. Practical implications are discussed.

  9. Getting Vaccinated against HPV: Attitudes, Intentions and Perceived Barriers of Female Undergraduates

    Science.gov (United States)

    Burke, Sloane C.; Vail-Smith, Karen; White, David M.; Baker, Elizabeth; Mitchell, Terri

    2010-01-01

    This study examines college women's intention to receive the Human Papilloma Virus (HPV) vaccine and their perceived barriers to being vaccinated. The study reports findings from an online questionnaire completed by 856 undergraduate women enrolled in a required personal health course at a large (27,000 plus) southeastern university. The majority…

  10. Perceived impact of environmental barriers on participation among people living with spinal cord injury in Switzerland

    NARCIS (Netherlands)

    Reinhardt, Jan D; Ballert, Carolina; Brinkhof, Martin W G; Post, Marcel W M

    Objective: To describe the impact of environmental barriers perceived by people living with spinal cord injury in the Swiss community and to compare this across subpopulations. Design: Cross-sectional study. Subjects: A total of 1,549 participants in the community survey of the Swiss spinal cord

  11. Determinants of Perceived Physical Environment Barriers among Community-Dwelling Elderly in Taiwan.

    Science.gov (United States)

    Lien, W-C; Chang, J-H; Guo, N-W; Lin, Y-C; Hsieh, P-C; Kuan, T-S

    2015-05-01

    To test the hypothesis that mobility, activities of daily living, and the interaction between them can play a key role in determining perceived physical environment barriers among community-dwelling elderly. Cross-sectional. Community. One hundred and ninety-seven community-dwelling elderly with more than 7 points on the Short Portable Mental State Questionnaire and less than 7 points on the Geriatric Depression Scale (15 items). None. Time Get-up and Go test (TUG), the subscales of basic activity of daily living (BADL)/instrumental activities of daily living (IADL) of the Hierarchy of Care Required (HCR), and the physical/structural subscale of the Craig Hospital Inventory of Environmental Factors in Community-dwelling Elderly in Taiwan were used to measure mobility, activities of daily living and perceived physical environment barriers, respectively. Hierarchical linear regression analyses were used to test the study hypothesis. Significant and positive relations were found to exist between perceived physical environment barriers and (1) the TUG time (β=.300, pdwelling elderly under consideration. Strategies targeting the enhancement of mobility among community-dwelling elderly are suggested to lead to improvements in the degree to which physical environment barriers are perceived. This beneficial effect could be greater in the case of elderly individuals with better IADL function.

  12. Perceived impact of environmental barriers on participation among people living with spinal cord injury in Switzerland

    NARCIS (Netherlands)

    Reinhardt, Jan D; Ballert, Carolina; Brinkhof, Martin W G; Post, Marcel W M

    2016-01-01

    OBJECTIVE: To describe the impact of environmental barriers perceived by people living with spinal cord injury in the Swiss community and to compare this across subpopulations. DESIGN: Cross-sectional study. SUBJECTS: A total of 1,549 participants in the community survey of the Swiss spinal cord

  13. Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning.

    Science.gov (United States)

    Janes, Ron; Arroll, Bruce; Buetow, Stephen; Coster, Gregor; McCormick, Ross; Hague, Iain

    2005-01-01

    The purpose of this research was to investigate rural North Island (New Zealand) health professionals' attitudes and perceived barriers to using the internet for ongoing professional learning. A cross-sectional postal survey of all rural North Island GPs, practice nurses and pharmacists was conducted in mid-2003. The questionnaire contained both quantitative and qualitative questions. The transcripts from two open questions requiring written answers were analysed for emergent themes, which are reported here. The first open question asked: 'Do you have any comments on the questionnaire, learning, computers or the Internet?' The second open question asked those who had taken a distance-learning course using the internet to list positive and negative aspects of their course, and suggest improvements. Out of 735 rural North Island health professionals surveyed, 430 returned useable questionnaires (a response rate of 59%). Of these, 137 answered the question asking for comments on learning, computers and the internet. Twenty-eight individuals who had completed a distance-learning course using the internet, provided written responses to the second question. Multiple barriers to greater use of the internet were identified. They included lack of access to computers, poor availability of broadband (fast) internet access, lack of IT skills/knowledge, lack of time, concerns about IT costs and database security, difficulty finding quality information, lack of time, energy or motivation to learn new skills, competing priorities (eg family), and a preference for learning modalities which include more social interaction. Individuals also stated that rural health professionals needed to engage the technology, because it provided rapid, flexible access from home or work to a significant health information resource, and would save money and travelling time to urban-based education. In mid-2003, there were multiple barriers to rural North Island health professionals making greater

  14. Development and psychometric evaluation of the Dialysis patient-perceived Exercise Benefits and Barriers Scale.

    Science.gov (United States)

    Zheng, Jing; You, Li-Ming; Lou, Tan-Qi; Chen, Nian-Chang; Lai, De-Yuan; Liang, Yan-Yi; Li, Ying-Na; Gu, Ying-Ming; Lv, Shao-Fen; Zhai, Cui-Qiu

    2010-02-01

    Perceptions of exercise benefits and barriers affect exercise behavior. Because of the clinical course and treatment, dialysis patients differ from the general population in their perceptions of exercise benefits and barriers, especially the latter. At present, no valid instruments for assessing perceived exercise benefits and barriers in dialysis patients are available. Our goal was to develop and test the psychometric properties of the Dialysis patient-perceived Exercise Benefits and Barriers Scale (DPEBBS). A literature review and two focus groups were conducted to generate the initial item pool. An expert panel examined the content validity. Then, 269 Chinese hemodialysis patients were recruited by convenience sampling. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed. The expert panel determined that the content validity index was satisfactory. The final 24-item scale consisted of six factors explaining 57% of the total variance in the data. Confirmative factor analysis supported the six-factor structure and a higher-order model. Cronbach's alpha was 0.87 for the total scale, and 0.84 for test-retest reliability. The DPEBBS was a valid and reliable instrument for evaluating dialysis patients' perceived benefits and barriers to exercise. The application value of this scale remains to be investigated by increasing the sample size and evaluating patients undergoing different dialysis modalities and coming from different regions and cultural backgrounds. Copyright 2009 Elsevier Ltd. All rights reserved.

  15. Barriers to Conducting Supervised Agricultural Experiences as Perceived by Preservice Agricultural Education Teachers

    Directory of Open Access Journals (Sweden)

    J. Joey Blackburn

    2014-10-01

    Full Text Available The purpose of this descriptive study was to assess preservice agriculture teachers’ perceptions of the importance of Supervised Agricultural Experience (SAE and their views on barriers to conducting SAE. A census of the sophomore-level agricultural education course at Oklahoma State University was conducted to measure perceptions at the beginning and end of the course. This study was framed upon Ajzen’s Theory of Planned Behavior. Results indicated that preservice teachers perceived SAE was an important component of agricultural education and important at the secondary school they attended. The greatest barrier to conducting SAE was their lack of familiarity with newer SAE categories. This was true at both the beginning and end of the course. It is recommended that preservice teachers receive instruction on and experiences in all types of SAE. This would increase the likelihood of preservice teachers perceiving they have control over this barrier regarding SAE implementation. This cohort of preservice teachers should be surveyed over time to determine change in their perceptions of barriers to SAE implementation as they progress in the agricultural education program and through their careers. Further, the views of in-service teachers should also be assessed to determine if perceived barriers differ with professional experience.

  16. Parent-identified barriers to pediatric health care: a process-oriented model.

    Science.gov (United States)

    Sobo, Elisa J; Seid, Michael; Reyes Gelhard, Leticia

    2006-02-01

    To further understand barriers to care as experienced by health care consumers, and to demonstrate the importance of conjoining qualitative and quantitative health services research. Transcripts from focus groups conducted in San Diego with English- and Spanish-speaking parents of children with special health care needs. Participants were asked about the barriers to care they had experienced or perceived, and their strategies for overcoming these barriers. Using elementary anthropological discourse analysis techniques, a process-based conceptual model of the parent experience was devised. The analysis revealed a parent-motivated model of barriers to care that enriched our understanding of quantitative findings regarding the population from which the focus group sample was drawn. Parent-identified barriers were grouped into the following six temporally and spatially sequenced categories: necessary skills and prerequisites for gaining access to the system; realizing access once it is gained; front office experiences; interactions with physicians; system arbitrariness and fragmentation; outcomes that affect future interaction with the system. Key to the successful navigation of the system was parents' functional biomedical acculturation; this construct likens the biomedical health services system to a cultural system within which all parents/patients must learn to function competently. Qualitative analysis of focus group data enabled a deeper understanding of barriers to care--one that went beyond the traditional association of marker variables with poor outcomes ("what") to reveal an understanding of the processes by which parents experience the health care system ("how,"why") and by which disparities may arise. Development of such process-oriented models furthers the provision of patient-centered care and the creation of interventions, programs, and curricula to enhance such care. Qualitative discourse analysis, for example using this project's widely applicable

  17. Maternal Reading Self-Efficacy Associated with Perceived Barriers to Reading

    Directory of Open Access Journals (Sweden)

    Joyce Lin

    2015-01-01

    Full Text Available Although early reading practices impact a host of child literacy, language, and school outcomes, many parents do not read to their young children. One possible explanation for this lack of early literacy practices is mothers’ feelings about their ability to successfully read to their children. A series of multiple regressions were used to explore whether new mothers’ reading self-efficacy predicted their perceived barriers to reading to their 18-month-old children. Findings suggest that self-efficacy buffers against mother-centered (e.g., too tired, child-centered (e.g., toddler fussy, and structural (e.g., environmental distractions barriers to reading. Given the importance of early literacy and that not all mothers read to their toddlers, increasing reading self-efficacy may offer a way to reduce perceived barriers to early literacy practices.

  18. Exploring the relationship between perceived barriers to healthy eating and dietary behaviours in European adults.

    Science.gov (United States)

    Pinho, M G M; Mackenbach, J D; Charreire, H; Oppert, J-M; Bárdos, H; Glonti, K; Rutter, H; Compernolle, S; De Bourdeaudhuij, I; Beulens, J W J; Brug, J; Lakerveld, J

    2017-04-26

    Dietary behaviours may be influenced by perceptions of barriers to healthy eating. Using data from a large cross-European study (N = 5900), we explored associations between various perceived barriers to healthy eating and dietary behaviours among adults from urban regions in five European countries and examined whether associations differed across regions and socio-demographic backgrounds. Frequency of consumption of fruit, vegetables, fish, fast food, sugar-sweetened beverages, sweets, breakfast and home-cooked meals were split by the median into higher and lower consumption. We tested associations between barriers (irregular working hours; giving up preferred foods; busy lifestyle; lack of willpower; price of healthy food; taste preferences of family and friends; lack of healthy options and unappealing foods) and dietary variables using multilevel logistic regression models. We explored whether associations differed by age, sex, education, urban region, weight status, household composition or employment. Respondents who perceived any barrier were less likely to report higher consumption of healthier foods and more likely to report higher consumption of fast food. 'Lack of willpower', 'time constraints' and 'taste preferences' were most consistently associated with consumption. For example, those perceiving lack of willpower ate less fruit [odds ratio (OR) 0.57; 95% confidence interval (CI) 0.50-0.64], and those with a busy lifestyle ate less vegetables (OR 0.54; 95% CI 0.47-0.62). Many associations differed in size, but not in direction, by region, sex, age and household composition. Perceived 'lack of willpower', 'time constraints' and 'taste preferences' were barriers most strongly related to dietary behaviours, but the association between various barriers and lower intake of fruit and vegetables was somewhat more pronounced among younger participants and women.

  19. Perceived Barriers and Home Care Needs When Adapting to a Fecal Ostomy: A Phenomenological Study.

    Science.gov (United States)

    Cengiz, Burcu; Bahar, Zuhal

    The aim of this study was to determine perceived barriers to adaptation to life with a fecal ostomy based on the Health Belief Model and to reveal home care needs related to these perceptions. Phenomenological study. Twelve participants undergoing ileostomy or colostomy within 3 months of data collection participated in the study. The participants were recruited from Stomatherapy Outpatient Clinic of Dokuz Eylül University Hospital. Their mean age was 54.41 ± 19.14 years (mean ± SD). Eight (67%) underwent ostomy surgery 2 to 3 months prior to study participation; 9 (75%) underwent stoma surgery for the treatment of colorectal cancer, 5 (42%) had a temporary stoma, and 8 also received chemotherapy for the management of an underlying malignancy. A semistructured interview form was used to collect data, and obtained data were analyzed with inductive content analysis. The questions were based on the Health Belief Model and were directed at identifying challenges to adaptation to life at home and home care needs in patients with stoma. Inductive content analysis identified 4 main themes: "restriction of daily life activities"; "factors affecting adaptation to stoma"; "need for health professionals"; and "emotional effects." The theme, need for health professionals, was expressed by the highest number of the participants. The respondents explained that services from ostomy nurse specialists should begin in the hospital and continue into the home. Participants suggested that ostomy nurses are needed to improve self-care skills via telephone contact and home visits. They also expressed the need for nursing interventions for the management of adverse effects associated with chemotherapy. Individuals experience physical, mental, and social barriers when adapting to live with a new stoma and when receiving chemotherapy for underlying cancer. Additional services from ostomy nurses are needed to aid patients when adapting to these challenges.

  20. Emerging Adulthood among Palestinian Minority in Israel: The Relation between Perceived Career Barriers, Future Orientation and Career Decisions

    Science.gov (United States)

    Mahajna, Sami

    2017-01-01

    This study examines the relation between perceived career barriers, future orientation and career decisions among young Palestinian-Israeli youth. The study employs a theoretical model that links perceived career barriers and career decisions via variables of future orientation. Three hundred eighty-eight young Palestinian-Israeli women (73.20%)…

  1. Measuring women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Nikiema Béatrice

    2012-02-01

    Full Text Available Abstract Background In sub-Saharan Africa, women must overcome numerous barriers when they need modern healthcare. Respect of gender norms within the household and the community may still influence women's ability to obtain care. A lack of gender-sensitive instruments for measuring women's ability to overcome barriers compromises attempts to adequately quantify the burden and risk of exclusion they face when seeking modern healthcare. The aim of this study was to create and validate a synthetic measure of women's access to healthcare from a publicly available and possibly internationally comparable population-based survey. Method Seven questionnaire items from the Burkina Faso 2003 DHS were combined to create the index. Cronbach's alpha coefficient was used to test the reliability of the index. Exploratory factor analyses (EFA and confirmatory factor analyses (CFA were applied to evaluate the factorial structure and construct validity of the index while taking into account the hierarchical structure of the data. Results The index has a Cronbach's alpha of 0.75, suggesting adequate reliability. In EFA, three correlated factors fitted the data best. In CFA, the construct of perceived ability to overcome barriers to healthcare seeking emerged as a second-order latent variable with three domains: socioeconomic barriers, geographical barriers and psychosocial barriers. Model fit indices support the index's global validity for women of reproductive age in Burkina Faso. Evidence for construct validity comes from the finding that women's index scores increase with household living standard. Conclusion The DHS items can be combined into a reliable and valid, gender-sensitive index quantifying reproductive-age women's perceived ability to overcome barriers to healthcare seeking in Burkina Faso. The index complies conceptually with the sector-cross-cutting capability approach and enables measuring directly the perceived access to healthcare. Therefore it

  2. Family presence during resuscitation (FPDR): Perceived benefits, barriers and enablers to implementation and practice.

    Science.gov (United States)

    Porter, Joanne E; Cooper, Simon J; Sellick, Ken

    2014-04-01

    There are a number of perceived benefits and barriers to family presence during resuscitation (FPDR) in the emergency department, and debate continues among health professionals regarding the practice of family presence. This review of the literature aims to develop an understanding of the perceived benefits, barriers and enablers to implementing and practicing FPDR in the emergency department. The perceived benefits include; helping with the grieving process; everything possible was done, facilitates closure and healing and provides guidance and family understanding and allows relatives to recognise efforts. The perceived barriers included; increased stress and anxiety, distracted by relatives, fear of litigation, traumatic experience and family interference. There were four sub themes that emerged from the literature around the enablers of FPDR, these included; the need for a designated support person, the importance of training and education for staff and the development of a formal policy within the emergency department to inform practice. In order to ensure that practice of FPDR becomes consistent, emergency personnel need to understand the need for advanced FPDR training and education, the importance of a designated support person role and the evidence of FPDR policy as enablers to implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Pharmacists’ Attitudes and Perceived Barriers about Community Pharmacy-Based Cardiovascular Risk Screening Services

    Directory of Open Access Journals (Sweden)

    Zahra Jahangard-Rafsanjani

    2015-10-01

    Full Text Available  Background: Community pharmacies are considered as ideal settings to provide cardiovascular risk screening (CRS. However, little is known about pharmacists’ views on providing such services in developing countries including Iran. In the present study, we evaluated the pharmacists’ attitudes and perceived barriers to providing CRS services. Methods:In a cross-sectional study, a questionnaire in three sections was developed by the investigators (attitudes, perceived barriers, and demographics. Five likert items (5 points bipolar scale were designed to evaluate pharmacists’ attitudes about their professional role in providing CRS services in community pharmacies. Seven likert items were designed to assess the pharmacists’ perceived importance of possible barriers to providing the services. The study tool was distributed among a convenient sample of 500 pharmacists, who had participated in a national continuing education event. Results:The response rate was 44% and descriptive statistics and Chi squared test were used to analyze data. Results showed that 70.4% participants had an overall positive attitude to providing CRS services. Pharmacists who were pharmacy owner and pharmacist-in-charge simultaneously were more positive about providing CRS services. Lack of regulatory policy and compensation mechanism, limited physical space in pharmacy and time limitation were reported to be the most important barriers to providing CRS services (> 50% rated as highly important. Low human resource and time limitation were significantly associated with negative attitudes (P: 0.02 and 0.001, respectively.Conclusion:The Iranian pharmacists’ attitudes seem to be positive about providing CRS services; however, their perceived barriers should be addressed prior to CRS service implementation.

  4. The influence of nurse home visits, including provision of 3 months of contraceptives and contraceptive counseling, on perceived barriers to contraceptive use and contraceptive use self-efficacy.

    Science.gov (United States)

    Melnick, Alan L; Rdesinski, Rebecca E; Creach, E Dawn; Choi, Dongseok; Harvey, S Marie

    2008-01-01

    To identify the influence of a community health nurse (CHN) home visit on perceived barriers to contraceptive access and contraceptive use self-efficacy. We enrolled 103 women into two groups in a randomized trial evaluating the influence of contraceptive dispensing and family planning counseling during home visits on perceived barriers to accessing contraceptives and contraceptive use self-efficacy. Both groups received counseling by a CHN about sexually transmitted disease and pregnancy prevention, and a resource card listing phone numbers of family planning clinics. After randomization, the CHN dispensed three months of hormonal contraception to the intensive intervention group and advised the minimal intervention group to schedule an appointment at a family planning clinic. Data collection at baseline and 12 months included demographic, reproductive and other health-related information as well as quantitative assessments of information on perceived barriers to contraceptive access and contraceptive use self-efficacy. The mean age of participants was 24.7 years. Three-fourths had household incomes under $25,000. We found significant reductions in three perceived barriers to contraceptive access for both groups, as well as significant increases in two measures of contraceptive use self-efficacy at twelve months compared to baseline. Nurse home visits involving family planning counseling might be effective in reducing perceived barriers to contraceptive access and increasing contraceptive use self-efficacy.

  5. Municipal officials' perceived barriers to consideration of physical activity in community design decision making.

    Science.gov (United States)

    Goins, Karin Valentine; Schneider, Kristin L; Brownson, Ross; Carnoske, Cheryl; Evenson, Kelly R; Eyler, Amy; Heinrich, Katie; Litt, Jill; Lyn, Rodney; Maddock, Jay; Reed, Hannah; Tompkins, Nancy Oʼhara; Lemon, Stephenie C

    2013-01-01

    Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to such consideration. This analysis sought to (a) establish prevalence estimates of selected barriers to the consideration of physical activity in community design and layout decisions and (b) describe how barrier reporting by public health officials differs from other municipal officials among a wide range of job functions and departments in a geographically diverse sample. A Web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50 000 residents in 8 states. A total of 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures in 83 cities and towns responded to the survey. Five barriers to consideration of physical activity in community design and layout were assessed. The most common barriers included lack of political will (23.5%), limited staff (20.4%), and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments than other professionals. They were also more likely to report lack of political will than city managers or mayors and municipal legislators. Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will despite public health staffing

  6. The acceptance of mobile government from a citizens’ perspective: Identifying perceived risks and perceived benefits

    DEFF Research Database (Denmark)

    Ohme, Jakob

    2014-01-01

    and citizens. There are many examples of failures of early e-government projects due to a lack of consideration of users’ requirements. Against this background, this article tries to contribute to governmental communication processes by addressing the driving factors influencing the acceptance of mobile......-government is significantly influenced by both, factors users see as a benefit but also by factors of perceived risks....

  7. A survey to identify barriers of implementing an antibiotic checklist

    NARCIS (Netherlands)

    van Daalen, F. V.; Geerlings, S. E.; Prins, J. M.; Hulscher, M. E. J. L.

    2016-01-01

    A checklist is an effective implementation tool, but addressing barriers that might impact on the effectiveness of its use is crucial. In this paper, we explore barriers to the uptake of an antibiotic checklist that aims to improve antibiotic use in daily hospital care. We performed an online

  8. Adults Who Do Not Want to Participate in Learning: A Cross-National European Analysis of Their Perceived Barriers

    Science.gov (United States)

    Roosmaa, Eve-Liis; Saar, Ellu

    2017-01-01

    This article explores cross-national differences in the intensity of perceived barriers to adult learning in Europe focusing on the barriers recognised by those not participating and having no intention to do so. This relatively large subgroup has received scant scholarly attention, yet exploring their participation barriers is critical for…

  9. Opiate Users' Perceived Barriers Against Attending Methadone Maintenance Therapy: A Qualitative Study in China

    Science.gov (United States)

    Lin, Chunqing; Wu, Zunyou; Detels, Roger

    2012-01-01

    Methadone maintenance therapy (MMT) in China is facing challenges such as high relapse rates and low coverage. The study assessed factors influencing MMT utilization among opiate users. In-depth interviews were conducted among 30 opiate users in 2008 to ascertain the barriers against seeking MMT. Data were analyzed using ATLAS.ti. Barriers to the treatment included requirement of registration with police, perceived discrimination, logistic difficulties, side effects, fear of being addicted to another drug, lack of additional services, and economic burden. The result suggests the need for structural changes such as improving comprehensive services, simplifying application procedure, and enhancing referral system. The study's limitations are noted. PMID:21417558

  10. Physical Activity Enjoyment, Perceived Barriers, and Beliefs Among Adolescents With and Without Intellectual Disabilities.

    Science.gov (United States)

    Stanish, Heidi I; Curtin, Carol; Must, Aviva; Phillips, Sarah; Maslin, Melissa; Bandini, Linda G

    2016-01-01

    Youths with intellectual disabilities (ID) exhibit low levels of physical activity, but the underlying contributors to behavior are unclear. We compared physical activity enjoyment, perceived barriers, beliefs, and self-efficacy among adolescents with ID and typically developing (TD) adolescents. A questionnaire was administered to 38 adolescents with ID (mean age, 16.8 years) and 60 TD adolescents (mean age, 15.3 years). Of the original 33 questionnaire items, 23 met the test-retest reliability criteria and were included in the group comparisons. Fewer adolescents with ID reported that they have someone with whom to do physical activity (64% vs 93%: P physical activities were too hard to learn (41% vs 0%; P physical activity would be good for their health (92% vs 100%; P = .05). More adolescents with ID reported a dislike of individual physical activities (P = .02). A large percentage of adolescents with ID (84%) responded that they were good at doing physical activities, but the difference between groups was only of borderline significance (95% of TD adolescents, P = .06). Adolescents shared many of the same perceptions about physical activity, but some important differences between groups were identified.

  11. City mouse, country mouse: a mixed-methods evaluation of perceived communication barriers between rural family physicians and urban consultants in Newfoundland and Labrador, Canada.

    Science.gov (United States)

    Renouf, Tia; Alani, Sabrina; Whalen, Desmond; Harty, Chris; Pollard, Megan; Morrison, Megan; Coombs-Thorne, Heidi; Dubrowski, Adam

    2016-05-06

    To examine perceived communication barriers between urban consultants and rural family physicians practising routine and emergency care in remote subarctic Newfoundland and Labrador (NL). This study used a mixed-methods design. Quantitative and qualitative data were collected through exploratory surveys, comprised of closed and open-ended questions. The quantitative data was analysed using comparative statistical analyses, and a thematic analysis was applied to the qualitative data. 52 self-identified rural family physicians and 23 urban consultants were recruited via email. Rural participants were also recruited at the Family Medicine Rural Preceptor meetings in St John's, NL. Rural family physicians and urban consultants in NL completed a survey assessing perceived barriers to effective communication. Data confirmed that both groups perceived communication difficulties with one another; with 23.1% rural and 27.8% urban, rating the difficulties as frequent (p=0.935); 71.2% rural and 72.2% urban as sometimes (p=0.825); 5.8% rural and 0% urban acknowledged never perceiving difficulties (p=0.714). Overall, 87.1% of participants indicated that perceived communication difficulties impacted patient care. Primary trends that emerged as perceived barriers for rural physicians were time constraints and misunderstanding of site limitations. Urban consultants' perceived barriers were inadequate patient information and lack of native language skills. Barriers to effective communication are perceived between rural family physicians and urban consultants in NL. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Perceived barriers and facilitators for general practitioner-patient communication in palliative care: a systematic review

    NARCIS (Netherlands)

    Slort, W.; Schweitzer, B.P.M.; Blankenstein, A.H.; Abarshi, E.A.; Riphagen, I.I.; Echteld, M.A.; Aaronson, N.K.; van der Horst, H.E.; Deliens, L.

    2011-01-01

    While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic

  13. Perceived barriers and facilitators for general practitioner-patient communication in palliative care: A systematic review

    NARCIS (Netherlands)

    Slort, W.; Schweitzer, B.P.M.; Blankenstein, A.H.; Abarshi-Fatiregun, E.A.B.; Riphagen, I.; Echteld, M.A.; Aaronson, N.K.; van der Horst, H.E.; Deliens, L.

    2011-01-01

    While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic

  14. Closing the Gap between Research Evidence and Clinical Practice: Jordanian Nurses' Perceived Barriers to Research Utilisation

    Science.gov (United States)

    Al Khalaileh, Murad; Al Qadire, Mohammad; Musa, Ahmad S.; Al-Khawaldeh, Omar A.; Al Qudah, Hani; Alhabahbeh, Atalla

    2016-01-01

    Background: The nursing profession is a combination of theory and practical skill, and nurses are required to generate and develop knowledge through implementing research into clinical practice. Considerable number of barriers could hind implementing research findings into practice. Barriers to research utilisation are not identified in the…

  15. Minimum recommended physical activity, and perceived barriers and benefits of exercise in methadone maintained persons.

    Science.gov (United States)

    Caviness, Celeste M; Bird, Jessica L; Anderson, Bradley J; Abrantes, Ana M; Stein, Michael D

    2013-04-01

    Methadone-maintained persons are at increased risk for many physical and mental health disorders compared to the general population. Increased physical activity could offset these risks. We assessed physical activity level, and perceived benefits and barriers to exercise in a group of 305 methadone-maintained smokers. Mean participant age was 39.9 years, 50.2% were male, 79.7% were non-Hispanic White, and mean body mass index was 29.8. Nearly 45% endorsed fair or poor physical health. Although participants perceived many benefits of exercise and few barriers, only 38% of participants met weekly recommendations for physical activity, and nearly 25% reported no physical activity. Those who met recommended guidelines were significantly more likely to endorse relapse prevention as a benefit of exercise. Motivating MMT patients to increase physical activity could have important physical, mental health, and drug treatment benefits. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Computer and internet access for long-term care residents: perceived benefits and barriers.

    Science.gov (United States)

    Tak, Sunghee H; Beck, Cornelia; McMahon, Ed

    2007-05-01

    In this study, the authors examined residents' computer and Internet access, as well as benefits and barriers to access in nursing homes. Administrators of 64 nursing homes in a national chain completed surveys. Fourteen percent of the nursing homes provided computers for residents to use, and 11% had Internet access. Some residents owned personal computers in their rooms. Administrators perceived the benefits of computer and Internet use for residents as facilitating direct communication with family and providing mental exercise, education, and enjoyment. Perceived barriers included cost and space for computer equipment and residents' cognitive and physical impairments. Implications of residents' computer activities were discussed for nursing care. Further research is warranted to examine therapeutic effects of computerized activities and their cost effectiveness.

  17. Research review: the effect of barriers to communication on job satisfaction and perceived work productivity.

    Science.gov (United States)

    Rudman, W J; Gumbita, L

    1995-05-01

    The article describes a study that examined the effects of communication barriers on job satisfaction and perceived work productivity. Data for this study were collected from a stratified random sample of health information management professionals (n = 237). In general, supervisors and employees had similar responses on all three measures. Both supervisors and employees focused on defensiveness and personality conflicts as important barriers to communication, personal satisfaction with work and job pride as the most satisfying elements of their work, and control over the work environment as the least satisfying work condition. Also in general, personality conflicts among workers and lack of organizational skills had the strongest effects on job satisfaction and perceived work productivity.

  18. Impact of virtual reality simulation on learning barriers of phacoemulsification perceived by residents

    Directory of Open Access Journals (Sweden)

    Ng DS

    2018-05-01

    Full Text Available Danny Siu-Chun Ng,1 Zihan Sun,1 Alvin Lerrmann Young,1,2 Simon Tak-Chuen Ko,3 Jerry Ka-Hing Lok,1 Timothy Yuk-Yau Lai,1 Shameema Sikder,4 Clement C Tham1 1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 2Department of Ophthalmology, Prince of Wales Hospital, 3Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, People’s Republic of China; 4Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA Objective: To identify residents’ perceived barriers to learning phacoemulsification surgical procedures and to evaluate whether virtual reality simulation training changed these perceptions. Design: The ophthalmology residents undertook a simulation phacoemulsification course and proficiency assessment on the Eyesi system using the previously validated training modules of intracapsular navigation, anti-tremor, capsulorrhexis, and cracking/chopping. A cross-sectional, multicenter survey on the perceived difficulties in performing phacoemulsification tasks on patients, based on the validated International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR, using a 5-point Likert scale (1 = least and 5 = most difficulty, was conducted among residents with or without prior simulation training. Mann–Whitney U tests were carried out to compare the mean scores, and multivariate regression analyses were performed to evaluate the association of lower scores with the following potential predictors: 1 higher level trainee, 2 can complete phacoemulsification most of the time (>90% without supervisor’s intervention, and 3 prior simulation training. Setting: The study was conducted in ophthalmology residency training programs in five regional hospitals in Hong Kong. Results: Of the 22 residents, 19 responded (86.3%, of which 13 (68.4% had completed simulation training. Nucleus cracking/chopping was ranked highest in difficulty by all respondents followed by

  19. Pharmacists’ Attitudes and Perceived Barriers to Human Papillomavirus (HPV) Vaccination Services

    OpenAIRE

    Hastings, Tessa J.; Hohmann, Lindsey A.; McFarland, Stuart J.; Teeter, Benjamin S.; Westrick, Salisa C.

    2017-01-01

    Use of non-traditional settings such as community pharmacies has been suggested to increase human papillomavirus (HPV) vaccination uptake and completion rates. The objectives of this study were to explore HPV vaccination services and strategies employed by pharmacies to increase HPV vaccine uptake, pharmacists’ attitudes towards the HPV vaccine, and pharmacists’ perceived barriers to providing HPV vaccination services in community pharmacies. A pre-piloted mail survey was sent to 350 randomly...

  20. Treatment of obesity in children: Parent's perceived emotional barriers as predictor of change in body fat.

    Science.gov (United States)

    Steinsbekk, Silje; Odegård, Rønnaug; Wichstrøm, Lars

    2011-01-01

    Research supports the use of family-based interventions in the treatment of obesity in children, but there is a lack of knowledge about what factors affect parents' ability to carry out the lifestyle changes necessary to reduce their child's obesity. The aim of the present study was to examine whether parents' self-efficacy, perceived emotional barriers, subjective norms, and attitudes could predict change in their children's body fat at 6 month and 2 year follow-ups after a family-based treatment of obesity. Body Mass Index Standard Deviation Scores (BMI SDS) were calculated and body fat (dual-energy X-ray absorptiometry) were measured in 99 treatment-seeking children with obesity (ages 7-12; 48 girls, 51 boys; mean BMI SDS = 2.99) at baseline, after 6 month and after 2 year follow-up. Parental cognitions regarding diet and physical activity were examined by parent-completed questionnaires. Structural equation modeling (SEM) was used to test whether the selected health cognitions could predict treatment outcome. Parental perceived emotional barriers was a significant predictor of change in body fat at 6 month (β = -.32, p = .001) and 2 year (β = -.38, p = .002) follow-up when the initial body fat values were controlled. Self-efficacy, subjective norms and attitudes did not improve the amount of variance explained. Parents' perceived emotional barriers significantly predict change in total body fat in children treated for obesity. In order to increase treatment-efficacy, perceived emotional barriers should be addressed. © 2011 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

  1. "They put you on your toes": Physical Therapists' Perceived Benefits from and Barriers to Supervising Students in the Clinical Setting.

    Science.gov (United States)

    Davies, Robyn; Hanna, Elizabeth; Cott, Cheryl

    2011-01-01

    To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff.

  2. A Survey of Knowledge About and Perceived Barriers to Prostate Cancer Screening Among Medical Staff

    Directory of Open Access Journals (Sweden)

    Akbarizadeh

    2016-04-01

    Full Text Available Background Prostate cancer is the most common cancer among men and the second leading cause of deaths from cancer. Results of previous studies indicate the effectiveness of screening and early detection in reducing mortality from this disease. Objectives The purpose of this study was to survey the knowledge about prostate cancer and perceived barriers to prostate cancer screening among medical staff of two universities in Ahvaz, Iran. Materials and Methods This cross-sectional descriptive study was performed on 120 employees over 40 years old at Ahvaz Jundishapur University of Medical Sciences and Shahid Chamran University of Ahvaz, who were selected by using simple random sampling. The data collection tool was a researcher-created questionnaire based on the study of texts and other studies. Data analysis was performed using SPSS software and through analytical methods including descriptive and inferential statistics. Results The most common barriers to screening for prostate cancer were a lack of knowledge about where to go for tests and how screening tests are done (70.8%, a lack of emphasis on screening tests (59.1%, and a fear of thinking about the disease (50%. Results showed that there was no significant relationship between doing the serum antigen test and having knowledge regarding prostate cancer. But there was a significant association between prostate cancer screening and perceived barriers (P = 0.001. Conclusions Results showed that whereas knowledge by itself cannot guarantee men’s participation in prostate cancer screenings, perceived barriers can play an important role in discouraging men from cancer screening participation. Therefore, designing programs to address these barriers is very important.

  3. Perceived Benefits and Barriers of a Community-Based Diabetes Prevention and Management Program.

    Science.gov (United States)

    Shawley-Brzoska, Samantha; Misra, Ranjita

    2018-03-13

    This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants' perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% females; 62% diabetic; 77% had adequate health literacy); 79% of participants completed the benefits and barriers survey. Principal component analysis indicated two components representing benefits (Cronbach's α = 0.83) and barriers (α = 0.65). The majority perceived high benefits and low barriers to program participation; benefits included helpful interaction with health coach or program leader (73%), improved lifestyle modification (65%) due to the program, and satisfaction with the program (75%). Open-ended questions confirmed themes related to benefits of program participation, suggestion for programmatic improvements as well as barriers to participation. Participant feedback could be used to guide interventions and tailor future program implementation.

  4. Nurse-physician communication in the long-term care setting: perceived barriers and impact on patient safety.

    Science.gov (United States)

    Tjia, Jennifer; Mazor, Kathleen M; Field, Terry; Meterko, Vanessa; Spenard, Ann; Gurwitz, Jerry H

    2009-09-01

    Clear and complete communication between health care providers is a prerequisite for safe patient management and is a major priority of the Joint Commission's 2008 National Patient Safety Goals. The goal of this study was to describe nurses' perceptions of nurse-physician communication in the long-term care (LTC) setting. Mixed-method study including a self-administered questionnaire and qualitative semistructured telephone interviews of licensed nurses from 26 LTC facilities in Connecticut. The questionnaire measured perceived openness to communication, mutual understanding, language comprehension, frustration, professional respect, nurse preparedness, time burden, and logistical barriers. Qualitative interviews focused on identifying barriers to effective nurse-physician communication that may not have previously been considered and eliciting nurses' recommendations for overcoming those barriers. Three hundred seventy-five nurses completed the questionnaire, and 21 nurses completed qualitative interviews. Nurses identified several barriers to effective nurse-physician communication: lack of physician openness to communication, logistic challenges, lack of professionalism, and language barriers. Feeling hurried by the physician was the most frequent barrier (28%), followed by finding a quiet place to call (25%), and difficulty reaching the physician (21%). In qualitative interviews, there was consensus that nurses needed to be brief and prepared with relevant clinical information when communicating with physicians and that physicians needed to be more open to listening. A combination of nurse and physician behaviors contributes to ineffective communication in the LTC setting. These findings have important implications for patient safety and support the development of structured communication interventions to improve quality of nurse-physician communication.

  5. Quantitative data analysis of perceived barriers and motivators to physical activity in stroke survivors.

    Science.gov (United States)

    Nicholson, S L; Greig, C A; Sniehotta, F; Johnston, M; Lewis, S J; McMurdo, M E; Johnston, D; Scopes, J; Mead, G E

    2017-09-01

    Levels of physical activity after stroke are low, despite multiple health benefits. We explored stroke survivors' perceived barriers, motivators, self-efficacy and intention to physical activity. Fifty independently mobile stroke survivors were recruited prior to hospital discharge. Participants rated nine possible motivators and four possible barriers based on the Mutrie Scale, as having 'no influence', 'some influence' or 'a major influence' on physical activity. Participants also rated their self-efficacy and intention to increasing walking. The most common motivator was 'physical activity is good for health' [34 (68%)]. The most common barrier was 'feeling too tired' [24 (48%)]. Intention and self-efficacy were high. Self-efficacy was graded as either 4 or 5 (highly confident) on a five-point scale by [34 (68%)] participants, while 42 (84%) 'strongly agreed' or 'agreed' that they intended to increase their walking. Participants felt capable of increasing physical activity but fatigue was often perceived as a barrier to physical activity. This needs to be considered when encouraging stroke survivors to be more active.

  6. Perceived Barriers to Success for Minority Nursing Students: An Integrative Review

    OpenAIRE

    Loftin, Collette; Newman, Susan D.; Dumas, Bonnie P.; Gilden, Gail; Bond, Mary Lou

    2012-01-01

    The objective of this paper was to identify barriers to successful program completion faced by underrepresented minority nursing students. This paper reveals that minority nursing student’s face multiple barriers to success including lack of financial support, inadequate emotional and moral support, as well as insufficient academic advising, program mentoring, technical support, and professional socialization. An additional theme—a resolve to succeed in spite of the identified barriers—was id...

  7. Perceived barriers and motivating factors influencing student midwives' acceptance of rural postings in Ghana.

    Science.gov (United States)

    Lori, Jody R; Rominski, Sarah D; Gyakobo, Mawuli; Muriu, Eunice W; Kweku, Nakua E; Agyei-Baffour, Peter

    2012-07-24

    Research on the mal-distribution of health care workers has focused mainly on physicians and nurses. To meet the Millennium Development Goal Five and the reproductive needs of all women, it is predicted that an additional 334,000 midwives are needed. Despite the on-going efforts to increase this cadre of health workers there are still glaring gaps and inequities in distribution. The objectives of this study are to determine the perceived barriers and motivators influencing final year midwifery students' acceptance of rural postings in Ghana, West Africa. An exploratory qualitative study using focus group interviews as the data collection strategy was conducted in two of the largest midwifery training schools in Ghana. All final year midwifery students from the two training schools were invited to participate in the focus groups. A purposive sample of 49 final year midwifery students participated in 6 focus groups. All students were women. Average age was 23.2 years. Glaser's constant comparative method of analysis was used to identify patterns or themes from the data. Three themes were identified through a broad inductive process: 1) social amenities; 2) professional life; and 3) further education/career advancement. Together they create the overarching theme, quality of life, we use to describe the influences on midwifery students' decision to accept a rural posting following graduation. In countries where there are too few health workers, deployment of midwives to rural postings is a continuing challenge. Until more midwives are attracted to work in rural, remote areas health inequities will exist and the targeted reduction for maternal mortality will remain elusive.

  8. Perceived barriers and motivating factors influencing student midwives’ acceptance of rural postings in Ghana

    Directory of Open Access Journals (Sweden)

    Lori Jody R

    2012-07-01

    Full Text Available Abstract Background Research on the mal-distribution of health care workers has focused mainly on physicians and nurses. To meet the Millennium Development Goal Five and the reproductive needs of all women, it is predicted that an additional 334,000 midwives are needed. Despite the on-going efforts to increase this cadre of health workers there are still glaring gaps and inequities in distribution. The objectives of this study are to determine the perceived barriers and motivators influencing final year midwifery students’ acceptance of rural postings in Ghana, West Africa. Methods An exploratory qualitative study using focus group interviews as the data collection strategy was conducted in two of the largest midwifery training schools in Ghana. All final year midwifery students from the two training schools were invited to participate in the focus groups. A purposive sample of 49 final year midwifery students participated in 6 focus groups. All students were women. Average age was 23.2 years. Glaser’s constant comparative method of analysis was used to identify patterns or themes from the data. Results Three themes were identified through a broad inductive process: 1 social amenities; 2 professional life; and 3 further education/career advancement. Together they create the overarching theme, quality of life, we use to describe the influences on midwifery students’ decision to accept a rural posting following graduation. Conclusions In countries where there are too few health workers, deployment of midwives to rural postings is a continuing challenge. Until more midwives are attracted to work in rural, remote areas health inequities will exist and the targeted reduction for maternal mortality will remain elusive.

  9. How does a lifestyle intervention during pregnancy influence perceived barriers to leisure-time physical activity? The Norwegian fit for delivery study, a randomized controlled trial.

    Science.gov (United States)

    Haakstad, Lene A H; Vistad, Ingvild; Sagedal, Linda Reme; Lohne-Seiler, Hilde; Torstveit, Monica K

    2018-05-03

    To develop effective health promotional and preventive prenatal programs, it is important to understand perceived barriers to leisure-time physical activity during pregnancy, including exercise and sport participation. The aims of the present study was 1) to assess the effect of prenatal lifestyle intervention on the perceived barrier to leisure-time physical activity during pregnancy and the first year after delivery and 2) identify the most important perceived barriers to leisure-time physical activity at multiple time points during and after pregnancy. This secondary analysis was part of the Norwegian Fit for Delivery study, a combined lifestyle intervention evaluated in a blinded, randomized controlled trial. Healthy, nulliparous women with singleton pregnancy of ≤20 gestational weeks, age ≥ 18 years and body mass index ≥19 kg/m 2 were recruited via healthcare clinics in southern Norway, including urban and rural settings. Participants were randomized to either twice-weekly supervised exercise sessions and nutritional counselling (n = 303) or standard prenatal care (n = 303). The principal analysis was based on the participants who completed the standardized questionnaire assessing their perceived barriers to leisure-time physical activity at inclusion (gestational week 16, n = 589) and following intervention (gestational week 36, n = 509), as well as six months (n = 470) and 12 months (n = 424) postpartum. Following intervention (gestation week 35.4 ± 1.0), a significant between-group difference in perceived barriers to leisure-time physical activity was found with respect to time constraints: "... I do not have the time" (intervention: 22 vs. control: 38, p = 0.030), mother-child safety concerns: "... afraid to harm the baby" (intervention: 8 vs. control: 25, p = 0.002) and self-efficacy: "... I do not believe/think that I can do it" (intervention: 3 vs. control: 10, p = 0.050). No positive effect was seen

  10. Communicating with disabled children when inpatients: barriers and facilitators identified by parents and professionals in a qualitative study.

    Science.gov (United States)

    Sharkey, Siobhan; Lloyd, Claire; Tomlinson, Richard; Thomas, Eleanor; Martin, Alice; Logan, Stuart; Morris, Christopher

    2016-06-01

    Communication is a fundamental part of health care, but can be more difficult with disabled children. Disabled children are more frequently admitted to hospital than other children. To explore experiences of ward staff and families to identify barriers and facilitators to effective communication with disabled children whilst inpatients. This was an exploratory qualitative study. We consulted 25 staff working on paediatric wards and 15 parents of disabled children recently admitted to those wards. We had difficulty in recruiting children and evaluating their experiences. Data were collected through interviews and focus groups. A thematic analysis of the data supported by the Framework Approach was used to explore experiences and views about communication. Emerging themes were subsequently synthesised to identify barriers and facilitators to good communication. Barriers to communication included time, professionals not prioritising communication in their role and poor information sharing between parents and professionals. Facilitators included professionals building rapport with a child, good relationships between professionals and parents, professionals having a family-centred approach, and the use of communication aids. Communication with disabled children on the ward was perceived as less than optimal. Parents are instrumental in the communication between their children and professionals. Although aware of the importance of communication with disabled children, staff perceived time pressures and lack of priority given to communicating directly with the child as major barriers. © 2014 John Wiley & Sons Ltd.

  11. Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents.

    Science.gov (United States)

    O'dea, Jennifer A

    2003-04-01

    The goal was to have children and adolescents identify and rank the major perceived benefits of and barriers to healthful eating and physical activity and to suggest strategies for overcoming barriers. Semistructured, in-depth focus groups were undertaken using standardized questions and prompts. Students in grades 2 through 11(ages 7 through 17; N=213) from 34 randomly selected schools participated in 38 focus groups. Major benefits of healthful eating included improvements to cognitive and physical performance, fitness, endurance, psychological benefits, physical sensation (feeling good physically), and production of energy. Barriers included convenience, taste, and social factors. Benefits of physical activity included social benefits, enhancement of psychological status, physical sensation, and sports performance. Barriers included a preference for indoor activities, lack of energy and motivation, time constraints, and social factors. Suggested strategies for overcoming barriers included support from parents and school staff, better planning, time management, self-motivation, education, restructuring the physical environment, and greater variety of physical activities.

  12. International medical graduate-patient communication: a qualitative analysis of perceived barriers.

    Science.gov (United States)

    Dorgan, Kelly A; Lang, Forrest; Floyd, Michael; Kemp, Evelyn

    2009-11-01

    International medical graduates (IMGs) represent a substantial portion of all medical residents in the United States. Yet, IMGs may be disadvantaged in their communications with U.S. patients for a variety of reasons. The authors conducted a qualitative study to examine IMGs' perceptions of the barriers to their communication with patients. A convenience sample of 12 IMGs participated in interviews that lasted 1 to 1.5 hours. Residents from the Caribbean, Colombia, Denmark, India, Iran, Pakistan, and Peru participated in individual interviews conducted on-site at one of three clinics. Interviews were transcribed and then coded independently and jointly. The authors used a qualitative analysis of interview transcripts to identify primary and secondary themes. IMGs' perceptions of the barriers to communication with their Appalachian patients fit into two broad themes: educational barriers and interpersonal barriers. Within each of these themes, the authors identified secondary themes: education-related barriers were science immersion and lack of communication training, and interpersonally related barriers were unfamiliar dialects, new power dynamics, and different rapport-building expectations. The analysis of the interview data yielded several important findings that residency programs should consider when designing orientations, training curricula, and communication interventions. Programs may need to address challenges related to regional dialect and "informal" English use, as well as communication barriers associated with cross-cultural differences in norms, values, and beliefs. Programs also need to draw on multilayered interventions to address the multidimensional challenges of cross-cultural physician-patient communication.

  13. Identifying climate risk perceptions, information needs, and barriers to information exchange among public land managers.

    Science.gov (United States)

    Peters, Casey B; Schwartz, Mark W; Lubell, Mark N

    2018-03-01

    Meeting ecosystem management challenges posed by climate change requires building effective communication channels among researchers, planners and practitioners to focus research on management issues requiring new knowledge. We surveyed resource managers within two regions of the western United States regions to better understand perceived risks and vulnerabilities associated with climate change and barriers to obtaining and using relevant climate science information in making ecosystem management decisions. We sought to understand what types of climate science information resource managers find most valuable, and the formats in which they prefer to receive climate science information. We found broad concern among natural resource managers in federal agencies that climate change will make it more difficult for them to achieve their management goals. Primary barriers to incorporating climate science into planning are distributed among challenges identifying, receiving, and interpreting appropriate science and a lack of direction provided by agency leadership needed to meaningfully use this emerging science in resource planning. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Effect of educational intervention on knowledge, perceived benefits, barriers and self-efficacy regarding AIDS preventive behaviors among drug addicts

    Science.gov (United States)

    Bastami, Fatemeh; Mostafavi, Firoozeh; Hassanzadeh, Akbar

    2015-01-01

    Background and Objectives: Addicts account for approximately 68.15% of AIDS cases in Iran and injection drug users are considered as a major factor in the spread of AIDS in Iran. The purpose of this study was to determine the effect of an educational intervention on the perceived self-efficacy, benefits, and barriers concerning AIDS preventive behaviors among drug addicts in Khorramabad, Iran. Methods: This is a quasi-experimental study carried out in 2013 on 88 addicts kept in rehabilitations center in Khorramabad. The data collection instruments included a questionnaire on self-efficacy, perceived benefits, perceived barriers, knowledge and preventive behaviors regarding HIV. Data were analyzed by paired t-test, independent t-test, Chi-square and analysis of covariance. Results: Paired t-test showed that the mean scores for perceived benefits and barriers, knowledge and preventive behaviors significantly increased in the intervention group after the intervention than before the intervention. But the increase in self-efficacy score was not statistically significant. Conclusions: The results of this study showed that training and education based on the health belief model led to an increase in knowledge, self-efficacy, perceived benefits, performance and reduction in perceived barriers in addicts. It is recommended that future studies should include strategies for enhancing self-efficacy and perceived benefits as well as strategies for reducing barriers to the adoption of preventive behaviors. PMID:27462632

  15. Patient-perceived barriers and facilitators to the implementation of a medication review in primary care: a qualitative thematic analysis.

    Science.gov (United States)

    Uhl, Mirella Carolin; Muth, Christiane; Gerlach, Ferdinand Michael; Schoch, Goentje-Gesine; Müller, Beate Sigrid

    2018-01-05

    Although polypharmacy can cause adverse health outcomes, patients often know little about their medication. A regularly conducted medication review (MR) can help provide an overview of a patient's medication, and benefit patients by enhancing their knowledge of their drugs. As little is known about patient attitudes towards MRs in primary care, the objective of this study was to gain insight into patient-perceived barriers and facilitators to the implementation of an MR. We conducted a qualitative study with a convenience sample of 31 patients (age ≥ 60 years, ≥3 chronic diseases, taking ≥5 drugs/d); in Hesse, Germany, in February 2016. We conducted two focus groups and, in order to ensure the participation of elderly patients with reduced mobility, 16 telephone interviews. Both relied on a semi-structured interview guide dealing with the following subjects: patients' experience of polypharmacy, general design of MRs, potential barriers and facilitators to implementation etc. Interviews were audio-recorded, transcribed verbatim, and analysed by two researchers using thematic analysis. Patients' average age was 74 years (range 62-88 years). We identified barriers and facilitators for four main topics regarding the implementation of MRs in primary care: patient participation, GP-led MRs, pharmacist-led MRs, and the involvement of healthcare assistants in MRs. Barriers to patient participation concerned patient autonomy, while facilitators involved patient awareness of medication-related problems. Barriers to GP-led MRs concerned GP's lack of resources while facilitators related to the trusting relationship between patient and GP. Pharmacist-led MRs might be hindered by a lack of patients' confidence in pharmacists' expertise, but facilitated by pharmacies' digital records of the patients' medications. Regarding the involvement of healthcare assistants in MRs, a potential barrier was patients' uncertainty regarding the extent of their training. Patients

  16. Perceived exercise barriers, enablers, and benefits among exercising and nonexercising adults with arthritis: results from a qualitative study.

    Science.gov (United States)

    Wilcox, Sara; Der Ananian, Cheryl; Abbott, Jill; Vrazel, JoEllen; Ramsey, Cornelia; Sharpe, Patricia A; Brady, Teresa

    2006-08-15

    Rates of participation in regular exercise are lower among individuals with arthritis than those without arthritis. This study examined perceived exercise barriers, benefits, and enablers in exercising and nonexercising adults with arthritis. Twelve focus groups were conducted with 68 adults with arthritis. Groups were segmented by exercise status, socioeconomic status, and race. Focus group discussions were transcribed verbatim and coded. NVivo software was used to extract themes for exercisers and nonexercisers. A wide range of physical, psychological, social, and environmental factors were perceived to influence exercise. Some of these factors were similar to those in general adult samples, whereas others were unique to individuals with chronic disease. Symptoms of arthritis were barriers to exercise, yet improvements in these outcomes were also seen as potential benefits of and motivations for exercise. Exercisers had experienced these benefits and were more likely to have adapted their exercise to accommodate the disease, whereas nonexercisers desired these benefits and were more likely to have stopped exercising since developing arthritis. Health care providers' advice to exercise and the availability of arthritis-specific programs were identified as needs. This study has implications for how to market exercise to individuals with arthritis and how communities and health care professionals can facilitate the uptake of exercise. These implications are discussed.

  17. Perceived Barriers to Adherence to Tuberculosis Infection Control Measures among Health Care Workers in the Dominican Republic.

    Science.gov (United States)

    Chapman, Helena J; Veras-Estévez, Bienvenido A; Pomeranz, Jamie L; Pérez-Then, Eddy N; Marcelino, Belkys; Lauzardo, Michael

    2017-01-01

    INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low. Identifying the causes of low adherence is a prerequisite to effective programming to reduce risk. OBJECTIVE Identify perceived barriers to adherence to tuberculosis infection control measures among health care workers in the Dominican Republic. METHODS During August 2014, a qualitative study was conducted in two tertiary-level hospitals in different regions of the Dominican Republic. A semi-structured interview guide of nine questions was developed, based on the scientific literature and with consensus of clinical experts. Nine semi-structured interviews were conducted with a purposive sample of seven physicians (five men, two women) and two baccalaureate nurses (both women) working in the emergency medicine, internal medicine or nursing departments of those institutions. Question topics included clinical experience of M. tuberculosis infection and disease; knowledge of disease transmission and preventive practices; clinical management strategies; and perceptions of effectiveness of directly observed treatment, short-course, and disease coping strategies. RESULTS Perceived barriers were described as: 1) sense of invincibility of health care workers; 2) personal beliefs of health care workers related to direct patient communication; 3) low provider-to-patient ratios in hospitals; 4) absence of tuberculosis isolation units for

  18. The Relationship between Glass Ceiling Barriers to Woman and Perceived Organizational Justice in Working Life

    OpenAIRE

    Özyer, Kubilay; Azizoğlu, Öznur

    2014-01-01

    Women are participating more and more to the working life nowadays. But they couldn’t adequately take part in high management positions. There are too many reasons which effect this case. Especially; in some research it suggested that women couldn’t go beyond to a barrier, “glass ceiling”, which is an invisible obstacle for women, and they have to work under it. For these reason; in this study firstly, the terms of glass ceiling obstacle to women and perceived organizational justice and the i...

  19. Implementing a novel dance intervention in rehabilitation: perceived barriers and facilitators.

    Science.gov (United States)

    Demers, Marika; Thomas, Aliki; Wittich, Walter; McKinley, Patricia

    2015-01-01

    To identify clinicians' perceptions regarding the facilitators and barriers to the use of dance in rehabilitation. This study used a qualitative descriptive design. Three focus groups were conducted with clinicians across three purposively selected rehabilitation centers. Data were analyzed using thematic content analysis. Fourteen allied health-care professionals (six occupational therapists, six physical therapists, and two social workers) with previous dance experience participated in this study. Four main themes emerged from the analysis representing the personal and organizational factors influencing on the implementation of dance interventions: (1) Clinician's dance experience and training, (2) Interest and personal beliefs towards using dance as a potential intervention, (3) Support from the organization of the institution, and (4) Available resources. Although each site was different, the main factors acting as barriers and facilitators were similar for all three sites. The identification of the barriers and facilitators to implementing dance in rehabilitation is the first step to support the translation of knowledge about dance. A tailored approach designed for clinicians and managers should address the main barriers to knowledge use about dance, as a potential rehabilitation modality for individuals with disabilities. Personal and organizational factors can act simultaneously as barriers and facilitators to the implementation of a dance intervention. Lack of time for professional development and lack of support from the organization are the main barriers to the uptake of knowledge about dance in rehabilitation. A knowledge translation strategy addressing the barriers to knowledge use is helpful for clinicians and managers facilitating the implementation of dance in rehabilitation settings.

  20. Perceived barriers to prostate cancer screenings among middle-aged men in north-eastern Germany.

    Science.gov (United States)

    Hannöver, Wolfgang; Köpke, David; Hannich, Hans-Joachim

    2010-01-01

    Prostate cancer ranks high in mortality. Only 18% of men entitled for screenings take advantage of this. Social-cognitive models of health psychology describe and predict health behavior. This study investigates what barriers men perceive that impede the utilization of cancer screenings. Semistructured interviews were conducted in 2 general practices and 3 hospital wards. One hundred and seventy-eight men over 45 years were addressed; 64 utilized cancer screenings regularly, 3 had a diagnosis of prostate cancer, and 18 declined participation. Content analyses were conducted with 83 interviews. The interview tapped into the following domains: barriers, risk perception, outcome expectancies, self-efficacy, and intentions. 57 men regarded their health as very important, while 47 had never utilized cancer screenings. Barriers were divided into emotional/cognitive versus organizational/structural. Sixty-four men did not utilize cancer screenings because of lack of symptoms, 22 feared a positive result, 20 had more pertinent health issues, and 18 assumed that their physicians would screen for cancer "automatically." Mainly emotional/cognitive barriers were seen as important for nonutilization, especially the absence of symptoms. Following the reasoning of social-cognitive models, a first step to enhance utilization rates would be to enhance risk perception. © 2010 Wiley Periodicals, Inc.

  1. Securing the Future of Cultural Heritage by Identifying Barriers to and Strategizing Solutions for Preservation under Changing Climate Conditions

    Directory of Open Access Journals (Sweden)

    Sandra Fatorić

    2017-11-01

    Full Text Available Climate change challenges cultural heritage management and preservation. Understanding the barriers that can impede preservation is of paramount importance, as is developing solutions that facilitate the planning and management of vulnerable cultural resources. Using online survey research, we elicited the opinions of diverse experts across southeastern United States, a region with cultural resources that are particularly vulnerable to flooding and erosion from storms and sea level rise. We asked experts to identify the greatest challenges facing cultural heritage policy and practice from coastal climate change threats, and to identify strategies and information needs to overcome those challenges. Using content analysis, we identified institutional, technical and financial barriers and needs. Findings revealed that the most salient barriers included the lack of processes and preservation guidelines for planning and implementing climate adaptation actions, as well as inadequate funding and limited knowledge about the intersection of climate change and cultural heritage. Experts perceived that principal needs to overcome identified barriers included increased research on climate adaptation strategies and impacts to cultural heritage characteristics from adaptation, as well as collaboration among diverse multi-level actors. This study can be used to set cultural heritage policy and research agendas at local, state, regional and national scales.

  2. Identifying common barriers and facilitators to linkage and retention in chronic disease care in western Kenya

    Directory of Open Access Journals (Sweden)

    Beth Rachlis

    2016-08-01

    Full Text Available Abstract Background Sub-Saharan Africa is increasingly being challenged in providing care and treatment for chronic diseases, both communicable and non-communicable. In order to address the challenges of linkage to and retention in chronic disease management, there is the need to understand the factors that can influence engagement in care. We conducted a qualitative study to identify barriers and facilitators to linkage and retention in chronic care for HIV, tuberculosis (TB and Hypertension (HTN as part of the Academic Model Providing Access to Healthcare (AMPATH program in western Kenya. Methods In-depth interviews and focus group discussions were conducted July 2012-August 2013. Study participants were purposively sampled from three AMPATH clinics and included patients within the AMPATH program receiving HIV, TB, and HTN care, as well as caregivers of children with HIV, community leaders, and healthcare providers. A set of interview guides were developed to explore perceived barriers and facilitators to chronic disease management, particularly related to linkage to and retention in HIV, TB and HTN care. Data were coded and various themes were identified. We organized the concepts and themes generated using the Andersen-Newman Framework of Health Services Utilization. Results A total of 235 participants including 110 individuals living with HIV (n = 50, TB (n = 39, or HTN (n = 21; 24 caregivers; 10 community leaders; and 62 healthcare providers participated. Barriers and facilitators were categorized as predisposing characteristics, enabling resources and need factors. Many of the facilitators and barriers reported in this study were consistently reported across disease categories including personal drive, patient-provider relationships and the need for social and peer support. Conclusions Our findings provide insight into the individual as well as broader structural factors that can deter or encourage linkage and retention that

  3. Identifying barriers to remaining physically active after rehabilitation: differences in perception between physical therapists and older adult patients.

    Science.gov (United States)

    Zalewski, Kathryn; Alt, Carlynn; Arvinen-Barrow, Monna

    2014-06-01

    Cross-sectional study. To describe readiness for change and barriers to physical activity in older adults and to contrast perceptions of physical therapists and patients using the Barriers to Being Active Quiz. Regular physical activity is vital to recovery after discharge from physical therapy. Physical therapists are positioned to support change in physical activity habits for those transitioning to home care. Understanding of readiness for change and barriers to physical activity could optimize recovery. Thirteen physical therapists enrolled in the study and invited patients who met the inclusion criteria to enroll (79 patients enrolled). The physical therapists provided the ICD-9 code, the physical therapist diagnosis, and completed the Barriers to Being Active Quiz as they perceived their patients would. The enrolled patients provided demographics and filled out the Satisfaction With Life Scale, the stages-of-change scale for physical activity, and the Barriers to Being Active Quiz. Patients were predominantly in the early stages of readiness for change. Both patients and physical therapists identified lack of willpower as the primary barrier to physical activity. Patients identified lack of willpower and social influence as critical barriers more often than physical therapists, whereas physical therapists identified fear of injury and lack of time more often than their patients did. Differences between physical therapists and their patients were noted for fear of injury (z = 2.66, P = .008) and lack of time (z = 3.46, P = .001). The stage of change for physical activity impacted perception of social influence (χ2 = 9.64, Pbarriers to physical activity may allow physical therapists to better tailor intervention strategies to impact physical activity behavior change.

  4. Mediating role of critical thinking disposition in the relationship between perceived barriers to research use and evidence-based practice.

    Science.gov (United States)

    Kim, Sun-Ae; Song, Youngshin; Sim, Hee-Sook; Ahn, Eun-Kyong; Kim, Jung-Hee

    2015-01-01

    Despite the importance of critical thinking in clinical and educational settings, little is known about its role in evidence-based practice (EBP). This study examined whether critical thinking disposition (CTD) mediates the relationship between perceived barriers to research use and EBP in clinical nurses (N=409). A path diagram using structural equation modeling was used to estimate the direct and indirect effects of perceived barriers to research use on EBP, controlling for CTD as a mediator. CTD partially mediated the relationship between perceived barriers to research use and EBP. Furthermore, the hypothesized mediation model demonstrated an appropriate fit to the data. Individual and organizational efforts are needed to help nurses further improve their critical thinking skills. CTD is important as research barriers to engage effectively in EBP. Without the skills to evaluate evidence carefully, research utilization may be compromised.

  5. Punjabi Sikh patients' perceived barriers to engaging in physical exercise following myocardial infarction.

    Science.gov (United States)

    Galdas, Paul M; Oliffe, John L; Kang, H Bindy K; Kelly, Mary T

    2012-11-01

    The aim of this research was to describe Punjabi Sikh patients' perceived barriers to engaging in physical exercise following myocardial infarction (MI). A qualitative, interpretive descriptive methodology was used. The sample included 15 Punjabi Sikh patients who were attending a cardiac rehabilitation education program in an urban center of British Columbia, Canada, following MI. Data were collected via semi-structured interviews and were audio recorded, translated from Punjabi to English, and transcribed verbatim. Data were analyzed using an interpretive thematic approach that involved a process of coding and constant comparison. Four key factors emerged that related to participants' perceived barriers to sustained engagement in physical activity: (1) difficulty in determining safe exertion levels independently; (2) fatigue and weakness; (3) preference for 'informal' exercise; and (4) migration-related challenges. The findings have implications for the design and delivery of health promotion strategies aimed at Punjabi Sikh patients' post-MI that is contingent on the use of 'formal' exercise settings to promote regular physical activity. The willingness among Punjabi Sikh patients to practise brisk walking offers a positive direction that public health nurses and other healthcare professionals may want to capitalize on in the delivery of exercise-related health promotion. © 2012 Wiley Periodicals, Inc.

  6. Identifiability of location and magnitude of flow barriers in slightly compressible flow

    NARCIS (Netherlands)

    Kahrobaei, S.; Mansoori Habib Abadi, M.; Joosten, G.J.P.; Hof, Van den P.M.J.; Jansen, J.D.

    2015-01-01

    Classic identifiability analysis of flow barriers in incompressible single-phase flow reveals that it is not possible to identify the location and permeability of low-permeability barriers from production data (wellbore pressures and rates), and that only averaged reservoir properties in between

  7. Identifiability of location and magnitude of flow barriers in slightly compressible flow

    NARCIS (Netherlands)

    Kahrobaei, S.; Mansoori Habib Abadi, M.; Joosten, G.J.P.; Van den Hof, P.; Jansen, J.D.

    2016-01-01

    Classic identifiability analysis of flow barriers in incompressible single-phase flow reveals that it is not possible to identify the location and permeability of low-permeability barriers from production data (wellbore pressures and rates), and that only averaged reservoir properties in between

  8. The Relationship between Race and Students' Identified Career Role Models and Perceived Role Model Influence

    Science.gov (United States)

    Karunanayake, Danesh; Nauta, Margaret M.

    2004-01-01

    The authors examined whether college students' race was related to the modal race of their identified career role models, the number of identified career role models, and their perceived influence from such models. Consistent with A. Bandura's (1977, 1986) social learning theory, students tended to have role models whose race was the same as…

  9. Stakeholders identify similar barriers but different strategies to facilitate return-to-work: A vignette of a worker with an upper extremity condition.

    Science.gov (United States)

    Peters, Susan E; Truong, Anthony P; Johnston, Venerina

    2018-01-01

    Stakeholders involved in the return-to-work (RTW) process have different roles and qualificationsOBJECTIVE:To explore the perspectives of Australian stakeholders of the RTW barriers and strategies for a worker with an upper extremity condition and a complex workers' compensation case. Using a case vignette, stakeholders were asked to identify barriers and recommend strategies to facilitate RTW. Content analysis was performed on the open-ended responses. The responses were categorised into RTW barriers and strategies using the biopsychosocial model. Pearson's Chi Square and ANOVA were performed to establish group differences. 621 participants (488 healthcare providers (HCPs), 62 employers, 55 insurers and 16 lawyers) identified 36 barriers (31 modifiable): 4 demographic; 8 biological; 15 psychological and 9 social barriers. 484 participants reported 16 RTW strategies: 4 biological; 6 psychological and 6 social strategies. 'Work relationship stressors' (83.4%) and 'Personal relationship stressors' (64.7%) were the most frequently nominated barriers. HCPs most frequently nominated 'Pain management' (49.6%), while employers, insurers and lawyers nominated 'RTW planning/Suitable duties programs' (40.5%; 42.9%; 80%). Stakeholders perceived similar barriers for RTW but recommended different strategies. Stakeholders appeared to be more proficient in identifying barriers than recommending strategies. Future research should focus on tools to both identify RTW barriers and direct intervention.

  10. A multi-institutional study of the perceived barriers and facilitators to implementing evidence-based practice.

    Science.gov (United States)

    Duncombe, Daphne C

    2018-03-01

    To examine perceived barriers and facilitators to implementing evidence-based practice among nurses working in psychiatric, geriatric, hospital and community settings in The Bahamas. It is evident from previous studies that a number of factors exist which either obstruct or promote the utilisation of research evidence in nursing practice. Identifying these factors is vital to the successful uptake of evidence-based practice in nursing. Descriptive, comparative study. Data were collected using self-administered questionnaires. A stratified random sample (n = 100) of registered nurses participated; 5-point Likert-like scales were used to examine nurses' perceptions of barriers and facilitators of evidence-based practice. Descriptive statistics were used to describe demographic characteristics and to compare responses of nurses. Participants were predominantly female (98.4%), in the 25 to implement evidence-based practice previously. The greatest barriers identified were as follows: "Inadequate resources for implementing research findings" (85.2%; n = 52) and "Inadequate training in research methods" (83.6%; n = 51). The top facilitators identified were as follows: "Training in research methods" (88.5%; n = 54) and "Organisational policies and protocols that are evidence-based" (86.9%; n = 53). Nurses generally expressed that they required additional training in research and evidence-based practice concepts. Although some nurses had a desire to implement evidence-based practice to provide quality care and improve patient outcomes, many expressed that they lacked the required resources. The study draws attention to the need for prioritisation of evidence-based practice both at institutional and governmental levels. Successful adoption of evidence-based practice implies combined efforts of nurses, healthcare providers and policymakers. Further research is needed to determine the best method for successfully incorporating evidence-based practice into nursing

  11. Perceived benefits and barriers to a career in pediatric neurosurgery: a survey of neurosurgical residents.

    Science.gov (United States)

    Dias, Mark S; Sussman, Jeffrey S; Durham, Susan; Iantosca, Mark R

    2013-11-01

    Research suggests that there may be a growing disparity between the supply of and demand for both pediatric specialists and neurosurgeons. Whether pediatric neurosurgeons are facing such a disparity is disputable, but interest in pediatric neurosurgery (PNS) has waxed and waned as evidenced by the number of applicants for PNS fellowships. The authors undertook a survey to analyze current neurosurgical residents' perceptions of both benefits and deterrents to a pediatric neurosurgical career. All residents and PNS fellows in the United States and Canada during the academic year 2008-2009 were invited to complete a Web-based survey that assessed 1) demographic and educational information about residents and their residency training, particularly as it related to training in PNS; 2) residents' exposure to mentoring opportunities from pediatric neurosurgical faculty and their plans for the future; and 3) residents' perceptions about how likely 40 various factors were to influence their decision about whether to pursue a PNS career. Four hundred ninety-six responses were obtained: 89% of the respondents were male, 63% were married, 75% were in at least their 3rd year of postgraduate training, 61% trained in a children's hospital and 29% in a children's "hospital within a hospital," and 72% were in programs having one or more dedicated PNS faculty members. The residencies of 56% of respondents offered 6-11 months of PNS training and nearly three-quarters of respondents had completed 2 months of PNS training. During medical school, 92% had been exposed to neurosurgery and 45% to PNS during a clinical rotation, but only 7% identified a PNS mentor. Nearly half (43%) are considering a PNS career, and of these, 61% are definitely or probably considering post-residency fellowship. On the other hand, 68% would prefer an enfolded fellowship during residency. Perceived strengths of PNS included working with children, developing lasting relationships, wider variety of operations

  12. Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences.

    Science.gov (United States)

    Learmonth, Yvonne C; Motl, Robert W

    2016-01-01

    This systematic review was conducted to provide rich and deep evidence of the perceived determinants and consequences of physical activity and exercise based on qualitative research in multiple sclerosis (MS). Electronic databases and article reference lists were searched to identify qualitative studies of physical activity and exercise in MS. Studies were included if they were written in English and examined consequences/determinants of physical activity in persons with MS. Content analysis of perceived determinants and consequences of physical activity and exercise was undertaken using an inductive analysis guided by the Physical Activity for people with Disabilities framework and Social Cognitive Theory, respectively. Nineteen articles were reviewed. The most commonly identified perceived barriers of physical activity and exercise were related to the environmental (i.e. minimal or no disabled facilities, and minimal or conflicting advice from healthcare professionals) and related to personal barriers (i.e. fatigue, and fear and apprehension). The most commonly identified perceived facilitators of physical activity were related to the environment (i.e. the type of exercise modality and peer support) and related to personal facilitators (i.e. appropriate exercise and feelings of accomplishment). The most commonly identified perceived beneficial consequences of physical activity and exercise were maintaining physical functions, increased social participation and feelings of self-management and control. The most commonly identified perceived adverse consequences were increased fatigue and feelings of frustration and lost control. Results will inform future research on the perceived determinants and consequences of physical activity and exercise in those with MS and can be adopted for developing professional education and interventions for physical activity and exercise in MS. Physical activity and exercise behaviour in people with multiple sclerosis (MS) is subject

  13. Investigating Perceived Barriers to the Use of Open Educational Resources in Higher Education in Tanzania

    Directory of Open Access Journals (Sweden)

    Joel S. Mtebe

    2014-04-01

    Full Text Available The past few years have seen increasingly rapid development and use of open educational resources (OER in higher education institutions (HEIs in developing countries. These resources are believed to be able to widen access, reduce the costs, and improve the quality of education. However, there exist several challenges that hinder the adoption and use of these resources. The majority of challenges mentioned in the literature do not have empirically grounded evidence and they assume Sub-Saharan countries face similar challenges. Nonetheless, despite commonalities that exist amongst these countries, there also exists considerable diversity, and they face different challenges. Accordingly, this study investigated the perceived barriers to the use of OER in 11 HEIs in Tanzania. The empirical data was generated through semi-structured interviews with a random sample of 92 instructors as well as a review of important documents. Findings revealed that lack of access to computers and the Internet, low Internet bandwidth, absence of policies, and lack of skills to create and/or use OER are the main barriers to the use of OER in HEIs in Tanzania. Contrary to findings elsewhere in Africa, the study revealed that lack of trust in others’ resources, lack of interest in creating and/or using OER, and lack of time to find suitable materials were not considered to be barriers. These findings provide a new understanding of the barriers to the use of OER in HEIs and should therefore assist those who are involved in OER implementation to find mitigating strategies that will maximize their usage.

  14. Barriers to glaucoma case finding as perceived by optometrists in Ireland.

    Science.gov (United States)

    Barrett, Catriona; O'Brien, Colm; Butler, John S; Loughman, James

    2018-01-01

    This research was designed to provide an in-depth exploration of the perceptions of optometrists relating to the challenges of glaucoma case finding in the Irish health-care system. A survey was developed, piloted and distributed for anonymous completion by optometrists registered to practise in Ireland. The survey included 10 five-level Likert items exploring potential barriers to glaucoma detection and a free-text box for participants to comment more broadly. One hundred and ninety-nine optometrists (27 per cent of registrants) responded to the survey. Among the barriers identified, there was notable agreement (71 per cent) with the need for extra training on glaucoma detection. Logistic regression showed that optometrists without postgraduate qualifications were more likely to agree with the need for extra training (OR 3.2, 95 per cent CI 1.3-8.1). Respondents largely agreed (61 per cent) that patient unwillingness to pay additional fees for supplementary glaucoma-specific tests was also a barrier. Appointment times of less than 30 minutes were significantly associated with six of the 10 proposed barriers to glaucoma detection. A logistic regression analysis (n = 179) confirmed that the time allotted per appointment was a significant predictor of the agreement time of optometrists as a barrier (χ 2 [1] = 13.52, p glaucoma indicates that optometrists wishing to increase their scope of practice in the new legislative environment in Ireland may more actively seek training in areas of interest. The responses also indicate a lack of funding for the level of diagnostic testing required for accurate glaucoma diagnosis. Recent increases in the state's eye examination fees look likely to address the identified time and financial barriers to glaucoma detection in Ireland. Future work should look to analyse the effects of increased funding on optometric case finding for glaucoma. © 2017 Optometry Australia.

  15. Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study.

    Science.gov (United States)

    Craike, Melinda J; Hose, Kaye; Courneya, Kerry S; Harrison, Simon J; Livingston, Patricia M

    2013-07-01

    Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM. This was a qualitative study that used a grounded theory approach. Semi-structured interviews were conducted in Victoria, Australia by telephone from December 2011-February 2012 with patients who had been treated for MM within the preceding 2-12 months. Interviews were transcribed and analysed using the constant comparison coding method to reduce the data to themes. Gender differences and differences between treatment groups were explored. Twenty-four interviews were completed. The sample comprised 13 females (54%), with a mean age of 62 years (SD = 8.8). Sixteen (67%) participants had received an autologous stem cell transplant (ASCT). All participants currently engaged in a range of light to moderate intensity physical activity; walking and gardening were the most common activities. Recovery from the symptoms of MM and side effects of therapy, psychological benefits, social factors and enjoyment were important benefits of physical activity. Barriers to physical activity predominately related to the symptoms of MM and side effects of therapy, including pain, fatigue, and fear of infection. Low self- motivation was also a barrier. Women participated in a more diverse range of physical activities than men and there were gender differences in preferred type of physical activity. Women were more likely to report psychological and social benefits; whereas men reported physical activity as a way to keep busy and self-motivation was a barrier. Patients treated with an ASCT more often reported affective benefits of participation in physical activity and fatigue as a barrier. Patients

  16. Barriers perceived by nurses in the optimal treatment of postoperative pain

    Directory of Open Access Journals (Sweden)

    Medrzycka-Dabrowka Wioletta

    2017-08-01

    Full Text Available It is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. On a national level, the greatest burden of inadequate treatment is borne, among others, by elderly patients. The purpose of the paper was to compare the prevalence of barriers to optimum post-operative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. The research project was a multi-center one and took over a year. The study was questionnaire-based. It used the Polish version of the Nurses’ Perceived Obstacles to Pain Assessment and Management Practices questionnaire. The study included a total of 1602 nurses working at a clinical, provincial and municipal hospital.

  17. Perceived barriers to accessing mental health services among black and minority ethnic (BME) communities: a qualitative study in Southeast England.

    Science.gov (United States)

    Memon, Anjum; Taylor, Katie; Mohebati, Lisa M; Sundin, Josefin; Cooper, Max; Scanlon, Thomas; de Visser, Richard

    2016-11-16

    In most developed countries, substantial disparities exist in access to mental health services for black and minority ethnic (BME) populations. We sought to determine perceived barriers to accessing mental health services among people from these backgrounds to inform the development of effective and culturally acceptable services to improve equity in healthcare. Qualitative study in Southeast England. 26 adults from BME backgrounds (13 men, 13 women; aged >18 years) were recruited to 2 focus groups. Participants were identified through the registers of the Black and Minority Ethnic Community Partnership centre and by visits to local community gatherings and were invited to take part by community development workers. Thematic analysis was conducted to identify key themes about perceived barriers to accessing mental health services. Participants identified 2 broad themes that influenced access to mental health services. First, personal and environmental factors included inability to recognise and accept mental health problems, positive impact of social networks, reluctance to discuss psychological distress and seek help among men, cultural identity, negative perception of and social stigma against mental health and financial factors. Second, factors affecting the relationship between service user and healthcare provider included the impact of long waiting times for initial assessment, language barriers, poor communication between service users and providers, inadequate recognition or response to mental health needs, imbalance of power and authority between service users and providers, cultural naivety, insensitivity and discrimination towards the needs of BME service users and lack of awareness of different services among service users and providers. People from BME backgrounds require considerable mental health literacy and practical support to raise awareness of mental health conditions and combat stigma. There is a need for improving information about services

  18. Perceived barriers to pediatrician and family practitioner participation in pediatric clinical trials: Findings from the Clinical Trials Transformation Initiative

    Directory of Open Access Journals (Sweden)

    Rachel G. Greenberg

    2018-03-01

    Of the 136 providers surveyed, 52/136 (38% had previously referred a pediatric patient to a trial, and only 17/136 (12% had ever been an investigator for a pediatric trial. Lack of awareness of existing pediatric trials was a major barrier to patient referral by providers, in addition to consideration of trial risks, distance to the site, and time needed to discuss trial participation with parents. Overall, providers perceived greater challenges related to parental concerns and parent or child logistical barriers than study implementation and ethics or regulatory barriers as barriers to their practice serving as a trial site. Providers who had previously been an investigator for a pediatric trial were less likely to be concerned with potential barriers than non-investigators. Understanding the barriers that limit pediatric providers from collaboration or inhibit their participation is key to designing effective interventions to optimize pediatric trial participation.

  19. Women׳s help-seeking behaviours for depressive symptoms during the perinatal period: Socio-demographic and clinical correlates and perceived barriers to seeking professional help.

    Science.gov (United States)

    Fonseca, Ana; Gorayeb, Ricardo; Canavarro, Maria Cristina

    2015-12-01

    This study aims to characterize the help-seeking behaviours of women who were screened positive for perinatal depression, to investigate its sociodemographic and clinical correlates, and to characterize the perceived barriers that prevent women from seeking professional help. Cross-sectional internet survey. Participants were recruited through advertisements published in pamphlets and posted on social media websites (e.g., Facebook) and websites and forums that focused on pregnancy and childbirth. 656 women (currently pregnant or who had a baby during the last 12 months) completed the survey. Participants were assessed with the Edinburgh Postpartum Depression Scale, and were questioned about sociodemographic and clinical data, help-seeking behaviours and perceived barriers to help-seeking. Different pathways of help-seeking were found, with only 13.6% of women with a perinatal depression seeking help for their emotional problems. Married women, currently pregnant women, and women without history of psychological problems had a higher likelihood of not engaging in any type of help-seeking behaviour. The majority of women who had not sought professional assistance identified several barriers to help-seeking, particularly knowledge barriers. Strategies to increase women׳s help-seeking behaviours should be implemented, namely improving mental health literacy, introducing screening procedures for mental health problems in pre/postnatal health care settings, and offering women innovative opportunities (e.g., web-based tools) that allow them to overcome the practical barriers to help-seeking. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Influenza Vaccine Uptake, Hand Hygiene Practices, and Perceived Barriers in Decision Making.

    Science.gov (United States)

    Stedman-Smith, Maggie; Kingsbury, Diana M; Dubois, Cathy L Z; Grey, Scott F

    2017-01-01

    The annual costs of influenza are in the billions of dollars, with employers bearing substantial burdens. Yet, influenza vaccine uptake is sub-optimal. A random survey was administered to employees at a Midwestern public university using mixed quantitative and qualitative methods to identify the rate, characteristics, and barriers of self-reported flu vaccine uptake during March-April of 2012. The lowest uptake was among adults, ages 18 to 49 (29.8%), even though they are included in universal recommendations. Multiple regression analysis adjusted for demographic confounders showed an increase in self-identified protective hand hygiene behavior among those who reported influenza vaccine uptake compared with those who did not. Qualitative thematic analysis revealed contextual accounts of why vaccine uptake was declined including structural, perceptual, and knowledge barriers. Implementation and evaluation of novel multicomponent worksite vaccine interventions tailored to reach young and middle-aged employees including utilization of risk communication is needed to facilitate increased uptake.

  1. Cohesion, leadership, mental health stigmatisation and perceived barriers to care in UK military personnel.

    Science.gov (United States)

    Jones, Norman; Campion, Ben; Keeling, Mary; Greenberg, Neil

    2018-02-01

    Military research suggests a significant association between leadership, cohesion, mental health stigmatisation and perceived barriers to care (stigma/BTC). Most studies are cross sectional, therefore longitudinal data were used to examine the association of leadership and cohesion with stigma/BTC. Military personnel provided measures of leadership, cohesion, stigma/BTC, mental health awareness and willingness to discuss mental health following deployment (n = 2510) and 4-6 months later (n = 1636). At follow-up, baseline leadership and cohesion were significantly associated with stigma/BTC; baseline cohesion alone was significantly associated with awareness of and willingness to discuss mental health at follow-up. Over time, changes in perceived leadership and cohesion were significantly associated with corresponding changes in stigma/BTC levels. Stigma/BTC content was similar in both surveys; fear of being viewed as weak and being treated differently by leaders was most frequently endorsed while thinking less of a help-seeking team member and unawareness of potential help sources were least common. Effective leadership and cohesion building may help to reduce stigma/BTC in military personnel. Mental health awareness and promoting the discussion of mental health matters may represent core elements of supportive leader behaviour. Perceptions of weakness and fears of being treated differently represent a focus for stigma/BTC reduction.

  2. Perceived facilitators of and barriers to healthful eating among university students.

    Science.gov (United States)

    Garcia, Alicia C; Sykes, Lesley; Matthews, June; Martin, Noelle; Leipert, Beverly

    2010-01-01

    Photovoice, an innovative qualitative research method in health care, has not been used to its full potential in nutrition/dietetics. We explored the use of Photovoice to determine perceived facilitators of and barriers to healthful eating among university students. The study included 28 students enrolled in a 2008 introductory nutrition class. The students participated in a camera orientation session to review ethics and privacy issues. They took photographs and selected two for discussion in a focus group moderated by a graduate student who used a semi-structured facilitation guide. Researchers coded the transcripts, analyzed the pictures and students' written comments about the project, and ensured data trustworthiness through credibility, dependability, confirmability, and transferability of data and methods. Six major themes emerged as facilitators and/or barriers: environment, nutrition knowledge, convenience foods, time, media influence, and food cost. More than one-third of the students thought the study "stimulated their critical thinking." They felt more empowered in sharing their perceptions and "getting their voices heard." Photovoice was a useful, "motivating," and "engaging" method for research on nutrition knowledge and dietary patterns of university students. Registered dietitians and other health professionals may benefit from the use of the Photovoice method when they are working with students.

  3. Perceived Benefits and Barriers to Exercise for Recently Treated Adults With Acute Leukemia.

    Science.gov (United States)

    Leak Bryant, Ashley; Walton, AnnMarie L; Pergolotti, Mackenzi; Phillips, Brett; Bailey, Charlotte; Mayer, Deborah K; Battaglini, Claudio

    2017-07-01

    To explore perceived exercise benefits and barriers in adults with acute leukemia who recently completed an inpatient exercise intervention during induction therapy.
. Descriptive, exploratory design using semistructured interviews.
. Inpatient hematology/oncology unit at North Carolina Cancer Hospital in Chapel Hill.
. 6 adults with acute leukemia aged 35-67 years.
. Content analyses of semistructured interviews that were conducted with each participant prior to hospital discharge.
. Most participants were not meeting the recommended physical activity levels of 150 minutes of moderate-intensity exercise per week before their diagnosis. Patients were highly pleased with the exercise intervention and the overall program. Common barriers to exercise were anxiety and aches and pains.
. Overall, participants experienced physical and psychological benefits with the exercise intervention with no adverse events from exercising regularly during induction chemotherapy. Referrals for cancer rehabilitation management will lead to prolonged recovery benefits.
. Findings inform the nurses' role in encouraging and supporting adults with acute leukemia to exercise and be physically active during their hospitalization. Nurses should also be responsible for assisting patients with physical function activities to increase mobility and enhance overall health-related quality of life.

  4. Implementing clinical guidelines in stroke: a qualitative study of perceived facilitators and barriers.

    Science.gov (United States)

    Donnellan, Claire; Sweetman, S; Shelley, E

    2013-08-01

    Clinical guidelines are frequently used as a mechanism for implementing evidence-based practice. However research indicates that health professionals vary in the extent to which they adhere to these guidelines. This study aimed to study the perceptions of stakeholders and health professionals on the facilitators and barriers to implementing national stroke guidelines in Ireland. Qualitative interviews using focus groups were conducted with stakeholders (n=3) and multidisciplinary team members from hospitals involved in stroke care (n=7). All focus group interviews were semi-structured, using open-ended questions. Data was managed and analysed using NVivo 9 software. The main themes to emerge from the focus groups with stakeholders and hospital multidisciplinary teams were very similar in terms of topics discussed. These were resources, national stroke guidelines as a tool for change, characteristics of national stroke guidelines, advocacy at local level and community stroke care challenges. Facilitators perceived by stakeholders and health professionals included having dedicated resources, user-friendly guidelines relevant at local level and having supportive advocates on the ground. Barriers were inadequate resources, poor guideline characteristics and insufficient training and education. This study highlights health professionals' perspectives regarding many key concepts which may affect the implementation of stroke care guidelines. The introduction of stroke clinical guidelines at a national level is not sufficient to improve health care quality as they should be incorporated in a quality assurance cycle with education programmes and feedback from surveys of clinical practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Perceived benefits and barriers of implementing nursing residency programs in Jordan.

    Science.gov (United States)

    AbuAlRub, R F; Abu Alhaija'a, M G

    2018-03-02

    To explore the challenges that face Jordanian nurses in the first year of employment; and understand the benefits and barriers of implementing a Nursing Residency Program from the perspectives of nurses and key informants. Many researchers reported that novice nurses do not have an adequate level of competence needed in the real clinical practice to meet the increasing demands of healthcare systems. A descriptive qualitative approach using individual interviews and focus group discussions was utilized. The sample was a purposive one that consisted of 30 Jordanian nurses and six key informants. Data were recorded and then transcribed. Content analysis was used to analyze the data. The results revealed several challenges that face nurses in their first year of experience such as reality shock, lack of self-confidence, and burnout and intent to leave. Some of the perceived barriers of implementing the Program were issues concerned with the responsible regulatory body, payment, and monitoring and evaluation. The findings asserted that the implementation of the Nursing Residency Program for new practicing nurses would enhance their competencies and self- confidence; and decrease the rate of reality shock and turnover within the first year of employment. Policy makers, nurse educators, and nurse administrators and clinical nurses need to collaborate to develop a formal system with binding policies and regulations concerning the implementation of Nursing Residency Program. There is also a need to address and modify current orientation programmes offered by hospitals for novice nurses to enhance their transition into clinical practice. © 2018 International Council of Nurses.

  6. The Perceived Barriers of Access to Health Care Among a Group of Non-camp Syrian Refugees in Jordan.

    Science.gov (United States)

    Ay, Merve; Arcos González, Pedro; Castro Delgado, Rafael

    2016-07-01

    The aims of this study were to identify the most needed health care services, accessibility of various health care services, and barriers to access as perceived by a group of Syrian refugees living in non-camp settings in Jordan and to compare accessibility among different groups. The study was conducted in the Amman, Irbid, Karak, and Maan governorates of Jordan. This is a cross-sectional, analytical, observational study using convenience and snowball sampling for data collection. A structured questionnaire was included in an ongoing needs assessment of a Jordanian nongovernment organization in April 2014, with a total of 196 surveys conducted. In addition to the prevalent acute and communicable diseases, chronic diseases and dental problems were common. Preventive and primary health care were more accessible than advanced services. Structural and financial barriers hindered access. The specific survey location and governorate were associated with a difference in reported access. Registration status, health provider, duration, and out-of-pocket payment did not affect accessibility. The capacities of health facilities at different levels should be increased. Enhanced information sharing among health providers can improve identification of needs and gaps. © The Author(s) 2016.

  7. Student-perceived barriers and facilitators to e-learning in continuing professional development in primary care.

    Science.gov (United States)

    Docherty, Andrea; Sandhu, Harbinder

    2006-01-01

    WHAT IS ALREADY KNOWN IN THIS AREA • E-learning is being increasingly used within learning and teaching including its application within healthcare education and service provision. Multiple advantages have been identified including enhanced accessibility and increased flexibility of learning. Guidance on the generic-design and development of e-learning courses has been generated. WHAT THIS WORK ADDS • This paper provides a detailed understanding of the barriers and facilitators to e-learning as perceived by students on a continuing professional development (CPD); course arid highlights its multifaceted values. In addition, the paper ṕrovides evidence-based guidance for the development of courses within CPD utilising e-learning. SUGGESTIONS FOR FUTURE RESEARCH • Future research would benefit from, focusing upon the perceptions of staff including barriers and facilitators to the implementation of e-learning and awareness of student experience to generate a balanced and informed understanding of e-learning within the context-of CPD.

  8. Identifying the barriers and enablers to palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study.

    Science.gov (United States)

    Hosie, Annmarie; Lobb, Elizabeth; Agar, Meera; Davidson, Patricia M; Phillips, Jane

    2014-11-01

    Delirium is underrecognized by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses' delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients' delirium outcomes. The aim of the study was to identify nurses' perceptions of the barriers and enablers to recognizing and assessing delirium symptoms in palliative care inpatient settings. A series of semistructured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants' recall of delirium and identification of the perceived factors (barriers and enablers) that impacted on their delirium recognition and assessment capabilities. Thematic content analysis was used to analyze the qualitative data. Thirty participants from nine palliative care services provided insights into the barriers and enablers of delirium recognition and assessment in the inpatient setting that were categorized as patient and family, health professional, and system level factors. Analysis revealed five themes, each reflecting both identified barriers and current and/or potential enablers: 1) value in listening to patients and engaging families, 2) assessment is integrated with care delivery, 3) respecting and integrating nurses' observations, 4) addressing nurses' delirium knowledge needs, and 5) integrating delirium recognition and assessment processes. Supporting the development of palliative care nursing delirium recognition and assessment practice requires attending to a range of barriers and enablers at the patient and family, health professional, and system levels. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  9. Identifying Barriers and Facilitators at Affect Community Pharmacists' Ability to Engage Children in Medication Counseling: A Pilot Study

    Science.gov (United States)

    Alexander, Dayna S.; Schleiden, Loren J.; Carpenter, Delesha M.

    2017-01-01

    OBJECTIVES This study aimed to describe the barriers and facilitators that influence community pharmacists' ability to provide medication counseling to pediatric patients. METHODS Semistructured interviews (n = 16) were conducted with pharmacy staff at 3 community pharmacies in 2 Eastern states. The interview guide elicited pharmacy staff experiences interacting with children and their perceived barriers and facilitators to providing medication counseling. Transcripts were reviewed for accuracy and a codebook was developed for data analysis. NVivo 10 was used for content analysis and identifying relevant themes. RESULTS Ten pharmacists and 6 pharmacy technicians were interviewed. Most participants were female (69%), aged 30 to 49 years (56%), with ≥5 years of pharmacy practice experience. Eight themes emerged as barriers to pharmacists' engaging children in medication counseling, the most prevalent being the child's absence during medication pickup, the child appearing to be distracted or uninterested, and having an unconducive pharmacy environment. Pharmacy staff noted 7 common facilitators to engaging children, most importantly, availability of demonstrative and interactive devices/technology, pharmacist demeanor and communication approach, and having child-friendly educational materials. CONCLUSIONS Findings suggest that pharmacy personnel are rarely able to engage children in medication counseling because of the patient's absence during medication pickup; however, having child-friendly materials could facilitate interactions when the child is present. These findings can inform programs and interventions aimed at addressing the barriers pharmacists encounter while educating children about safe and appropriate use of medicines. PMID:29290741

  10. A qualitative study exploring nurses’ attitudes, confidence, and perceived barriers to implementing a traumatic brain injury nursing chart in Uganda

    Directory of Open Access Journals (Sweden)

    Leslie Wynveen

    2018-06-01

    Full Text Available Introduction: In Africa, traumatic brain injuries frequently result from road traffic injuries and assaults. Despite limited resources and the high costs of life-saving neurosurgical interventions, secondary brain injury prevention has the potential for improving outcomes. However, nurses and other medical personnel infrequently monitor vital signs, blood sugar, and pulse oximetry and only sporadically re-assess neurological status. Methods: In one-on-one, semi-structured interviews, 27 nurses from Mulago Hospital’s emergency centre, a tertiary care trauma hospital in Kampala, Uganda, provided feedback regarding a traumatic brain injury-focused education session and use of a nursing chart for detecting secondary brain injury. The interviews explored the nurses’ confidence and perceived barriers to long-term chart implementation and traumatic brain injury care, as well as their ideas for improving this intervention. Interviews were audio recorded, transcribed, and coded using ATLAS.ti: Qualitative Data Analysis and Research Software (Cleverbridge, Inc., Chicago, USA and Microsoft Word and Excel (Microsoft Office, Redmond, USA for thematic content analysis. Results: Key findings identified in the interviews included the nurses’ attitudes toward the chart and their feelings of increased confidence in assessing and caring for these patients. The main barriers to continuous implementation included inadequate staffing and resources. Conclusion: Nurses were receptive to the education session and nursing chart, and felt that it increased their confidence and improved their ability to care for traumatic brain injured patients. However, lack of supplies, overwhelming numbers of patients, and inadequate staffing interfered with consistent monitoring of patients. The nurses offered various suggestions for improving traumatic brain injury care that should be further investigated. More research is needed to assess the applicability of a standardised

  11. Perceived barriers in accessing dental care among patients attending dental institute using decision-making trial and evaluation laboratory method

    Directory of Open Access Journals (Sweden)

    Ravneet Malhi

    2015-01-01

    Full Text Available Introduction: Utilization of dental service is a concept of expressing the extent of interaction between the service provider and the people for whom it is indented. However, one of the major issues in social welfare is the equitable provision of these services to the population. Aim: To determine the perceived barriers affecting access to the dental services in the dental institute. Materials and Methods: A cross-sectional survey was conducted in the dental institute during the month of February in the year 2014 using decision-making trial and evaluation laboratory (DEMATEL method. The study sample included the 364 subjects. The required data were collected using a specially designed and pretested questionnaire. The data were analyzed using SPSS 18.0 (SPSS Inc., Chicago, IL, USA and MATLAB 7.6.0. The mean, standard deviations were used to describe the data, and inferential statistics included one-way ANOVA and DEMATEL. Results: The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access dental services. Based on subjects′ responses to the questions, the cost (54.75% agreed or strongly agreed was identified as the most important factor affecting the access to dental health care followed by dentist-patient relationship (48.57%, inconvenience (36.55%, fear (23.70%, and organization (14.02%. The difference was found to be statistically significant (P = 0.0001. When the hierarchy of the affecting and affected factors was calculated, based on the factor analysis by using DEMATEL method, the cost (R−J = 0.16 and organization (R−J = 1.15, were certain affecting determinant which influenced the access to dental services and inconvenience. Conclusion: The major barriers to oral health care utilization among our patients were cost, fear, and organization. Policymakers, administrators, and insurance organizations have a major role. Hence, the policies should be fair and

  12. Mental health help-seeking patterns and perceived barriers for care among nulliparous pregnant women.

    Science.gov (United States)

    Da Costa, Deborah; Zelkowitz, Phyllis; Nguyen, Tuong-Vi; Deville-Stoetzel, Jean-Benoit

    2018-05-30

    This study examined the patterns of consultation with health providers for emotional symptoms and barriers preventing mental health help-seeking among pregnant women. A total of 652 nulliparous women in their third trimester completed an online questionnaire assessing depressed mood, adjustment in their couple relationship, demographics, help-seeking behaviors for emotional problems and barriers to help-seeking in the past year. The prevalence of having consulted with at least one health provider over the past year for emotional symptoms was 20.1% for the entire sample and 32.7% for the subgroup of women reporting elevated depressive symptoms in the third trimester. Women in the 30-39 age range were more likely to discuss their emotional symptoms with a health provider in the past year compared to younger women (OR = 1.6, CI = 1.0, 2.6, p = 0.041). Among women depressed in the third trimester, being White was independently associated with a greater likelihood of having consulted with a health provider about their emotional symptoms (OR = 2.9, CI = 1.4, 6.1, p = 0.005). Barriers to mental help-seeking included not having gotten around to it (46.1%), being too busy (26.1%), deciding not to seek care (24.3%), cost (22.6%) and not knowing where to go (19.1%). Women with more depressive symptoms in the third trimester endorsed more barriers to mental health service use (β = 0.25, 95% CI = 0.02, 0.12, p = 0.015). Innovative, evidence-based approaches are needed to more effectively promote mental health during the perinatal period and help women overcome the practical barriers identified to help-seeking.

  13. HIV testing implementation in two urban cities: practice, policy, and perceived barriers.

    Directory of Open Access Journals (Sweden)

    Camden J Hallmark

    Full Text Available Although funding has supported the scale up of routine, opt-out HIV testing in the US, variance in implementation mechanisms and barriers in high-burden jurisdictions remains unknown.We conducted a survey of health care organizations in Washington, DC and Houston/Harris County to determine number of HIV tests completed in 2011, policy and practices associated with HIV testing, funding mechanisms, and reported barriers to testing in each jurisdiction and to compare results between jurisdictions.In 2012, 43 Houston and 35 DC HIV-testing organizations participated in the survey. Participants represented 85% of Department of Health-supported testers in DC and 90% of Department of Health-supported testers in Houston. The median number of tests per organization was 568 in DC and 1045 in Houston. Approximately 50% of organizations in both DC and Houston exclusively used opt-in consent and most conducted both pre- and post-test counseling with HIV testing (80% of organizations in DC, 70% in Houston. While the most frequent source of funding in DC was the Department of Health, Houston organizations primarily billed the patient or third-party payers. Barriers to testing most often reported were lack of funding, followed by patient discomfort/refusal with more barriers reported in DC.Given unique policies, resources and programmatic contexts, DC and Houston have taken different approaches to support routine testing. Many organizations in both cities reported opt-in consent approaches and pre-test counseling, suggesting 2006 national HIV testing recommendations are not being followed consistently. Addressing the barriers to testing identified in each jurisdiction may improve expansion of testing.

  14. Perceived Barriers and Facilitators to Integrating HIV Prevention and Treatment with Cross-Sex Hormone Therapy for Transgender Women in Lima, Peru.

    Science.gov (United States)

    Reisner, Sari L; Perez-Brumer, Amaya G; McLean, Sarah A; Lama, Javier R; Silva-Santisteban, Alfonso; Huerta, Leyla; Sanchez, Jorge; Clark, Jesse L; Mimiaga, Matthew J; Mayer, Kenneth H

    2017-12-01

    Transgender women (TW) represent a vulnerable population at increased risk for HIV infection in Peru. A mixed-methods study with 48 TW and 19 healthcare professionals was conducted between January and February 2015 to explore barriers and facilitators to implementing a model of care that integrates HIV services with gender-affirmative medical care (i.e., hormone therapy) in Lima, Peru. Perceived acceptability of the integrated care model was high among TW and healthcare professionals alike. Barriers included stigma, lack of provider training or Peruvian guidelines regarding optimal TW care, and service delivery obstacles (e.g., legal documents, spatial placement of clinics, hours of operation). The hiring of TW staff was identified as a key facilitator for engagement in health care. Working in partnership with local TW and healthcare provider organizations is critical to overcoming existing barriers to successful implementation of an integrated HIV services and gender-affirmative medical care model for this key population in Peru.

  15. Pengaruh Customer Service Quality, Customer Perceived Value, Customer Satisfaction, Customer Trust Dan Switching Barriers Terhadap Customer Retention.

    OpenAIRE

    Hardjanti, Adiati; Amalia, Dinna

    2014-01-01

    Penelitian ini bertujuan untuk mengetahui pengaruh customer service quality, customer perceived value, customer satisfaction, customer trust dan switching barriers terhadap customer retention. Rancangan penelitian yang digunakan dalam penelitian ini adalah pengujian hipotesis (testing hypotesis). Pengambilan sampel dalam penelitian ini menggunakan teknik purposive sampling dan keseluruhan hipotesis diuji dengan metode structural equation modeling yang menggunakan Amos 7.0. Data dalam peneliti...

  16. Examining E-Learning Barriers as Perceived by Faculty Members of Engineering Colleges in the Jordanian Universities

    Science.gov (United States)

    Al-Alawneh, Muhammad K.

    2014-01-01

    Employing computer's technology that includes e-learning system in the field of Engineering is a vital issue which needs to be discussed. Therefore, this study purposed to examine e-learning barriers as perceived by faculty members of engineering in three major universities in Jordan (Yarmouk University, Jordan University of Science and…

  17. Perceived barriers to and facilitators of physical activity in recipients of solid organ transplantation, a qualitative study

    NARCIS (Netherlands)

    van Adrichem, Edwin; van de Zande, Saskia C; Dekker, Rienk; Verschuuren, Erik A M; Dijkstra, Pieter U; van der Schans, Cees

    2016-01-01

    BACKGROUND: Sufficient physical activity is important for solid organ transplant recipients (heart, lung, liver, kidney). However, recipients do not meet the recommended amount or required type of physical activity. The perceived barriers to and facilitators of physical activity in this population

  18. Perceived Barriers to and Facilitators of Physical Activity in Recipients of Solid Organ Transplantation, a Qualitative Study

    NARCIS (Netherlands)

    van Adrichem, Edwin J; van de Zande, Saskia C; Dekker, Rienk; Verschuuren, Erik A M; Dijkstra, Pieter U; Schans, van der Cornelis

    2016-01-01

    Background Sufficient physical activity is important for solid organ transplant recipients (heart, lung, liver, kidney). However, recipients do not meet the recommended amount or required type of physical activity. The perceived barriers to and facilitators of physical activity in this population

  19. Facilitators and barriers to physical activity as perceived by older adults with intellectual disability.

    Science.gov (United States)

    van Schijndel-Speet, Marieke; Evenhuis, Heleen M; van Wijck, Ruud; van Empelen, Pepijn; Echteld, Michael A

    2014-06-01

    Older people with intellectual disability (ID) are characterized by low physical activity (PA) levels. PA is important for reducing health risks and maintaining adequate fitness levels for performing activities of daily living. The aim of this study was to explore preferences of older adults with ID for specific physical activities, and to gain insight into facilitators and barriers to engaging into PA. Fourteen in-depth interviews and four focus groups were undertaken, with a total of 40 older adults with mild and moderate ID included in the analysis. NVivo software was used for analysing the transcribed verbatim interviews. In total, 30 codes for facilitators and barriers were identified. Themes concerning facilitators to PA were enjoyment, support from others, social contact and friendship, reward, familiarity, and routine of activities. Themes concerning barriers to PA were health and physiological factors, lack of self-confidence, lack of skills, lack of support, transportation problems, costs, and lack of appropriate PA options and materials. The results of the present study suggest that older adults with ID may benefit from specific PA programs, adapted to their individual needs and limitations. Results can be used for developing feasible health promotion programs for older adults with ID.

  20. Identifying barriers to the implementation of nutrition education in South Korea.

    Science.gov (United States)

    Lee, Jounghee; Hong, Youngsun

    2015-01-01

    To improve the nutritional status of children and adolescents, it is critical to identify the barriers to the implementation of nutrition education in schools. We carried out a cross-sectional study by analyzing data from 121 subjects (45 nutrition teachers and 76 school dietitians). Among the personal, environmental and systematic barriers, the top four barriers to the implementation of nutrition education were heavy workload (4.28 points), lack of a systematic curriculum (4.12 points), lack of perception of nutrition education by school administrators and teachers (4.07 points), and lack of continuing education for nutrition teachers and school dietitians (4.05 points). Additionally, poor working conditions, such as low pay, were identified as significant barriers to nutrition education for school dietitians compared with nutrition teachers (4.33 vs 3.47 points, peducation in schools in South Korea.

  1. 78 FR 66950 - Trade Barriers That U.S. Small and Medium-Sized Enterprises Perceive as Affecting Exports to the...

    Science.gov (United States)

    2013-11-07

    ... report that catalogs trade barriers that U.S. small and medium-sized enterprises (SMEs) perceive as... INTERNATIONAL TRADE COMMISSION [Investigation No. 332-541] Trade Barriers That U.S. Small and Medium-Sized Enterprises Perceive as Affecting Exports to the European Union; Rescheduling of Washington...

  2. Identifying factors associated with perceived success in the transition from hospital to home after brain injury.

    Science.gov (United States)

    Nalder, Emily; Fleming, Jennifer; Foster, Michele; Cornwell, Petrea; Shields, Cassandra; Khan, Asad

    2012-01-01

    : To identify the factors associated with perceived success of the transition from hospital to home after traumatic brain injury (TBI). : Prospective longitudinal cohort design with data collection at discharge and 1, 3, and 6 months postdischarge. : A total of 127 individuals with TBI discharged to the community and 83 significant others. : An analog scale (0-100) of perceived success of the transition from hospital to home rated by individuals and significant others; Sentinel Events Questionnaire; EuroQol Group Quality-of-Life measure visual analog scale; Sydney Psychosocial Reintegration Scale; Mayo-Portland Adaptability Inventory-4; short form of the Depression, Anxiety, Stress Scales; Craig Hospital Inventory of Environmental Factors; and Caregiver Strain Index. : Greater perceived success of transition for individuals with a TBI was associated with higher levels of health-related quality of life, level of community integration, and more severe injury. Among survivors, sentinel events such as returning to work and independent community access and changing living situation were associated with greater perceived success; financial strain and difficulty accessing therapy services were associated with less success. Among significant others, lower ratings of transition success were associated with higher significant other stress levels as well as lower levels of community integration and changes in the living situation of the individual with TBI. : A combination of sentinel events and personal and environmental factors influences the perceptions of individuals and their families regarding the success of the transition from hospital to home.

  3. Perceived barriers to and facilitators of physical activity in young adults with childhood-onset physical disabilities.

    Science.gov (United States)

    Buffart, Laurien M; Westendorp, Tessa; van den Berg-Emons, Rita J; Stam, Henk J; Roebroeck, Marij E

    2009-11-01

    To explore the main barriers to and facilitators of physical activity in young adults with childhood-onset physical disabilities. Qualitative study using focus groups. Sixteen persons (12 men and 4 women) aged 22.4 (standard deviation 3.4) years, of whom 50% were wheelchair-dependent, participated in the study. Eight were diagnosed with myelomeningocele, 4 with cerebral palsy, 2 with acquired brain injury and 2 with rheumatoid arthritis. Three focus group sessions of 1.5 h were conducted using a semi-structured question route to assess perceived barriers to and facilitators of physical activity. Tape recordings were transcribed verbatim and content analysed. According to the Physical Activity for People with a Physical Disability model, barriers and facilitators were subdivided into personal factors and environmental factors. Participants reported several barriers related to attitude and motivation. In addition, lack of energy, existing injury or fear of developing injuries or complications, limited physical activity facilities, and lack of information and knowledge, appeared to be barriers to physical activity. Fun and social contacts were mentioned as facilitators of engaging in physical activity, as well as improved health and fitness. Young adults with childhood-onset physical disabilities perceived various personal and environmental factors as barriers to or facilitators of physical activity. These should be taken into account when developing interventions to promote physical activity in this population.

  4. Evidence-based surgery: knowledge, attitudes, and perceived barriers among surgical trainees.

    Science.gov (United States)

    Mittal, Rohin; Perakath, Benjamin

    2010-01-01

    This study was conducted to assess the knowledge and attitude of surgical trainees toward evidence-based medicine (EBM) and their perceived barriers to its practice. The McColl questionnaire and the BARRIERS scale were modified and incorporated into a single questionnaire, which was administered to all surgical trainees attending a Continuing Surgical Education meeting. Department of Surgery, Christian Medical College, Vellore, India. One hundred ten surgical trainees from 22 medical colleges. In all, 84.5% (93/110) trainees returned the questionnaire. The attitudes toward EBM were welcoming, although individual participants reported they welcomed EBM more than their colleagues did. Participants agreed that EBM was useful in everyday practice and that it improved patient care. About 50% of actual practice was considered evidence based. In all, 12.6% (10/89) of participants had received formal training in EBM, and 64.3% (54/84) of participants were aware of the Cochrane database of systemic reviews, but only 35.7% (30/84) read it regularly. Also, 67.8% (61/90) of respondents used protocols and guidelines developed by colleagues. However, 61.5% (56/91) of participants were interested in learning the skills of EBM. The terms absolute risk, relative risk, and clinical effectiveness were understood by >80% of respondents, whereas publication bias, confidence interval, and heterogeneity were poorly understood. The major barriers to practice of EBM were the inability to understand statistical analysis, inadequate facilities for implementation, lack of a single compiled source of literature, relevant literature not being readily available, and insufficient time on the job. Surgical trainees have a positive attitude towards EBM and have some familiarity with the common terms used in EBM. There is a need to increase awareness of, and provide access to, available sources of medical literature. Formal training in EBM, as well as basic statistical analysis, should form a part

  5. Predictors of perceived barriers to physical activity in the general adult population: a cross-sectional study.

    Science.gov (United States)

    Herazo-Beltrán, Yaneth; Pinillos, Yisel; Vidarte, José; Crissien, Estela; Suarez, Damaris; García, Rafael

    The perception of personal barriers to physical activity varies according to the sociodemographic characteristics of individuals. To determine the predictors of the perception of barriers to physical activity in the adult population. A cross-sectional study with 1066 adult women and 1036 adult men. The sociodemographic variables (age, gender, marital status, socioeconomic level, level of education), the perception of barriers that do not allow performance of physical activity (i.e. lack of time, social support, energy, motivation, skill, resources, and fear of injury during practice); and the level of physical activity through the International Physical Activity Questionnaire in its short-form version were evaluated. Individuals from low socioeconomic level (1 and 2) have higher risks of perceiving barriers such as lack of motivation [OR 1.76 (95% CI (1.4-2.1))] and lack of resources [OR 1.37 (95% CI (1.1-1.6))]; individuals with partners did not perceive the lack of social support [OR 0.29 (95% CI (0.2-0.4))] and lack of motivation [OR 0.54 (95% CI (0.4-0.7))] as barriers to physical activity. Individuals with low schooling perceived lack of social support [OR 3.81 (95% CI (3-4.7))], lack of resources [OR 2.78 (95% CI (2.2-3.3))], and fear of injury [OR 2.70 (95% CI (2.2-3.3))] as barrier to physical activity. Factors such as socioeconomic level, marital status, level of education, and self-perception of health are predictors of barriers to physical activity. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  6. Perceived Barriers to Healthy Eating and Physical Activity among Adolescents in Seven Arab Countries: A Cross-Cultural Study

    Directory of Open Access Journals (Sweden)

    Abdulrahman O. Musaiger

    2013-01-01

    Full Text Available Objective. To highlight the perceived personal, social, and environmental barriers to healthy eating and physical activity among Arab adolescents. Method. A multistage stratified sampling method was used to select 4698 students aged 15–18 years (2240 males and 2458 females from public schools. Seven Arab counties were included in the study, namely, Algeria, Jordan, Kuwait, Libya, Palestine, Syria, and the United Arab Emirates. Self-reported questionnaire was used to list the barriers to healthy eating and physical activity facing these adolescents. Results. It was found that lack of information on healthy eating, lack of motivation to eat a healthy diet, and not having time to prepare or eat healthy food were the main barriers to healthy eating among both genders. For physical activity, the main barriers selected were lack of motivation to do physical activity, less support from teachers, and lack of time to do physical activity. In general, females faced more barriers to physical activity than males in all countries included. There were significant differences between males and females within each country and among countries for most barriers. Conclusion. Intervention programmes to combat obesity and other chronic noncommunicable diseases in the Arab world should include solutions to overcome the barriers to weight maintenance, particularly the sociocultural barriers to practising physical activity.

  7. French healthcare professionals' perceived barriers to and motivation for therapeutic patient education: A qualitative study.

    Science.gov (United States)

    Lelorain, Sophie; Bachelet, Adeline; Bertin, Nicole; Bourgoin, Maryline

    2017-09-01

    Therapeutic patient education is effective for various patient outcomes; however, healthcare professionals sometimes lack the motivation to carry out patient education. Surprisingly, this issue has rarely been addressed in research. Therefore, this study explores healthcare professionals' perceived barriers to and motivation for therapeutic patient education. Healthcare professionals, mainly nurses, working in different French hospitals were interviewed. Thematic content analysis was performed. Findings included a lack of skills, knowledge, and disillusionment of the effectiveness of therapeutic patient education were features of a demotivated attitude. In contrast, a positive attitude was observed when therapeutic patient education met a need to work differently and more effectively. A key factor motivating professionals was the integration of therapeutic patient education in routine care within a multidisciplinary team. To keep healthcare professionals motivated, managers should ensure that therapeutic patient education is implemented in accordance with its core principles: a patient-centered approach within a trained multidisciplinary team. In the latter case, therapeutic patient education is viewed as an efficient and rewarding way to work with patients, which significantly motivates healthcare professionals. © 2017 John Wiley & Sons Australia, Ltd.

  8. Identifying and prioritizing barriers to implementation of smart energy city projects in Europe: An empirical approach

    International Nuclear Information System (INIS)

    Mosannenzadeh, Farnaz; Di Nucci, Maria Rosaria; Vettorato, Daniele

    2017-01-01

    Successful implementation of smart energy city projects in Europe is crucial for a sustainable transition of urban energy systems and the improvement of quality of life for citizens. We aim to develop a systematic classification and analysis of the barriers hindering successful implementation of smart energy city projects. Through an empirical approach, we investigated 43 communities implementing smart and sustainable energy city projects under the Sixth and Seventh Framework Programmes of the European Union. Validated through literature review, we identified 35 barriers categorized in policy, administrative, legal, financial, market, environmental, technical, social, and information-and-awareness dimensions. We prioritized these barriers, using a novel multi-dimensional methodology that simultaneously analyses barriers based on frequency, level of impact, causal relationship among barriers, origin, and scale. The results indicate that the key barriers are lacking or fragmented political support on the long term at the policy level, and lack of good cooperation and acceptance among project partners, insufficient external financial support, lack of skilled and trained personnel, and fragmented ownership at the project level. The outcome of the research should aid policy-makers to better understand and prioritize implementation barriers to develop effective action and policy interventions towards more successful implementation of smart energy city projects. - Highlights: • A solid empirical study on the implementation of European smart energy city projects. • We found 35 barriers in nine dimensions; e.g. policy, legal, financial, and social. • We suggested a new multi-dimensional methodology to prioritize barriers. • Lacking or fragmented political support on the long term is a key barrier. • We provided insights for action for project coordinators and policy makers.

  9. Assessment of active play, inactivity and perceived barriers in an inner city neighborhood

    Science.gov (United States)

    Kottyan, Gregg; Kottyan, Leah; Edwards, Nicholas M.; Unaka, Ndidi I.

    2014-01-01

    Avondale, a disadvantaged neighborhood in Cincinnati, lags behind on a number of indicators of child well-being. Childhood obesity has become increasingly prevalent, as one third of Avondale’s kindergarteners are obese or overweight. The study objective was to determine perceptions of the quantity of and obstacles to childhood physical activity in the Avondale community. Caregivers of children from two elementary schools were surveyed to assess their child’s physical activity and barriers to being active. Three hundred forty surveys were returned out of 1,047 for a response rate of 32%. On school days, 41% of caregivers reported that their children spent more than 2 hours watching television, playing video games, or spending time on the computer. While over half of respondents reported that their children get more than 2 hours of physical activity on school days, 14% of children were reported to be physically active less than 1 hour per day. Caregivers identified violence, cost of extracurricular activities, and lack of organized activities as barriers to their child’s physical activity. The overwhelming majority of caregivers expressed interest in a program to make local playgrounds safer. In conclusion, children in Avondale are not participating in enough physical activity and are exposed to more screen time than is recommended by the AAP. Safety concerns were identified as a critical barrier to address in future advocacy efforts in this community. This project represents an important step toward increasing the physical activity of children in Avondale and engaging the local community. PMID:24306236

  10. Perceived barriers and facilitators of using dietary modification for CKD prevention among African Americans of low socioeconomic status: a qualitative study.

    Science.gov (United States)

    Johnson, Amber E; Boulware, L Ebony; Anderson, Cheryl A M; Chit-ua-aree, Tatpong; Kahan, Kimberly; Boyér, LaPricia Lewis; Liu, Yang; Crews, Deidra C

    2014-12-06

    Factors influencing the use of dietary interventions for modification of CKD risk among African Americans have not been well-explored. We assessed perceived barriers and facilitators of CKD prevention through dietary modifications among African Americans with low socioeconomic status (SES) and at high risk for CKD. We conducted a qualitative study involving three 90 minute focus groups of low SES (limited education, unemployed, uninsured, or incomehabits. They identified vouchers for healthy foods, family-based interventions, nutritional counseling and group gatherings for persons interested in making dietary changes as acceptable facilitators of dietary CKD prevention efforts. Low SES African Americans at high risk for CKD had limited perception of their risk but they identified multiple barriers and potential facilitators of CKD prevention via dietary modifications which can inform future studies and public health interventions.

  11. Stuck in tradition - A qualitative study on barriers for implementation of evidence-based nutritional care perceived by nursing staff

    DEFF Research Database (Denmark)

    O Connell, Malene Barfod; Jensen, Pia Søe; Andersen, Signe Lindgård

    2018-01-01

    -based practice. Barriers for nutritional care are grounded in lack of knowledge among nursing staff and insufficient collaboration between nursing staff and the doctors. There is a need for nutritional education for the nursing staff and better support from the organisation to help nursing staff provide evidence......AIM: To explore the barriers for nutritional care as perceived by nursing staff at an acute orthopedic ward, aiming to implement evidence-based nutritional care. BACKGROUND: Previous studies indicate that nurses recognize nutritional care as important, but interventions are often lacking....... These studies show that a range of barriers influence the attempt to optimize nutritional care. Before the implementation of evidence-based nutritional care, we examined barriers for nutritional care among the nursing staff. DESIGN: Qualitative study. METHODS: Four focus groups with thirteen members...

  12. Perceived Benefits, Facilitators, Disadvantages, and Barriers for Physical Activity Amongst South Asian Adolescents in India and Canada.

    Science.gov (United States)

    Rajaraman, Divya; Correa, Natasha; Punthakee, Zubin; Lear, Scott A; Jayachitra, Krishnaswamy G; Vaz, Mario; Swaminathan, Sumathi

    2015-07-01

    The purpose of this study was to understand perceived benefits, facilitators, disadvantages, and barriers for physical activity among South Asian adolescents in India and Canada. Thirteen focus group discussions with South Asian (origin) adolescent boys and girls of different nutritional status and socioeconomic status in rural and urban India and urban Canada. Across the groups, fitness and 'energy' were perceived to be major benefits of physical activity. In India, better academic performance was highlighted, while health benefits were well detailed in Canadian groups. In all settings, friends, family, and teachers were perceived as facilitators of as well as barriers to physical activity. Lack of a safe space to play was a major concern for urban adolescents, while academic pressures and preference for other sedentary recreational activities were common barriers across all groups. Girls were less likely than boys to be interested in physical activity, with girls' participation in India further limited by societal restrictions. The study suggests key areas for promotion of physical activity among South Asian adolescents: balance between academic pressure and opportunities for physical activity, especially in India; urban planning for a built environment conducive to physical activity; and gender-sensitive programming to promote girls' activity which also addresses culture-specific barriers.

  13. Breast Cancer Awareness and Prevention Behavior Among Women of Delhi, India: Identifying Barriers to Early Detection

    OpenAIRE

    Dey, Subhojit; Sharma, Surabhi; Mishra, Arti; Krishnan, Suneeta; Govil, Jyotsna; Dhillon, Preet K.

    2016-01-01

    Background Globally, breast cancer (BC) has become the leading cause of mortality in women. Awareness and early detection can curb the growing burden of BC and are the first step in the battle against BC. The aim of this qualitative study was to explore the awareness and perceived barriers concerning the early detection of BC. Methods A total of 20 focus group discussions (FGDs) were conducted during May 2013–March 2014. Pre-existing themes were used to conduct FGDs; each FGD group consisted ...

  14. Implementation of the guidelines for targeted temperature management after cardiac arrest: a longitudinal qualitative study of barriers and facilitators perceived by hospital resuscitation champions

    Science.gov (United States)

    Kim, Young-Min; Lee, Seung Joon; Jo, Sun Jin; Park, Kyu Nam

    2016-01-01

    Objectives To identify the barriers to and facilitators of implementing guidelines for targeted temperature management (TTM) after cardiac arrest perceived by hospital resuscitation champions and to investigate the changes in their perceptions over the early implementation period. Design A longitudinal qualitative study (up to 2 serial semistructured interviews over 1 year and focus groups). The individual interviews and focus groups were transcribed and coded by 2 independent assessors. Contents were analysed thematically; group interaction was also examined. Setting 21 hospitals, including community and tertiary care centres in South Korea. Participants 21 hospital champions (14 acting champions and 7 managerial champions). Results The final data set included 40 interviews and 2 focus groups. The identified barriers and facilitators could be classified into 3 major themes: (1) healthcare professionals’ perceptions of the guidelines and protocols, (2) interdisciplinary and interprofessional collaboration and (3) organisational resources. Lack of resources was the most commonly agreed on barrier for the acting champions, whereas lack of interdisciplinary collaboration was the most common barrier for the managerial champions. Educational activities and sharing successfully treated cases were the most frequently identified facilitators. Most of the participants identified and agreed that cooling equipment was an important barrier as well as a facilitator of successful TTM implementation. Perception of the guidelines and protocols has improved with the accumulation of clinical experience over the study period. Conclusions Healthcare professionals’ internal barriers to TTM implementation may be influenced by new guidelines and can be changed with the accumulation of successful clinical experiences during the early implementation period. Promoting interprofessional and interdisciplinary collaboration through educational activities and the use of cooling equipment

  15. Nurse-perceived barriers to effective communication regarding prognosis and optimal end-of-life care for surgical ICU patients: a qualitative exploration.

    Science.gov (United States)

    Aslakson, Rebecca A; Wyskiel, Rhonda; Thornton, Imani; Copley, Christina; Shaffer, Dauryne; Zyra, Marylou; Nelson, Judith; Pronovost, Peter J

    2012-08-01

    Integration of palliative care for intensive care unit (ICU) patients is important but often challenging, especially in surgical ICUs (SICUs), in part because many surgeons equate palliative care with terminal care and failure of restorative care. SICU nurses, who are key front-line clinicians, can provide insights into barriers for delivery of optimal palliative care in their setting. We developed a focus group guide to identify barriers to two key components of palliative care-optimal communication regarding prognosis and optimal end-of-life care-and used the tool to conduct focus groups of nurses providing bedside care in three SICUs at a tertiary care, academic, inner city hospital. Using content analysis technique, responses were organized into thematic domains that were validated by independent observers and a subset of participating nurses. Four focus groups included a total of 32 SICU nurses. They identified 34 barriers to optimal communication regarding prognosis, which were summarized into four domains: logistics, clinician discomfort with discussing prognosis, inadequate skill and training, and fear of conflict. For optimal end-of-life care, the groups identified 24 barriers in four domains: logistics, inability to acknowledge an end-of-life situation, inadequate skill and training, and cultural differences relating to end-of-life care. Nurses providing bedside care in SICUs identify barriers in several domains that may impede optimal discussions of prognoses and end-of-life care for patients with surgical critical illness. Consideration of these perceived barriers and the underlying SICU culture is relevant for designing interventions to improve palliative care in this setting.

  16. Perceived Barriers to Implementing Individual Choosing Wisely® Recommendations in Two National Surveys of Primary Care Providers.

    Science.gov (United States)

    Zikmund-Fisher, Brian J; Kullgren, Jeffrey T; Fagerlin, Angela; Klamerus, Mandi L; Bernstein, Steven J; Kerr, Eve A

    2017-02-01

    While some research has examined general attitudes about efforts to reduce overutilization of services, such as the Choosing Wisely ® (CW) initiative, little data exists regarding primary care providers' attitudes regarding individual recommendations. We sought to identify whether particular CW recommendations were perceived by primary care providers as difficult to follow, difficult for patients to accept, or both. Two national surveys, one by mail to a random sample of 2000 U.S. primary care physicians in November 2013, and the second electronically to a random sample of 2500 VA primary care providers (PCPs) in October-December 2014. A total of 603 U.S. primary care physicians and 1173 VA primary care providers. Response rates were 34 and 48 %, respectively. PCP ratings of whether 12 CW recommendations for screening, testing and treatments applicable to adult primary care were difficult to follow and difficult for patients to accept; and ratings of potential barriers to reducing overutilization. For four recommendations regarding not screening or testing in asymptomatic patients, less than 20 % of PCPs found the CW recommendations difficult to accept (range 7.2-16.6 %) or difficult for patients to follow (12.2-19.3 %). For five recommendations regarding testing or treatment for symptomatic conditions, however, there was both variation in reported difficulty to follow (9.8-32 %) and a high level of reported difficulty for patients to accept (35.7-87.1 %). The most frequently reported barriers to reducing overuse included malpractice concern, patient requests for services, lack of time for shared decision making, and the number of tests recommended by specialists. While PCPs found many CW recommendations easy to follow, they felt that some, especially those for symptomatic conditions, would be difficult for patients to accept. Overcoming PCPs' perceptions of patient acceptability will require approaches beyond routine physician education, feedback and

  17. Identifying the barriers and enablers in the implementation of the New Zealand and Australian Antenatal Corticosteroid Clinical Practice Guidelines

    Directory of Open Access Journals (Sweden)

    E. L. Mc Goldrick

    2016-10-01

    enablers and barriers to implementation of the New Zealand and Australian Antenatal Corticosteroid Clinical Practice Guidelines using the validated Theoretical Domains Framework, as perceived by health professionals. We have identified differences between individual health professional groups and organisations. The identification of these behavioural determinants can be used to enhance an implementation strategy, assist in the design of interventions to achieve improved implementation and facilitate process evaluations to understand why or how change interventions are effective.

  18. Local food in Iceland: identifying behavioral barriers to increased production and consumption

    Science.gov (United States)

    Ósk Halldórsdóttir, Þórhildur; Nicholas, Kimberly A.

    2016-11-01

    Increased production and consumption of local food may reduce the negative environmental, social, and economic impacts of industrialized and globalized food production. Here we examined potential barriers to increasing production and consumption of food produced in Iceland. First, we developed a new framework to address the behaviors of production and consumption simultaneously, to comprehensively analyze their potential barriers. We examined structural barriers by estimating the food production capacity of Iceland, and cultural and personal barriers through survey data on cultural norms and purchasing behavior from Matís, a research and development company. We found no structural barriers preventing Iceland from increasing production of local cereals, which would compliment current local production of meat and dairy and reduce reliance on imports, currently at 50% of the daily caloric intake. However, if food production became entirely local without changing the current mix of crops grown, there would be a 50% reduction in diversity (from 50 to 25 items in eight out of ten food categories). We did not identify any cultural barriers, as survey results demonstrated that consumers hold generally positive worldviews towards local food, with 88% satisfied with local food they had purchased. More than two-thirds of consumers regarded supporting the local farmer and considerations such as environmentally friendly production, fewer food miles, lower carbon footprint as important. However, they rated the local food they have access to as lower in meeting sustainability criteria, showing that they make justifications for not choosing local food in practice. This is a personal barrier to increased consumption of local food, and implies that marketing strategies and general knowledge connected to local food in Iceland might be improved. Although the results apply to the case of Iceland, the method of identifying behavioral barriers to change is applicable to other countries

  19. Impact of compliance with different guidelines on physical activity during pregnancy and perceived barriers to leisure physical activity.

    Science.gov (United States)

    Santos, Paula Clara; Abreu, Sandra; Moreira, Carla; Lopes, Diana; Santos, Rute; Alves, Odete; Silva, Pedro; Montenegro, Nuno; Mota, Jorge

    2014-01-01

    The aims of the this prospective study were to analyse physical activity (PA) engagement during the first and second trimesters, considering the different guidelines published on PA, to document the individual characteristics associated with the accomplishment of these guidelines and to examine pregnant women's perceived barriers to leisure PA, using a socioecological framework. A sample of 133 pregnant women in two stages--at 10-12 weeks' gestation (T1) and 20-22 weeks' gestation (T2)--were evaluated. PA was assessed by accelerometry during the T1 and T2 evaluation stages. Socio-demographic characteristics, lifestyle factors and barriers to leisure PA were assessed via questionnaire. A large proportion of women (ranging from 32% to 96%) did not reach the levels of PA recommended by the guidelines. There were no significant differences between T1 and T2 with regard to compliance with PA recommendations. A decrease in PA levels from T1 to T2 was noted for all recommendations. No associations were found between participants' characteristics and adherence to the recommendations in T1 and T2. No significant differences were found in barriers to leisure PA between T1 and T2. The most commonly reported barriers to leisure PA were intrapersonal, not health related. Our results indicate that there were no differences between trimesters regarding compliance of PA recommendations, and perceived barriers were similar in both trimesters.

  20. Perceived physical activity barriers related to body weight status and sociodemographic factors among Malaysian men in Klang Valley

    Science.gov (United States)

    2013-01-01

    Background Physical inactivity has been acknowledged as a public health issue and has received increasing attention in recent years. This cross-sectional study was conducted to determine the barriers to physical activity among Malaysian men. These barriers were analyzed with regards to sociodemographic factors, physical activity level, BMI and waist circumference. Methods Subjects in this study included 308 Malay men and 422 Chinese men aged 20 years and older. Subjects completed the International Physical Activity Questionnaire (IPAQ) and a questionnaire on barriers to physical activity, categorized into personal and psychological, physical and social environment barriers. Weight, height and waist circumference were also measured and BMI was calculated. Results Descriptive analyses showed that 79.3% of subjects were married, 52.1% had secondary educational level, 68.8% were still working, and 39.7% had household income between RM1500 to RM3500. The perception that other recreational activities with family and friends were more fun was the most frequently reported barrier, followed by weather, lack of discipline, lack of free time, lack of money, and lack of friends. Marriage status, educational level, household income, BMI, and physical activity status were shown to be associated with perceived barriers. Conclusions To increase participation in physical activity, policy makers should consider significant personal, social and environmental barriers when developing appropriate intervention programmes. Health-promoting strategies that increase awareness, knowledge, skills and motivation related to physical activity are required. PMID:23530696

  1. Exploring perceived barriers, drivers, impacts and the need for evaluation of public involvement in health and social care research: a modified Delphi study

    Science.gov (United States)

    Snape, D; Kirkham, J; Britten, N; Froggatt, K; Gradinger, F; Lobban, F; Popay, Jennie; Wyatt, K; Jacoby, Ann

    2014-01-01

    Objective To explore areas of consensus and conflict in relation to perceived public involvement (PI) barriers and drivers, perceived impacts of PI and ways of evaluating PI approaches in health and social care research. Background Internationally and within the UK the recognition of potential benefits of PI in health and social care research is gathering momentum and PI is increasingly identified by organisations as a prerequisite for funding. However, there is relatively little examination of the impacts of PI and how those impacts might be measured. Design Mixed method, three-phase, modified Delphi technique, conducted as part of a larger MRC multiphase project. Sample Clinical and non-clinical academics, members of the public, research managers, commissioners and funders. Findings This study found high levels of consensus about the most important barriers and drivers to PI. There was acknowledgement that tokenism was common in relation to PI; and strong support for the view that demonstrating the impacts and value of PI was made more difficult by tokenistic practice. PI was seen as having intrinsic value; nonetheless, there was clear support for the importance of evaluating its impact. Research team cohesion and appropriate resources were considered essential to effective PI implementation. Panellists agreed that PI can be challenging, but can be facilitated by clear guidance, together with models of good practice and measurable standards. Conclusions This study is the first to present empirical evidence of the opinions voiced by key stakeholders on areas of consensus and conflict in relation to perceived PI barriers and drivers, perceived impacts of PI and the need to evaluate PI. As such it further contributes to debate around best practice in PI, the potential for tokenism and how best to evaluate the impacts of PI. These findings have been used in the development of the Public Involvement Impact Assessment Framework (PiiAF), an online resource which offers

  2. Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care.

    Science.gov (United States)

    Tropea, Joanne; LoGiudice, Dina; Liew, Danny; Roberts, Carol; Brand, Caroline

    2017-03-01

    Best practice dementia care is not always provided in the hospital setting. Knowledge, attitudes and motivation, practitioner behavior, and external factors can influence uptake of best practice and quality care. The aim of this study was to determine hospital staff perceived barriers and enablers to implementing best practice dementia care. A 17-item survey was administered at two Australian hospitals between July and September 2014. Multidisciplinary staff working in the emergency departments and general medical wards were invited to participate in the survey. The survey collected data about the respondents' current role, work area, and years of experience, their perceived level of confidence and knowledge in dementia care and common symptoms of dementia, barriers and enablers to implementing best practice dementia care, job satisfaction in caring for people with dementia, and to rate the hospital's capacity and available resources to support best practice dementia care. A total of 112 survey responses were received. The environment, inadequate staffing levels and workload, time, and staff knowledge and skills were identified as barriers to implementing best practice dementia care. Most respondents rated their knowledge of dementia care and common symptoms of dementia, and confidence in recognizing whether a person has dementia, as moderate or high dementia. Approximately, half the respondents rated access to training and equipment as low or very low. The survey findings highlighted hospital staff perceived barriers to implementing best practice dementia care that can be used to inform locally tailored improvement interventions.

  3. Male Nurses in Israel: Barriers, Motivation, and How They Are Perceived by Nursing Students.

    Science.gov (United States)

    Ashkenazi, Liat; Livshiz-Riven, Ilana; Romem, Pnina; Grinstein-Cohen, Orli

    The current worldwide nursing shortage remains a challenge for the nursing profession. Encouraging men to become nurses and, thereby, increasing the number of practitioners are crucial factors in facing this challenge. The historiography of nursing presents nursing as "women's work," based on the assumption that it is inherently appropriate for women only. Although men were employed as nurses even before nursing was recognized as a profession, male nurses were always a minority in the field. Over the years, the proportion of male nurses has increased, but they still comprise only 5 to 10% of the nursing workforce in the western world. This study examined men's motives for a career choice of nursing, how male nurses are perceived, and the barriers that they face. The study was conducted among 336 nursing students studying in a co-educational program in various academic tracks at a public, nonsectarian university in the south of Israel. Participants completed the following questionnaires in one study session: sociodemographic questionnaire; Attitudes Towards Men in Nursing Scale; motives for career choice questionnaire; and the questionnaire of the perceptions of the professional status of nursing. Study findings revealed that men tended to choose nursing because of financial constraints significantly more frequently than women (P=.001). Among the participants, there was no significant between-sex difference in the perception nursing as women's work (P=.002) or in perception of male nurses as homosexuals. Results of the study showed that the status of the nursing profession is considered low, and the low status deters men from choosing nursing as a career. The motivation for men's career choice must be understood, and men must be empowered to improve their work conditions and financial remuneration in order to recruit men to the field and to improve the perception of the profession and its public status. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Identifying Perceived Neighborhood Stressors Across Diverse Communities in New York City.

    Science.gov (United States)

    Shmool, Jessie L C; Yonas, Michael A; Newman, Ogonnaya Dotson; Kubzansky, Laura D; Joseph, Evelyn; Parks, Ana; Callaway, Charles; Chubb, Lauren G; Shepard, Peggy; Clougherty, Jane E

    2015-09-01

    There is growing interest in the role of psychosocial stress in health disparities. Identifying which social stressors are most important to community residents is critical for accurately incorporating stressor exposures into health research. Using a community-academic partnered approach, we designed a multi-community study across the five boroughs of New York City to characterize resident perceptions of key neighborhood stressors. We conducted 14 community focus groups; two to three in each borough, with one adolescent group and one Spanish-speaking group per borough. We then used systematic content analysis and participant ranking data to describe prominent neighborhood stressors and identify dominant themes. Three inter-related themes regarding the social and structural sources of stressful experiences were most commonly identified across neighborhoods: (1) physical disorder and perceived neglect, (2) harassment by police and perceived safety and (3) gentrification and racial discrimination. Our findings suggest that multiple sources of distress, including social, political, physical and economic factors, should be considered when investigating health effects of community stressor exposures and psychological distress. Community expertise is essential for comprehensively characterizing the range of neighborhood stressors that may be implicated in psychosocial exposure pathways.

  5. Examining E-Learning Barriers As Perceived By Faculty 
Members Of Engineering Colleges In The Jordanian Universities

    OpenAIRE

    Muhammad K. AL-ALAWNEH,

    2014-01-01

    Employing computer's technology that includes e-learning system in the field of Engineering is a vital issue which needs to be discussed. Therefore, this study purposed to examine e-learning barriers as perceived by faculty members of engineering in three major universities in Jordan (Yarmouk University, Jordan University of Science and Technology, and Al-Balqaa Applied University) in the second semester of 2012. The study's instrument was distributed to collect the data from a sam...

  6. “They put you on your toes”: Physical Therapists' Perceived Benefits from and Barriers to Supervising Students in the Clinical Setting

    Science.gov (United States)

    Hanna, Elizabeth; Cott, Cheryl

    2011-01-01

    ABSTRACT Purpose: To identify the perceived benefits of and barriers to clinical supervision of physical therapy (PT) students. Method: In this qualitative descriptive study, three focus groups and six key-informant interviews were conducted with clinical physical therapists or administrators working in acute care, orthopaedic rehabilitation, or complex continuing care. Data were coded and analyzed for common ideas using a constant comparison approach. Results: Perceived barriers to supervising students tended to be extrinsic: time and space constraints, challenging or difficult students, and decreased autonomy or flexibility for the clinical physical therapists. Benefits tended to be intrinsic: teaching provided personal gratification by promoting reflective practice and exposing clinical educators to current knowledge. The culture of different health care institutions was an important factor in therapists' perceptions of student supervision. Conclusions: Despite different disciplines and models of supervision, there is considerable synchronicity in the issues reported by physical therapists and other disciplines. Embedding the value of clinical teaching in the institution, along with strong communication links among academic partners, institutions, and potential clinical faculty, may mitigate barriers and increase the commitment and satisfaction of teaching staff. PMID:22379263

  7. Theory of Planned Behavior including self-stigma and perceived barriers explain help-seeking behavior for sexual problems in Iranian women suffering from epilepsy.

    Science.gov (United States)

    Lin, Chung-Ying; Oveisi, Sonia; Burri, Andrea; Pakpour, Amir H

    2017-03-01

    To apply the Theory of Planned Behavior (TPB) and the two additional concepts self-stigma and perceived barriers to the help-seeking behavior for sexual problems in women with epilepsy. In this 18-month follow-up study, TPB elements, including attitude, subjective norm, perceived behavioral control, and behavioral intention along with self-stigma and perceived barriers in seeking help for sexual problems were assessed in n=818 women with epilepsy (94.0% aged ≤40years). The basic TPB model (model 1) and the TPB model additionally including self-stigma and perceived barriers (Model 2) were analyzed using structural equation modeling (SEM). Both SEM models showed satisfactory model fits. According to model, attitude, subjective norms, perceived behavioral control, and intention explained 63.1% of the variance in help-seeking behavior. Variance was slightly higher (64.5%) when including self-stigma and perceived barriers (model 2). In addition, the fit indices of the models were better highlighting the importance of self-stigma and perceived barriers in help-seeking behavior for sexual problems. Theory of Planned Behavior is useful in explaining help-seeking behavior for sexual problems in women with epilepsy. Self-stigma and perceived barriers are additional factors that should be considered in future interventions aiming to adopt TPB to improve help-seeking behavior for sexual problems. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease.

    Science.gov (United States)

    Varni, James W; Shulman, Robert J; Self, Mariella M; Saeed, Shehzad A; Zacur, George M; Patel, Ashish S; Nurko, Samuel; Neigut, Deborah A; Franciosi, James P; Saps, Miguel; Denham, Jolanda M; Dark, Chelsea Vaughan; Bendo, Cristiane B; Pohl, John F

    2018-01-01

    The primary objective was to investigate the mediating effects of patient-perceived medication adherence barriers in the relationship between gastrointestinal symptoms and generic health-related quality of life (HRQOL) in adolescents with inflammatory bowel disease (IBD). The secondary objective explored patient health communication and gastrointestinal worry as additional mediators with medication adherence barriers in a serial multiple mediator model. The Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms, Medicines, Communication, Gastrointestinal Worry, and Generic Core Scales were completed in a 9-site study by 172 adolescents with IBD. Gastrointestinal Symptoms Scales measuring stomach pain, constipation, or diarrhea and perceived medication adherence barriers were tested for bivariate and multivariate linear associations with HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of perceived medication adherence barriers as an intervening variable between gastrointestinal symptoms and HRQOL. The predictive effects of gastrointestinal symptoms on HRQOL were mediated in part by perceived medication adherence barriers. Patient health communication was a significant additional mediator. In predictive analytics models utilizing multiple regression analyses, demographic variables, gastrointestinal symptoms (stomach pain, constipation, or diarrhea), and perceived medication adherence barriers significantly accounted for 45, 38, and 29 percent of the variance in HRQOL (all Ps barriers explain in part the effects of gastrointestinal symptoms on HRQOL in adolescents with IBD. Patient health communication to healthcare providers and significant others further explain the mechanism in the relationship between gastrointestinal symptoms, perceived medication adherence barriers, and HRQOL.

  9. Building America Guidance for Identifying and Overcoming Code, Standard, and Rating Method Barriers

    Energy Technology Data Exchange (ETDEWEB)

    Cole, P. C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Halverson, M. A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-09-01

    This guidance document was prepared using the input from the meeting summarized in the draft CSI Roadmap to provide Building America research teams and partners with specific information and approaches to identifying and overcoming potential barriers to Building America innovations arising in and/or stemming from codes, standards, and rating methods.

  10. Identifying Barriers in Implementing Outcomes-Based Assessment Program Review: A Grounded Theory Analysis

    Science.gov (United States)

    Bresciani, Marilee J.

    2011-01-01

    The purpose of this grounded theory study was to identify the typical barriers encountered by faculty and administrators when implementing outcomes-based assessment program review. An analysis of interviews with faculty and administrators at nine institutions revealed a theory that faculty and administrators' promotion, tenure (if applicable),…

  11. Moderated mediation to identify the knowledge stocks, learning flows and barriers at a Dutch telecom operator

    NARCIS (Netherlands)

    de Schryver, Tom; Rosendaal, Bas

    2013-01-01

    Drawing on the 4I-model of Crossan et al. (1999), we have identified the knowledge stocks, learning flows and barriers at a Dutch telecom operator by means of moderated mediation. In this company, the strategic relevant knowledge stocks move in the same direction and many processes support their

  12. Identifying Facilitators and Barriers to Physical Activity for Adults with Down Syndrome

    Science.gov (United States)

    Mahy, J.; Shields, N.; Taylor, N. F.; Dodd, K. J.

    2010-01-01

    Background: Adults with Down syndrome are typically sedentary, and many do not participate in the recommended levels of physical activity per week. The aim of this study was to identify the facilitators and barriers to physical activity for this group. Method: Semi-structured interviews were conducted to elicit the views of adults with Down…

  13. Barriers to installing innovative energy systems in existing housing stock identified

    NARCIS (Netherlands)

    Hoppe, Thomas

    2013-01-01

    Several barriers to upgrading existing social housing with innovative energy systems (IES) have been identified by a study of eight large-scale renovation projects in the Netherlands. These include a lack of trust between stakeholders, opposition from tenants on grounds of increased costs or delays,

  14. Perceived Enablers and Barriers to Optimal Health among Music Students: A Qualitative Study in the Music Conservatoire Setting.

    Science.gov (United States)

    Perkins, Rosie; Reid, Helen; Araújo, Liliana S; Clark, Terry; Williamon, Aaron

    2017-01-01

    Student health and wellbeing within higher education has been documented as poor in relation to the general population. This is a particular problem among students at music conservatoires, who are studying within a unique educational context that is known to generate both physical and psychological challenges. This article examines how conservatoire students experience health and wellbeing within their institutional context, using a framework from health promotion to focus attention on perceived enablers and barriers to optimal health in relation to three levels: lifestyle, support services, and conservatoire environment. In order to respond to the individuality of students' experiences, a qualitative approach was taken based on semi-structured interviews with 20 current or recent conservatoire students in the United Kingdom. Thematic analysis revealed a complex set of enablers and barriers: (i) lifestyle enablers included value placed on the importance of optimal health and wellbeing for musicians and daily practices to enable this; lifestyle barriers included struggling to maintain healthy lifestyles within the context of musical practice and learning; (ii) support enablers included accessible support sources within and beyond the conservatoire; support barriers included a perceived lack of availability or awareness of appropriate support; (iii) environmental enablers included positive and enjoyable experiences of performance as well as strong relationships and communities; environmental barriers included experiences of comparison and competition, pressure and stress, challenges with negative performance feedback, psychological distress, and perceived overwork. The findings reveal a need for health promotion to focus not only on individuals but also on the daily practices and routines of conservatoires. Additionally, they suggest that continued work is required to embed health and wellbeing support as an integral component of conservatoire education, raising

  15. Perceived Enablers and Barriers to Optimal Health among Music Students: A Qualitative Study in the Music Conservatoire Setting

    Directory of Open Access Journals (Sweden)

    Rosie Perkins

    2017-06-01

    Full Text Available Student health and wellbeing within higher education has been documented as poor in relation to the general population. This is a particular problem among students at music conservatoires, who are studying within a unique educational context that is known to generate both physical and psychological challenges. This article examines how conservatoire students experience health and wellbeing within their institutional context, using a framework from health promotion to focus attention on perceived enablers and barriers to optimal health in relation to three levels: lifestyle, support services, and conservatoire environment. In order to respond to the individuality of students’ experiences, a qualitative approach was taken based on semi-structured interviews with 20 current or recent conservatoire students in the United Kingdom. Thematic analysis revealed a complex set of enablers and barriers: (i lifestyle enablers included value placed on the importance of optimal health and wellbeing for musicians and daily practices to enable this; lifestyle barriers included struggling to maintain healthy lifestyles within the context of musical practice and learning; (ii support enablers included accessible support sources within and beyond the conservatoire; support barriers included a perceived lack of availability or awareness of appropriate support; (iii environmental enablers included positive and enjoyable experiences of performance as well as strong relationships and communities; environmental barriers included experiences of comparison and competition, pressure and stress, challenges with negative performance feedback, psychological distress, and perceived overwork. The findings reveal a need for health promotion to focus not only on individuals but also on the daily practices and routines of conservatoires. Additionally, they suggest that continued work is required to embed health and wellbeing support as an integral component of conservatoire

  16. Perceived Exercise Self-Efficacy, Benefits and Barriers, and Commitment to a Plan for Exercise among Jordanians with Chronic Illnesses.

    Science.gov (United States)

    Darawad, Muhammad W; Khalil, Amani A; Hamdan-Mansour, Ayman M; Nofal, Basema M

    2016-11-01

    To explore Jordanian chronic illnesses patients' perceived exercise self-efficacy, benefits and barriers, and commitment to exercise planning, and to assess the relationship between those variables. Descriptive cross-sectional design. Data were collected from a convenience sample of 402 outpatient Jordanians with chronic illnesses, using Exercise Self-Efficacy Scale, Exercise Benefits and Barriers Scale, and Commitment to a Plan for Exercise Scale. The average BMI was 28.3, and exercise period 3.2 hours/ week. Participants reported moderate perceived self-efficacy (M= 47.5%, SD= 11.7), commitment to exercise planning (M=2.0/3, SD=0.3), exercise barriers (M=2.4/4, SD=0.3), and benefits (M=2.3/4, SD=0.3). Commitment to exercise planning had a significant correlation with barriers (r=0.11) and benefits (r=0.10). Self-efficacy was not found to correlate with other variables. Even though participants reported higher perceived self-efficacy and commitment to exercise plan than that reported in literature, they were found to be overweight and inactive, which indicates the importance of such study. Exercise education programs are needed taking into considerations patients' individual differences. However, the broad grouping of diseases may not produce a homogenous sample, for which disease categories are recommended in future studies. Patients with chronic illness need more encouragement to engage themselves in exercise practices. Exercise educational program for patients with chronic illnesses should consider patients' reported exercise benefits and barriers. © 2014 Association of Rehabilitation Nurses.

  17. Physical activity practice among children and adolescents with visual impairment--influence of parental support and perceived barriers.

    Science.gov (United States)

    Greguol, Márcia; Gobbi, Erica; Carraro, Attilio

    2015-01-01

    To analyze the practice of physical activity among children and adolescents with visual impairments (VI), regarding the possible influence of parental support and perceived barriers. Twenty-two young people with VIs (10 + 2.74 years old) and one of each of their parents were evaluated. They responded to the Physical Activity Questionnaire for Older Children (PAQ-C), Baecke Questionnaire, the Parental Support Scale and a questionnaire about perceived barriers to physical activity. The independent samples t-test, pearson correlation test and chi-square test were performed. Blind young people showed lower physical activity levels. There were significant correlations both between parents' physical activity and the support offered to children and between the PAQ-C results and the importance given by young people to physical activity, but only for those aged between 8 and 10 years old. The main perceived barriers were lack of security, motivation, professional training and information about available physical activity programs. The influence of parental support seems to be an important factor in the adoption of a physically active lifestyle for young people with VI. Parents and children should have more information about the benefits and opportunities of physical activity. Implications for Rehabilitation Young people with visual impairment should be encouraged by parents to practice physical activity. More information should be provided on the benefits of physical activity to both parents and children. Professional training should be available to help support this group become more active.

  18. Paving the Way to Successful Implementation: Identifying Key Barriers to Use of Technology-Based Therapeutic Tools for Behavioral Health Care.

    Science.gov (United States)

    Ramsey, Alex; Lord, Sarah; Torrey, John; Marsch, Lisa; Lardiere, Michael

    2016-01-01

    This study aimed to identify barriers to use of technology for behavioral health care from the perspective of care decision makers at community behavioral health organizations. As part of a larger survey of technology readiness, 260 care decision makers completed an open-ended question about perceived barriers to use of technology. Using the Consolidated Framework for Implementation Research (CFIR), qualitative analyses yielded barrier themes related to characteristics of technology (e.g., cost and privacy), potential end users (e.g., technology literacy and attitudes about technology), organization structure and climate (e.g., budget and infrastructure), and factors external to organizations (e.g., broadband accessibility and reimbursement policies). Number of reported barriers was higher among respondents representing agencies with lower annual budgets and smaller client bases relative to higher budget, larger clientele organizations. Individual barriers were differentially associated with budget, size of client base, and geographic location. Results are discussed in light of implementation science frameworks and proactive strategies to address perceived obstacles to adoption and use of technology-based behavioral health tools.

  19. Perceived barriers to weight maintenance among university students in Kuwait: the role of gender and obesity.

    Science.gov (United States)

    Musaiger, Abdulrahman O; Al-Kandari, Fawzia I; Al-Mannai, Mariam; Al-Faraj, Alaa M; Bouriki, Fajer A; Shehab, Fatima S; Al-Dabous, Lulwa A; Al-Qalaf, Wassin B

    2014-05-01

    To investigate the barriers to weight maintenance among university students in Kuwait by gender and obesity. A sample of 530 students was selected at convenience from four universities in Kuwait (2 public and 2 private). The age of students ranged from 19 to 26 years. A self-reported pretested questionnaire was used to obtain the barriers, which were divided into barriers to healthy eating and barriers to physical activity. Weight and height were based on self-reporting, and the students were grouped into non-obese and obese according to the WHO classification. The response options to barriers were: very important, somewhat important and not important. The main barriers to healthy eating for both genders were: "Do not have skills to plan, shop for, prepare or cook healthy foods" and "Not having time to prepare or eat healthy food". In general, there were no significant differences between men and women in barriers to healthy eating. There were highly significant differences between men and women regarding barriers to physical activity (P values ranged from Obese men were more likely to face barriers to healthy eating than non-obese men. There were no significant differences between obese and non-obese women regarding barriers to healthy eating and physical activity. The findings of this study can be utilized in intervention activities to promote a healthy lifestyle and to combat obesity in Kuwait, and maybe in other Arab countries.

  20. Provider-identified barriers and facilitators to implementing a supported employment program in spinal cord injury.

    Science.gov (United States)

    Cotner, Bridget A; Ottomanelli, Lisa; O'Connor, Danielle R; Trainor, John K

    2018-06-01

    In a 5-year study, individual placement and support (IPS) significantly increased employment rate of United States Veterans with spinal cord injury (SCI), a historically underemployed population. In a follow-up study, data on barriers and facilitators to IPS implementation were identified. Over 24 months of implementation, 82 key medical and vocational staff underwent semi-structured interviews (n = 130). Interviews were digitally recorded and qualitatively analyzed (ATLAS.ti v0.7) using a constant comparative method to generate themes. Some barriers to implementation occurred throughout the study, such as Veterans' lack of motivation and providers' difficulty integrating vocational and medical rehabilitation. Other barriers emerged at specific stages, for example, early barriers included a large geographic service area and a large patient caseload, and late barriers included need for staff education. Facilitators were mostly constant throughout implementation and included leadership support and successful integration of vocational staff into the medical care team. Implementation strategies need to be adjusted as implementation progresses and matures. The strategies that succeeded in this setting, which were situated in a real-world context of providing IPS as a part of SCI medical care, may inform implementation of IPS for other populations with physical disabilities. Implications for Rehabilitation Key facilitators to IPS in SCI implementation are integrating vocational staff with expertise in IPS and SCI on clinical rehabilitation teams and providing leadership support. Ongoing barriers to IPS in SCI include patient specific and program administration factors such as caseload size and staffing patterns. Varying implementation strategies are needed to address barriers as they arise and facilitate successful implementation.

  1. Allergists' self-reported adherence to anaphylaxis practice parameters and perceived barriers to care: an American College of Allergy, Asthma, and Immunology member survey.

    Science.gov (United States)

    Fineman, Stanley; Dowling, Paul; O'Rourke, Dianne

    2013-12-01

    Anaphylaxis is life-threatening and requires rapid medical intervention. Knowledge of treatment guidelines and addressing barriers to care are essential for appropriate management. To investigate allergists' self-reported practices in managing patients at risk for anaphylaxis, specifically in following practice parameters for diagnosis, treatment, and appropriate use of epinephrine, and to identify perceived barriers to care. Online questionnaires were distributed to members of the American College of Allergy, Asthma, and Immunology. The US physicians who self-identified as "allergist/immunologist" were eligible to participate. The first 500 completed questionnaires were analyzed. Nearly all (≥95%) reported adherence to practice parameters in prescribing an epinephrine auto-injector and instructing patients on its use, taking a detailed allergy history, counseling patients on avoidance measures, and educating patients on the signs and symptoms of anaphylaxis. More than 90% stated they determined the best diagnostic procedures to identify triggers and coordinated laboratory and allergy testing. Adherence to practice parameters was less robust for providing patients with written action plans and in-office anaphylaxis preparedness. Perceived barriers to care included a significant proportion of patients who were uncomfortable using epinephrine auto-injectors and inadequate knowledge of anaphylaxis among referral physicians. Allergists overwhelmingly adhere to practice parameter recommendations for the treatment and management of anaphylaxis, including appropriate use of epinephrine as first-line treatment, educating patients, and testing to diagnose anaphylaxis and identify its triggers. Opportunities for improvement include preparing staff and patients for anaphylactic events, providing written action plans, and improving knowledge of referring physicians. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights

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

    Science.gov (United States)

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

    2018-01-01

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

  3. Perceived barriers to pediatrician and family practitioner participation in pediatric clinical trials: Findings from the Clinical Trials Transformation Initiative.

    Science.gov (United States)

    Greenberg, Rachel G; Corneli, Amy; Bradley, John; Farley, John; Jafri, Hasan S; Lin, Li; Nambiar, Sumathi; Noel, Gary J; Wheeler, Chris; Tiernan, Rosemary; Smith, P Brian; Roberts, Jamie; Benjamin, Daniel K

    2018-03-01

    Despite legislation to stimulate pediatric drug development through clinical trials, enrolling children in trials continues to be challenging. Non-investigator (those who have never served as a clinical trial investigator) providers are essential to recruitment of pediatric patients, but little is known regarding the specific barriers that limit pediatric providers from participating in and referring their patients to clinical trials. We conducted an online survey of pediatric providers from a wide variety of practice types across the United States to evaluate their attitudes and awareness of pediatric clinical trials. Using a 4-point Likert scale, providers described their perception of potential barriers to their practice serving as a site for pediatric clinical trials. Of the 136 providers surveyed, 52/136 (38%) had previously referred a pediatric patient to a trial, and only 17/136 (12%) had ever been an investigator for a pediatric trial. Lack of awareness of existing pediatric trials was a major barrier to patient referral by providers, in addition to consideration of trial risks, distance to the site, and time needed to discuss trial participation with parents. Overall, providers perceived greater challenges related to parental concerns and parent or child logistical barriers than study implementation and ethics or regulatory barriers as barriers to their practice serving as a trial site. Providers who had previously been an investigator for a pediatric trial were less likely to be concerned with potential barriers than non-investigators. Understanding the barriers that limit pediatric providers from collaboration or inhibit their participation is key to designing effective interventions to optimize pediatric trial participation.

  4. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

    Directory of Open Access Journals (Sweden)

    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  5. Identifying barriers to and facilitators of tuberculosis contact investigation in Kampala, Uganda: a behavioral approach.

    Science.gov (United States)

    Ayakaka, Irene; Ackerman, Sara; Ggita, Joseph M; Kajubi, Phoebe; Dowdy, David; Haberer, Jessica E; Fair, Elizabeth; Hopewell, Philip; Handley, Margaret A; Cattamanchi, Adithya; Katamba, Achilles; Davis, J Lucian

    2017-03-09

    The World Health Organization recommends routine household tuberculosis contact investigation in high-burden countries but adoption has been limited. We sought to identify barriers to and facilitators of TB contact investigation during its introduction in Kampala, Uganda. We collected cross-sectional qualitative data through focus group discussions and interviews with stakeholders, addressing three core activities of contact investigation: arranging household screening visits through index TB patients, visiting households to screen contacts and refer them to clinics, and evaluating at-risk contacts coming to clinics. We analyzed the data using a validated theory of behavior change, the Capability, Opportunity, and Motivation determine Behavior (COM-B) model, and sought to identify targeted interventions using the related Behavior Change Wheel implementation framework. We led seven focus-group discussions with 61 health-care workers, two with 21 lay health workers (LHWs), and one with four household contacts of newly diagnosed TB patients. We, in addition, performed 32 interviews with household contacts from 14 households of newly diagnosed TB patients. Commonly noted barriers included stigma, limited knowledge about TB among contacts, insufficient time and space in clinics for counselling, mistrust of health-center staff among index patients and contacts, and high travel costs for LHWs and contacts. The most important facilitators identified were the personalized and enabling services provided by LHWs. We identified education, persuasion, enablement, modeling of health-positive behaviors, incentivization, and restructuring of the service environment as relevant intervention functions with potential to alleviate barriers to and enhance facilitators of TB contact investigation. The use of a behavioral theory and a validated implementation framework provided a comprehensive approach for systematically identifying barriers to and facilitators of TB contact

  6. Physical activity during pregnancy: predictors of change, perceived support and barriers among women at increased risk of gestational diabetes.

    Science.gov (United States)

    Leppänen, Marja; Aittasalo, Minna; Raitanen, Jani; Kinnunen, Tarja I; Kujala, Urho M; Luoto, Riitta

    2014-11-01

    The aim of this study was to examine the predictors of change in intensity-specific leisure-time physical activity (LTPA) during pregnancy, and the perceived support and barriers of LTPA in Finnish pregnant women at increased risk of gestational diabetes. The study population consisted of 399 pregnant women who participated in a randomized controlled trial aiming to prevent gestational diabetes. Evaluation of LTPA was based on a self-report at baseline, 26-28, and 36-37 weeks' gestation. Data on predictors of change, perceived support and barriers were collected with questionnaires and from the maternity cards. Multinomial logistic regression was used to assess associations between the variables. The average weekly minutes of light-intensity LTPA were 179 at baseline, 161 at 26-28 weeks' gestation, and 179 at 36-37 weeks' gestation. The corresponding minutes of moderate-to-vigorous-intensity LTPA were 187, 133 and 99. At 26-28 weeks' gestation, the strongest predictors for light-intensity LTPA were meeting the PA recommendations prior to pregnancy, having polytechnic education and working part-time, while having a physically active spouse prior to pregnancy was the strongest predictor for moderate-to-vigorous-intensity LTPA. The people and/or factors that encouraged women to LTPA the most were the spouse, a child, other family members and weather, whereas tiredness, nausea, perceived health, work and lack of time restricted their LTPA the most. The strongest predictors for maintaining LTPA during pregnancy were pre-pregnancy LTPA, education, working part-time and a spouse's LTPA. Most common barriers were perceived health, work and lack of time.

  7. Perceived Barriers and Facilitators for Return to Work Among Colorectal Cancer Survivors: Malaysian Healthcare Professionals Experience- A Qualitative Inquiry.

    Science.gov (United States)

    Chow, Sze Loon; Loh, Siew Yim; Su, Tin Tin

    2015-06-01

    Return to work (RTW) can be a challenging occupational health (OH) issue among previously-employed colorectal cancer survivors. This study aimed to explore the various perceived barriers and facilitators encountered during the RTW process in cancer survivorship, from the perception of healthcare professionals (HCP). Face to face, semistructured interviews were carried out on twelve HCP (government and private sectors) from various disciplines. Data collected were transcribed verbatim and data management was aided by NVivo software 8.0. A new theory from contextual data was generated using open coding, axial coding and selective coding. The HCP shared numerous barriers and facilitators associated with RTW, under four categories. The key barriers were disturbing side effects, psychological barriers (personal factor), compensation (financial factor), poor ability to multitask (work-related factor), long paid medical leaves policy, employer's lackadaisical attitude, lack of knowledge and awareness of RTW (environmental factor). Key facilitators identified were desire to resume working life and to contribute to society (personal factor), financial pressure, maintain organizational health insurance (financial factor), less physically demanding job (work-related factor), supportive workplace and strict organizational policy on medical leaves (environmental factor). While not all HCP were trained in RTW, they all agreed that RTW is important for survivors and workplace. Occupational health doctors have a direct role in helping survivors RTW. Early Intervention on RTW during survivorship should involve occupational health doctors and employers, targeting the modifiable factors (environmental and work-related) to improve RTW after cancer.

  8. Quantifying family dissemination and identifying barriers to communication of risk information in Australian BRCA families.

    Science.gov (United States)

    Healey, Emma; Taylor, Natalie; Greening, Sian; Wakefield, Claire E; Warwick, Linda; Williams, Rachel; Tucker, Kathy

    2017-12-01

    PurposeRecommendations for BRCA1 and BRCA2 mutation carriers to disseminate information to at-risk relatives pose significant challenges. This study aimed to quantify family dissemination, to explain the differences between fully informed families (all relatives informed verbally or in writing) and partially informed families (at least one relative uninformed), and to identify dissemination barriers.MethodsBRCA1 and BRCA2 mutation carriers identified from four Australian hospitals (n=671) were invited to participate in the study. Distress was measured at consent using the Kessler psychological distress scale (K10). A structured telephone interview was used to assess the informed status of relatives, geographical location of relatives, and dissemination barriers. Family dissemination was quantified, and fully versus partially informed family differences were examined. Dissemination barriers were thematically coded and counted.ResultsA total of 165 families participated. Information had been disseminated to 81.1% of relatives. At least one relative had not been informed in 52.7% of families, 4.3% were first-degree relatives, 27.0% were second-degree relatives, and 62.0% were cousins. Partially informed families were significantly larger than fully informed families, had fewer relatives living in close proximity, and exhibited higher levels of distress. The most commonly recorded barrier to dissemination was loss of contact.ConclusionLarger, geographically diverse families have greater difficulty disseminating BRCA mutation risk information to all relatives. Understanding these challenges can inform future initiatives for communication, follow-up and support.

  9. Perceived ambiguity as a barrier to intentions to learn genome sequencing results.

    Science.gov (United States)

    Taber, Jennifer M; Klein, William M P; Ferrer, Rebecca A; Han, Paul K J; Lewis, Katie L; Biesecker, Leslie G; Biesecker, Barbara B

    2015-10-01

    Many variants that could be returned from genome sequencing may be perceived as ambiguous-lacking reliability, credibility, or adequacy. Little is known about how perceived ambiguity influences thoughts about sequencing results. Participants (n = 494) in an NIH genome sequencing study completed a baseline survey before sequencing results were available. We examined how perceived ambiguity regarding sequencing results and individual differences in medical ambiguity aversion and tolerance for uncertainty were associated with cognitions and intentions concerning sequencing results. Perceiving sequencing results as more ambiguous was associated with less favorable cognitions about results and lower intentions to learn and share results. Among participants low in tolerance for uncertainty or optimism, greater perceived ambiguity was associated with lower intentions to learn results for non-medically actionable diseases; medical ambiguity aversion did not moderate any associations. Results are consistent with the phenomenon of "ambiguity aversion" and may influence whether people learn and communicate genomic information.

  10. Perceived Barriers to and Facilitators of Physical Activity in Recipients of Solid Organ Transplantation, a Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Edwin J van Adrichem

    Full Text Available Sufficient physical activity is important for solid organ transplant recipients (heart, lung, liver, kidney. However, recipients do not meet the recommended amount or required type of physical activity. The perceived barriers to and facilitators of physical activity in this population are largely unknown.Semi-structured in depth interviews were conducted with solid organ transplant recipients in order to explore experienced barriers and facilitators. Qualitative methodology with thematic line-by-line analysis was used for analysis, and derived themes were classified into personal and environmental factors.The most important indicated barriers were physical limitations, insufficient energy level, fear, and comorbidities. The most frequently mentioned facilitators included motivation, coping, consequences of (inactivity, routine/habit, goals/goal priority, and responsibility for the transplanted organ. Neutral factors acting as a barrier or facilitator were self-efficacy and expertise of personnel. A comparison of barriers and facilitators between transplant recipient groups yielded no overt differences.Several personal and environmental factors were indicated that should be considered in intervention development to increase physical activity behavior in solid organ transplant recipients.

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

    Directory of Open Access Journals (Sweden)

    Lee Yew

    2012-07-01

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

  12. Identifying a motor proficiency barrier for meeting physical activity guidelines in children.

    Science.gov (United States)

    De Meester, An; Stodden, David; Goodway, Jacqueline; True, Larissa; Brian, Ali; Ferkel, Rick; Haerens, Leen

    2018-01-01

    This study examined the existence of a threshold level (proficiency barrier) of actual motor competence (MC) below which a child is not likely to attain 60min of moderate-to-vigorous physical activity (MVPA) per day. A cross-sectional study. Actual MC was assessed in 326 children (48.5% boys; age=9.50±1.24years) using the Test of Gross Motor Development-2; MVPA was measured with ActiGraph GT3X+accelerometers. Perceived MC, included as a potential mediating variable, was assessed with the Self-Perception Profile for Children. Binary logistic (mediation) regression analyses controlling for sex and a chi-squared test were used to gain insight into the relationship between (the levels of) actual MC and the percentage of children meeting the MVPA guideline. Actual MC significantly predicted the percentage of children meeting the guideline (B=.03, SE=.01, p<.001), even when controlling for sex. Perceived MC did not mediate this relationship. Children with high actual MC (65-100 percentile) were 2.46 (p=.003) times more likely to meet the guideline than children with low actual MC (0-27 percentile). The present study demonstrates the potential impact of low MC on children's MVPA levels and suggests evidence for the existence of a proficiency barrier for meeting MVPA guidelines. Almost 90% of the children whose actual MC is below the 'average' threshold do not meet the MVPA guideline. As more children with higher levels of actual MC meet the guideline than their less competent peers, it is crucial to provide opportunities to sufficiently develop children's actual MC. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. A Study of Perceived Admission and Achievement Barriers of Learning-Disabled Students in Postsecondary Institutions

    Science.gov (United States)

    Lamberg, Catherine Denise

    2012-01-01

    Learning-disabled students face ongoing challenges in higher education. Despite efforts to promote recruitment and retention of students with learning disabilities to trade schools, colleges, and universities, barriers to enrollment and academic achievement persist. Barriers for learning-disabled students are not fully understood and might be…

  14. Identifying motivators and barriers to student completion of instructor evaluations: A multi-faceted, collaborative approach from four colleges of pharmacy.

    Science.gov (United States)

    McAuley, James W; Backo, Jennifer Lynn; Sobota, Kristen Finley; Metzger, Anne H; Ulbrich, Timothy

    To identify motivators and barriers to pharmacy student completion of instructor evaluations, and to develop potential strategies to improve the evaluation process. Completed at four Ohio Colleges of Pharmacy, Phase I consisted of a student/faculty survey and Phase II consisted of joint student/faculty focus groups to discuss Phase I data and to problem solve. In Phase I, the top three student-identified and faculty-perceived motivators to completion of evaluations were to (1) make the course better, (2) earn bonus points, and (3) improve the instructor's teaching. The top three student-identified barriers to completion of evaluations were having to (1) evaluate multiple instructors, (2) complete several evaluations around the same time, and (3) complete lengthy evaluations. Phase II focus groups identified a number of potential ways to enhance the motivators and reduce barriers, including but not limited to making sure faculty convey to students that the feedback they provide is useful and to provide examples of how student feedback has been used to improve their teaching/the course. Students and faculty identified motivators and barriers to completing instructor evaluations and were willing to work together to improve the process. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Physical Activity Correlates in Middle School Adolescents: Perceived Benefits and Barriers and Their Determinants.

    Science.gov (United States)

    Roth, Sarah E; Gill, Monique; Chan-Golston, Alec M; Rice, Lindsay N; Crespi, Catherine M; Koniak-Griffin, Deborah; Cole, Brian L; Upchurch, Dawn M; Prelip, Michael L

    2018-01-01

    The purpose of this study was to examine the determinants of benefits and barriers and their relationship with physical activity (PA) among predominantly Latino middle school students. Data were collected in a cross-sectional survey of 4,773 seventh-grade students recruited from a large, urban school district in Los Angeles. Hierarchical logistic regression models were used to assess determinants of benefits and barriers as well as their association with self-reported PA. Differences in benefits and barriers were observed by gender, ethnicity, and body size. Barriers were negatively correlated with all three PA outcomes while benefits were positively associated with exercising at least 60 min daily. A deeper understanding of benefits and barriers can facilitate the development of interventions and collaborative efforts among physical education teachers, school nurses, and administrators to implement comprehensive approaches that encourage students' participation in PA inside and outside of the classroom.

  16. Green Dentistry: Practices and Perceived Barriers Among Dental Practitioners of Chandigarh, Panchkula, and Mohali (Tricity, India

    Directory of Open Access Journals (Sweden)

    Amandeep Chopra

    2017-01-01

    Full Text Available Introduction: Dental professionals have a responsibility to conserve natural resources and to eliminate/reduce toxic wastes from their practices that could harm human health and environment. Aim: To investigate the implementation of eco-friendly dental office strategies by the dentists of tricity (Chandigarh, Panchkula, and Mohali. Materials and Methods: Self-designed questionnaires were distributed to 120 Indian Dental Association registered dentists. Descriptive statistics and cross tabulations were calculated using the Statistical Package for the Social Sciences version 20.0 software. Results: Most of the dentists followed eco-friendly dental practices including the alternatives to amalgam filling (98%, use of light-emitting diode bulbs (91%, unplugging electronic devices when not in use (96%, use of steam sterilization with cloth instrument wraps (93%, using reusable lab coats (89%, and using digital radiography (78.6%. The most frequently identified barriers to implementation of eco-friendly dental office strategies were cost and lack of incentives from the government. Conclusion: Eco-friendly practice implementation by dentists is at its stage of infancy. There is a need for creating awareness among dentists regarding eco-friendly dental practices through formal and continuing dental education.

  17. IEA Wind Task 32: Wind lidar identifying and mitigating barriers to the adoption of wind lidar

    DEFF Research Database (Denmark)

    Clifton, Andrew; Clive, Peter; Gottschall, Julia

    2018-01-01

    IEA Wind Task 32 exists to identify and mitigate barriers to the adoption of lidar for wind energy applications. It leverages ongoing international research and development activities in academia and industry to investigate site assessment, power performance testing, controls and loads, and complex...... flows. Since its initiation in 2011, Task 32 has been responsible for several recommended practices and expert reports that have contributed to the adoption of ground-based, nacelle-based, and floating lidar by the wind industry. Future challenges include the development of lidar uncertainty models......, best practices for data management, and developing community-based tools for data analysis, planning of lidar measurements and lidar configuration. This paper describes the barriers that Task 32 identified to the deployment of wind lidar in each of these application areas, and the steps that have been...

  18. Knowledge sharing in Chinese hospitals identifying sharing barriers in traditional Chinese and Western medicine collaboration

    CERN Document Server

    Zhou, Lihong

    2015-01-01

    This book aims to identify, understand and qualify barriers to the patient-centred knowledge sharing (KS) in interprofessional practice of Traditional Chinese Medicine (TCM) and Western Medicine (WM) healthcare professionals in Chinese hospitals.  This collaboration is particularly crucial and unique to China since, contrary to Western practice, these two types of professionals actually work together complimentary in the same hospital. This study adopted a Grounded Theory approach as the overarching methodology to guide the analysis of the data collected in a single case-study design.  A public hospital in central China was selected as the case-study site, at which 49 informants were interviewed by using semi-structured and evolving interview scripts.  The research findings point to five categories of KS barriers: contextual influences, hospital management, philosophical divergence, Chinese healthcare education and interprofessional training.  Further conceptualising the research findings, it is identifie...

  19. Assessment of physical inactivity and perceived barriers to physical activity among health college students, south-western Saudi Arabia.

    Science.gov (United States)

    Awadalla, N J; Aboelyazed, A E; Hassanein, M A; Khalil, S N; Aftab, R; Gaballa, I I; Mahfouz, A A

    2014-10-20

    Physical inactivity is a public health problem in Saudi Arabia. A cross-sectional study was carried out to evaluate the pattern of physical activity, predictors of physical inactivity and perceived barriers to physical activity among health college students in King Khalid University. A total of 1257 students (426 males and 831 females) were recruited. The Arabic short form of the International Physical Activity Questionnaire was used. Overall, 58.0% of the students were physically inactive. Only 13.4% of the students performed vigorous physical activity, 14.8% moderate-intensity physical activity and 29.9% walking activities which met World Health Organization criteria of health-enhancing physical activities. The prevalence of inactive leisure time was 47.5%. The independent predictors of physical inactivity were non-membership of sports clubs and being a medical student. The top reported barrier to physical activity among inactive students was time limitations (51.3%). Overcoming perceived barriers may increase physical activity among students.

  20. Perceived Barriers and Support Strategies for Reducing Sodium Intake in Patients with Chronic Kidney Disease: a Qualitative Study.

    Science.gov (United States)

    Meuleman, Yvette; Ten Brinke, Lucia; Kwakernaak, Arjan J; Vogt, Liffert; Rotmans, Joris I; Bos, Willem Jan W; van der Boog, Paul J M; Navis, Gerjan; van Montfrans, Gert A; Hoekstra, Tiny; Dekker, Friedo W; van Dijk, Sandra

    2015-08-01

    Reducing sodium intake can prevent cardiovascular complications and further decline of kidney function in patients with chronic kidney disease. However, the vast majority of patients fail to reach an adequate sodium intake, and little is known about why they do not succeed. This study aims to identify perceived barriers and support strategies for reducing sodium intake among both patients with chronic kidney disease and health-care professionals. A purposive sample of 25 patients and 23 health-care professionals from 4 Dutch medical centers attended 8 focus groups. Transcripts were analyzed thematically and afterwards organized according to the phases of behavior change of self-regulation theory. Multiple themes emerged across different phases of behavior change, including the patients' lack of practical knowledge and intrinsic motivation, the maladaptive illness perceptions and refusal skills, the lack of social support and feedback regarding disease progression and sodium intake, and the availability of low-sodium foods. The results indicate the need for the implementation of support strategies that target specific needs of patients across the whole process of changing and maintaining a low-sodium diet. Special attention should be paid to supporting patients to set sodium-related goals, strengthening intrinsic motivation, providing comprehensive and practical information (e.g., about hidden salt in products), increasing social support, stimulating the self-monitoring of sodium intake and disease progression, and building a supportive patient-professional relationship that encompasses shared decision making and coaching. Moreover, global programs should be implemented to reduce sodium levels in processed foods, introduce sodium-related product labels, and increase consumer awareness.

  1. Malaria programme personnel's experiences, perceived barriers and facilitators to implementing malaria elimination strategy in South Africa.

    Science.gov (United States)

    Hlongwana, Khumbulani Welcome; Sartorius, Benn; Tsoka-Gwegweni, Joyce

    2018-01-10

    South Africa has set an ambitious goal targeting to eliminate malaria by 2018, which is consistent with the United Nations Sustainable Development Goals' call to end the epidemic of malaria by 2030 across the globe. There are conflicting views regarding the feasibility of malaria elimination, and furthermore studies investigating malaria programme personnel's perspectives on strategy implementation are lacking. The study was a cross-sectional survey conducted in 2014 through a face-to-face investigator-administered semi-structured questionnaire to all eligible and consenting malaria programme personnel (team leader to senior manager levels) in three malaria endemic provinces (KwaZulu-Natal, Mpumalanga, and Limpopo) of South Africa. The overall response rate was 88.6% (148/167) among all eligible malaria personnel. The mean age of participants was 47 years (SD 9.7, range 27-70), and the mean work experience of 19.4 years (SD 11.1, range 0-42). The majority were male (78.4%), and 66.9% had secondary level education. Awareness of the malaria elimination policy was high (99.3%), but 89% contended that they were never consulted when the policy was formulated and few had either seen (29.9%) or read (23%) the policy, either in full or in part. Having read the policy was positively associated with professional job designations (managers, EHPs and entomologists) (p = 0.010) and tertiary level education (p = 0.042). There was a sentiment that the policy was neither sufficiently disseminated to all key healthcare workers (76.4%) nor properly adapted (68.9%) for the local operational context in the elimination strategy. Most (89.1%) participants were not optimistic about eliminating malaria by 2018, as they viewed the elimination strategy in South Africa as too theoretical with unrealistic targets. Other identified barriers included inadequate resources (53.5%) and high cross-border movements (19.8%). Most participants were not positive that South Africa could achieve

  2. Faculty Perceptions about Barriers to Active Learning

    Science.gov (United States)

    Michael, Joel

    2007-01-01

    Faculty may perceive many barriers to active learning in their classrooms. Four groups of participants in a faculty development workshop were asked to list their perceived barriers to active learning. Many of the problems identified were present on more than one list. The barriers fall into three categories: student characteristics, issues…

  3. Breast Cancer Awareness and Prevention Behavior among Women of Delhi, India: Identifying Barriers to Early Detection

    Directory of Open Access Journals (Sweden)

    Subhojit Dey

    2016-01-01

    Full Text Available Background Globally, breast cancer (BC has become the leading cause of mortality in women. Awareness and early detection can curb the growing burden of BC and are the first step in the battle against BC. The aim of this qualitative study was to explore the awareness and perceived barriers concerning the early detection of BC. Methods A total of 20 focus group discussions (FGDs were conducted during May 2013–March 2014. Pre-existing themes were used to conduct FGDs; each FGD group consisted of an average of ~10 women (aged ≥18–70 years who came to participate in a BC awareness workshop. All FGDs were audio taped and transcribed verbatim. The transcripts were inductively analyzed using ATLAS.ti. Based on emerged codes and categories, thematic analysis was done, and theory was developed using the grounded theory approach. Results Data were analyzed in three major themes: i knowledge and perception about BC; ii barriers faced by women in the early presentation of BC; and iii healthcare-seeking behavior. The findings revealed that shyness, fear, and posteriority were the major behavioral barriers in the early presentation of BC. Erroneously, pain was considered as an initial symptom of BC by most women. Financial constraint was also mentioned as a cause for delay in accessing treatment. Social stigma that breast problems reflect bad character of women also contributed in hiding BC symptoms. Conclusions Lack of BC awareness was prevalent, especially in low socioeconomic class. Women's ambivalence in prioritizing their own health and social and behavioral hurdles should be addressed by BC awareness campaigns appropriately suited for various levels of social class.

  4. Breast Cancer Awareness and Prevention Behavior Among Women of Delhi, India: Identifying Barriers to Early Detection.

    Science.gov (United States)

    Dey, Subhojit; Sharma, Surabhi; Mishra, Arti; Krishnan, Suneeta; Govil, Jyotsna; Dhillon, Preet K

    2016-01-01

    Globally, breast cancer (BC) has become the leading cause of mortality in women. Awareness and early detection can curb the growing burden of BC and are the first step in the battle against BC. The aim of this qualitative study was to explore the awareness and perceived barriers concerning the early detection of BC. A total of 20 focus group discussions (FGDs) were conducted during May 2013-March 2014. Pre-existing themes were used to conduct FGDs; each FGD group consisted of an average of ~10 women (aged ≥18-70 years) who came to participate in a BC awareness workshop. All FGDs were audio taped and transcribed verbatim. The transcripts were inductively analyzed using ATLAS.ti. Based on emerged codes and categories, thematic analysis was done, and theory was developed using the grounded theory approach. Data were analyzed in three major themes: i) knowledge and perception about BC; ii) barriers faced by women in the early presentation of BC; and iii) healthcare-seeking behavior. The findings revealed that shyness, fear, and posteriority were the major behavioral barriers in the early presentation of BC. Erroneously, pain was considered as an initial symptom of BC by most women. Financial constraint was also mentioned as a cause for delay in accessing treatment. Social stigma that breast problems reflect bad character of women also contributed in hiding BC symptoms. Lack of BC awareness was prevalent, especially in low socioeconomic class. Women's ambivalence in prioritizing their own health and social and behavioral hurdles should be addressed by BC awareness campaigns appropriately suited for various levels of social class.

  5. Oculocutaneous albinism: identifying and overcoming barriers to vision care in a Nigerian population.

    Science.gov (United States)

    Udeh, N N; Eze, B I; Onwubiko, S N; Arinze, O C; Onwasigwe, E N; Umeh, R E

    2014-06-01

    To assess eye care service utilization, and identify access barriers in a south-eastern Nigerian albino population. The study was a population-based, cross-sectional survey conducted in Enugu state between August, 2011 and January, 2012. Using the data base of the state's Albino Foundation and tailored awareness creation, persons living with albinism were identified and recruited at two study centres. Data on participants' socio-demographics, perception of vision, visual needs, previous eye examination and or low vision assessment, use of glasses or low vision devices were collected. Reasons for non-utilisation of available vision care services were also obtained. Descriptive and comparative statistics were performed. A p low vision assessment and none--0.0% had used low vision device. Of the participants, 82.4% reported previous eye examination, 33.3% had not used spectacles previously, despite the existing need. Ignorance--88.9% and poor access--8.5% were the main barriers to uptake of vision care services. In Enugu, Nigeria, there is poor awareness and low utilization of vision care services among people with albinism. The identified barriers to vision care access are amenable to awareness creation and logistic change in the provision of appropriate vision care services.

  6. IDENTIFYING AND ANALYZING THE TRANSIENT AND PERMANENT BARRIERS FOR BIG DATA

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    SARFRAZ NAWAZ BROHI

    2016-12-01

    Full Text Available Auspiciously, big data analytics had made it possible to generate value from immense amounts of raw data. Organizations are able to seek incredible insights which assist them in effective decision making and providing quality of service by establishing innovative strategies to recognize, examine and address the customers’ preferences. However, organizations are reluctant to adopt big data solutions due to several barriers such as data storage and transfer, scalability, data quality, data complexity, timeliness, security, privacy, trust, data ownership, and transparency. Despite the discussion on big data opportunities, in this paper, we present the findings of our in-depth review process that was focused on identifying as well as analyzing the transient and permanent barriers for adopting big data. Although, the transient barriers for big data can be eliminated in the near future with the advent of innovative technical contributions, however, it is challenging to eliminate the permanent barriers enduringly, though their impact could be recurrently reduced with the efficient and effective use of technology, standards, policies, and procedures.

  7. Identifying the Barriers to Using Games and Simulations in Education: Creating a Valid and Reliable Survey Instrument

    Science.gov (United States)

    Justice, Lenora Jean

    2012-01-01

    The purpose of this study was to create a valid and reliable instrument to measure teacher perceived barriers to the adoption of games and simulations in instruction. Previous research, interviews with educators, a focus group, an expert review, and a think aloud protocol were used to design a survey instrument. After finalization, the survey was…

  8. Perceived stress among medical students: To identify its sources and coping strategies

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    Shubhada Gade

    2014-01-01

    Full Text Available Context: Stress in medical education is common and process-oriented. It often exerts a negative effect on their academic performance, physical health, and psychological well being. Aims: This study aims at identification of such susceptible students in the early stage i.e. first year of medical education, and to provide them essential support in the form of an intervention program to lessen the negative consequences of stress. Materials and Methods: A cross-sectional survey was carried out among the First MBBS students of NKP Salve Institute of Medical Sciences and Research Center, Nagpur, India. A 41-item questionnaire was designed to assess the sources of stress and their severity. Likert′s 5-point scale was used to quantify the extent of severity on each item. Coping strategies adopted by students were assessed by using a 22-item stress inventory, and a questionnaire based on 19 institutional stress-reducing factors was used to identify its role. Results: The survey resulted into an overall response rate of 87% (131 out of 150 students. Median stress level based on 41 items was evaluated for each student. About 29% (40 students had median stress level greater than 3. Female students were more stressed (17.19% than male students (14.93%. The study revealed that students generally adopt active coping strategies rather than avoidant strategies like alcohol and drug abuse. The study indicated that emotional support system is a major stress-relieving factor for students. Conclusion: Prevalence of perceived stress is high among medical students. It seems that academic-related problems are greater perceived stressors. Review of academics, exam schedules and patterns, better interaction with the faculty and proper guidance, intervention programs and counseling could certainly help a lot to reduce stress in medical students.

  9. Perceived Barriers to Healthy Eating and Physical Activity Among Participants in a Workplace Obesity Intervention.

    Science.gov (United States)

    Stankevitz, Kayla; Dement, John; Schoenfisch, Ashley; Joyner, Julie; Clancy, Shayna M; Stroo, Marissa; Østbye, Truls

    2017-08-01

    To characterize barriers to healthy eating (BHE) and physical activity (BPA) among participants in a workplace weight management intervention. Steps to health participants completed a questionnaire to ascertain barriers to physical activity and healthy eating faced. Exploratory factor analysis was used to determine the factor structure for BPA and BHE. The relationships of these factors with accelerometer data and dietary behaviors were assessed using linear regression. Barriers to physical activity included time constraints and lack of interest and motivation, and to healthy eating, lack of self-control and convenience, and lack of access to healthy foods. Higher BHE correlated with higher sugary beverage intake but not fruit and vegetable and fat intake. To improve their effectiveness, workplace weight management programs should consider addressing and reducing barriers to healthy eating and physical activity.

  10. Perceived barriers to physical activity in older and younger veterans with serious mental illness.

    Science.gov (United States)

    Muralidharan, Anjana; Klingaman, Elizabeth A; Molinari, Victor; Goldberg, Richard W

    2018-03-01

    Individuals with serious mental illness endorse many more medical and psychosocial barriers to physical activity (PA) than the general population. However, it is unknown if older adults with serious mental illness are at greater risk of experiencing barriers to PA than their younger counterparts. The present study utilized a national VA dataset to compare veterans with serious mental illness ages 55 and older (n = 9,044) to veterans with serious mental illness ages 54 and younger (n = 8,782) on their responses to a questionnaire assessment of barriers to PA. Older veterans were more likely to endorse arthritis and cardiopulmonary disease, and less likely to endorse work schedule, as barriers to PA. Interventions designed to increase PA for young/middle-aged adults with serious mental illness may be broadly useful for older adults with serious mental illness, with some modification to address specific health concerns. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach

    OpenAIRE

    Saligheh, Maryam; McNamara, Beverley; Rooney, Rosanna

    2016-01-01

    Background Postpartum women?s recovery from birth can be assisted through increased physical activity (PA). However, women face substantial barriers to participating in exercise and require support to enable them to benefit from increased PA. Methods This study sought to explore women?s beliefs about and experiences of PA and exercise during the 6?weeks to 12?months postpartum period. A cohort of 14 postpartum women from a survey study of the barriers and enablers to exercise participation ag...

  12. Perceived Barriers in Accessing the Reproductive Health Care Services in Odisha

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    Madhulika Sahoo

    2017-09-01

    Full Text Available Background: The utilization of Reproductive, Maternal, and Newborn and Child health (RMNCH services is often influenced by the socio-cultural, financial, access, political barriers acting at the community, family and individual level. Yet, very little attention has been given, either by policy makers or researchers for minimizing their effect. Aim and objective: To examine the demand and supply side barriers in accessing the maternity services and to understand the perception on maternal healthcare services. Material & Methods: The study was carried out in four districts of Odisha state, with a well representative sample of 1194 women, who delivered a child in last 2 years. Quantitative and qualitative study design was followed to collect the data. Results: The supply side barriers such as physical access and facilities were faced by the service providers. The demand side barriers such as socio-cultural, financial and access barriers were faced by the service receivers in order to avail the services. Conclusions: In order to overcome the barriers faced by the women of Odisha it is important to improve the access to services so that they get them easily. Some of the imperative actions such as strengthening community mobilization through inter-personal communication, dialogue with the key influencers in the community as well as continuous engagement with and sensitization of the service providers

  13. Perceived Barriers in Accessing the Reproductive Health Care Services in Odisha

    Directory of Open Access Journals (Sweden)

    Madhulika Sahoo

    2017-09-01

    Full Text Available Background: The utilization of Reproductive, Maternal, and Newborn and Child health (RMNCH services is often influenced by the socio-cultural, financial, access, political barriers acting at the community, family and individual level. Yet, very little attention has been given, either by policy makers or researchers for minimizing their effect. Aim and objective: To examine the demand and supply side barriers in accessing the maternity services and to understand the perception on maternal healthcare services. Material & Methods: The study was carried out in four districts of Odisha state, with a well representative sample of 1194 women, who delivered a child in last 2 years. Quantitative and qualitative study design was followed to collect the data. Results: The supply side barriers such as physical access and facilities were faced by the service providers. The demand side barriers such as socio-cultural, financial and access barriers were faced by the service receivers in order to avail the services. Conclusions: In order to overcome the barriers faced by the women of Odisha it is important to improve the access to services so that they get them easily. Some of the imperative actions such as strengthening community mobilization through inter-personal communication, dialogue with the key influencers in the community as well as continuous engagement with and sensitization of the service providers

  14. Physical activity and mental disorders: a case-control study on attitudes, preferences and perceived barriers in Italy.

    Science.gov (United States)

    Carpiniello, Bernardo; Primavera, Diego; Pilu, Alessandra; Vaccargiu, Nicola; Pinna, Federica

    2013-12-01

    Mentally ill people experience greater difficulty than the general population in exercising regularly. We aimed to evaluate attitudes displayed and barriers perceived towards physical activity in a sample of psychiatric patients. A total of 138 (M = 48, F = 90) patients attending a community mental health centre were compared with a control group made up of 138 subjects not affected by mental disorders matched for gender, mean age and education. Both groups underwent a self-administered questionnaire. Patients reported a more sedentary lifestyle in terms of weekly physical activities and daily hours of exercise; their body mass index (BMI) was significantly higher compared with the BMI of controls (p barriers to physical activity; moreover, stating how feeling sad or "distressed" reduced their propensity to physical exercise (p = 0.002). A higher number of patients (p physical activity, and the experiencing of scarce enjoyment (p barriers may limit regular physical activity in subjects affected by mental disorders; these barriers should be taken into account and appropriately addressed.

  15. Perceived barriers, resources, and training needs of rural primary care providers relevant to the management of childhood obesity.

    Science.gov (United States)

    Findholt, Nancy E; Davis, Melinda M; Michael, Yvonne L

    2013-08-01

    To explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity. In-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded. Barriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics. Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings. © 2013 National Rural Health Association.

  16. IEA Wind Task 32: Wind Lidar Identifying and Mitigating Barriers to the Adoption of Wind Lidar

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    Andrew Clifton

    2018-03-01

    Full Text Available IEA Wind Task 32 exists to identify and mitigate barriers to the adoption of lidar for wind energy applications. It leverages ongoing international research and development activities in academia and industry to investigate site assessment, power performance testing, controls and loads, and complex flows. Since its initiation in 2011, Task 32 has been responsible for several recommended practices and expert reports that have contributed to the adoption of ground-based, nacelle-based, and floating lidar by the wind industry. Future challenges include the development of lidar uncertainty models, best practices for data management, and developing community-based tools for data analysis, planning of lidar measurements and lidar configuration. This paper describes the barriers that Task 32 identified to the deployment of wind lidar in each of these application areas, and the steps that have been taken to confirm or mitigate the barriers. Task 32 will continue to be a meeting point for the international wind lidar community until at least 2020 and welcomes old and new participants.

  17. STI Services for Adolescents and Youth in Low and Middle Income Countries: Perceived and Experienced Barriers to Accessing Care

    Science.gov (United States)

    Newton-Levinson, Anna; Leichliter, Jami S.; Chandra-Mouli, Venkatraman

    2017-01-01

    Access to sexual and reproductive health services (SRH) is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001–2014 with a study population of youth (aged 10–24 years) and/or health service providers. Nineteen studies were identified for inclusion from fifteen countries. Thematic analyses identified key themes across the studies. Findings suggest that youth lacked knowledge about STIs and services. Additionally, youth experienced barriers related to service availability and a lack of integration of services. The most reported barriers were related to acceptability of services. Youth reported avoiding services or having confidentiality concerns based on provider demographics and some behaviors. Finally, experiences of shame and stigma were common barriers to seeking care. Adolescents in low and middle income countries experience significant barriers in obtaining STI and SRH services. Improving uptake may require efforts to address clinic systems and provider attitudes, including confidentiality issues. Moreover, addressing barriers to STI services may require addressing cultural norms related to adolescent sexuality. PMID:27338664

  18. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams

    DEFF Research Database (Denmark)

    Andersen, P.O.; Jensen, Michael Kammer; Lippert, A.

    2010-01-01

    Background: The application of non-technical skills (NTSs) in health care has previously been described in other health-care educational programmes. NTSs are behavioural principles such as leadership, task distribution and communication. The aim of this study was to identify NTSs suitable...... for improving team performance in multi-professional cardiac arrest teams, and to describe barriers to the use and implementation of such NTSs by using a qualitative method. Methods: Individual semi-structured interviews were conducted with 11 Danish Advanced Life Support instructors during the period April...... 2006 to November 2006. Interviews were focussed on barriers and recommendations for teamwork in the cardiac arrest team, optimal policy for improvement of resuscitation training and clinical practice, use of cognitive aids and adoption of European Resuscitation Council (ERC) Guidelines 2005. Interviews...

  19. An exploratory study of how sports and recreation industry personnel perceive the barriers and facilitators of physical activity in children with disability.

    Science.gov (United States)

    Shields, Nora; Synnot, Anneliese J

    2014-01-01

    To explore the perceived barriers and facilitators to participation in physical activity among children with disability in physical activity and community sports from the perspective of sports and recreation industry personnel. A convenient sample of 24 participants was recruited from delegates attending a symposium on physical activity for organisations in the sport and recreation sector in Victoria, Australia. The participants completed a brief questionnaire. Data were analysed by content analysis using an inductive approach. The participants reported 25 facilitators and 20 barriers to participation for children with disability. The top five reported facilitators were: welcoming providers, support and encouragement from parents or others, inclusive providers, adaptable approaches and accessibility of facilities. The top five reported barriers were: inaccessible facilities, non-inclusive providers, transport, lack of relevant opportunities and cost. Sports industry personnel share a similar perspective to families of potential barriers and facilitators to engagement by children with disability in physical activity and community sports. Policy change was not considered as a facilitator of physical activity, even though four of the top five facilitators identified could be implemented through local policy change. Implications for Rehabilitation There are multiple factors that interact with each other which influence the participation by children with disability in physical activity and community sports. The sports and recreation industry should consider policy change as a relevant way to facilitate participation by children with disability in physical activity. More professional development and disability engagement opportunities for sports and recreation industry personnel may help address some of the barriers to participation for children with disability experience.

  20. Perceived barriers to the regionalization of adult critical care in the United States: a qualitative preliminary study

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    Rubenfeld Gordon D

    2008-11-01

    Full Text Available Abstract Background Regionalization of adult critical care services may improve outcomes for critically ill patients. We sought to develop a framework for understanding clinician attitudes toward regionalization and potential barriers to developing a tiered, regionalized system of care in the United States. Methods We performed a qualitative study using semi-structured interviews of critical care stakeholders in the United States, including physicians, nurses and hospital administrators. Stakeholders were identified from a stratified-random sample of United States general medical and surgical hospitals. Key barriers and potential solutions were identified by performing content analysis of the interview transcriptions. Results We interviewed 30 stakeholders from 24 different hospitals, representing a broad range of hospital locations and sizes. Key barriers to regionalization included personal and economic strain on families, loss of autonomy on the part of referring physicians and hospitals, loss of revenue on the part of referring physicians and hospitals, the potential to worsen outcomes at small hospitals by limiting services, and the potential to overwhelm large hospitals. Improving communication between destination and source hospitals, provider education, instituting voluntary objective criteria to become a designated referral center, and mechanisms to feed back patients and revenue to source hospitals were identified as potential solutions to some of these barriers. Conclusion Regionalization efforts will be met with significant conceptual and structural barriers. These data provide a foundation for future research and can be used to inform policy decisions regarding the design and implementation of a regionalized system of critical care.

  1. Identifying meaning and perceived level of satisfaction within the context of work.

    Science.gov (United States)

    Brown, Angie; Kitchell, Molly; O'Neill, Tiffany; Lockliear, Jennifer; Vosler, Alyson; Kubek, Dayna; Dale, Lucinda

    2001-01-01

    OBJECTIVE: The primary objectives of this study were to identify sources of meaning for individuals within the context of a work environment, and to compare varied sources of meaning for individuals with high and low work satisfaction levels. METHOD: Participants were chosen based on satisfaction levels in employment, full-time employment status within an organization for at least one year, and diversity in the work setting. Data were gathered through a series of interviews and observations of the participants' workplaces. A comparative analysis of transcribed interviews was conducted by the researchers and with an expert occupational therapy faculty panel. From these analyses, the researchers developed work narratives for a mechanical engineer, a high school teacher, an employee of mechanical services, and a career service counselor. RESULTS: Emerging themes from the work narratives indicated that the various meanings employees found in work had an effect on their perceived levels of job satisfaction. Participants conveyed that organization identification, financial benefits, independent decision-making, reciprocal respect, opportunities for creativity, and maintaining significant relationships outside of work enhanced meaning and satisfaction. CONCLUSIONS: The worker role is a significant source of an individual's identity, meaning, and satisfaction in life. Professionals in various fields can work with employers to develop meaningful work environments for increased job satisfaction, greater motivation for work, increased productivity, and decreased employee turnover.

  2. Managerial attitudes and perceived barriers regarding evidence-based practice : An international survey

    NARCIS (Netherlands)

    Barends, Eric; Villanueva, Josh; Rousseau, Denise M.; Briner, Rob B.; Jepsen, Denise M.; Houghton, Edward; Ten Have, Steven

    2017-01-01

    Evidence-based practice (EBP) in management is still in its infancy. Several studies suggest that managers in businesses and other organizations do not consult the scientific evidence when making decisions. To facilitate its uptake, we need to better understand practitioner attitudes and perceived

  3. Perceived barriers and facilitators to increasing physical activity among people with musculoskeletal disorders: a qualitative investigation to inform intervention development

    Directory of Open Access Journals (Sweden)

    McPhail SM

    2014-12-01

    Full Text Available Steven M McPhail,1,2 Mandy Schippers,1,2 Alison L Marshall,1 Monique Waite,1,2 Pim Kuipers2,3 1Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, 2Centre for Functioning and Health Research, Metro South Health, 3Griffith Health Institute and School of Human Services and Social Work, Griffith University, Brisbane, QLD, Australia Purpose: Musculoskeletal conditions can impair people’s ability to undertake physical activity as they age. The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing ambulatory hospital clinics for musculoskeletal disorders.Patients and methods: A questionnaire with open-ended items was administered to patients (n=217, 73.3% of 296 eligible from three clinics providing ambulatory services for nonsurgical treatment of musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them to be physically active. Participants’ responses to the two open-ended questions were read, coded, and thematically analyzed independently by two researchers, with a third researcher available to arbitrate any unresolved disagreement. Results: The mean (standard deviation age of participants was 53 (15 years; n=113 (52.1% were male. A total of 112 (51.6% participants reported having three or more health conditions; n=140 (64.5% were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were “health conditions”, “time restrictions”, “poor physical condition”, “emotional, social, and psychological

  4. Perceived barriers to care and provider gender preferences among veteran men who have experienced military sexual trauma: a qualitative analysis.

    Science.gov (United States)

    Turchik, Jessica A; McLean, Caitlin; Rafie, Samantha; Hoyt, Tim; Rosen, Craig S; Kimerling, Rachel

    2013-05-01

    Research suggests that there may be unique barriers to accessing care among men who have experienced sexual trauma. The primary goal of the current research was to elucidate potential barriers to accessing military sexual trauma (MST)-related care for male veterans. A secondary goal was to explore whether veterans have preferences regarding the gender of clinicians providing MST-related care. Qualitative analyses were used to examine data collected from semistructured interviews conducted with 20 male veterans enrolled in Veterans Health Administration care who reported MST but who had not received any MST-related mental health care. Veterans identified a number of potential barriers, with the majority of reported barriers relating to issues of stigma and gender. Regarding provider gender preferences, veterans were mixed, with 50% preferring a female provider, 25% a male provider, and 25% reporting no gender preference. These preliminary data suggest that stigma, gender, and knowledge-related barriers may exist for men regarding seeking MST-related care. Interventions to address potential barriers, such as outreach interventions and providing gender-specific psychoeducation, may increase access to care for male veterans who report MST. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  5. Na+/K+-ATPase α1 identified as an abundant protein in the blood-labyrinth barrier that plays an essential role in the barrier integrity.

    Directory of Open Access Journals (Sweden)

    Yue Yang

    2011-01-01

    Full Text Available The endothelial-blood/tissue barrier is critical for maintaining tissue homeostasis. The ear harbors a unique endothelial-blood/tissue barrier which we term "blood-labyrinth-barrier". This barrier is critical for maintaining inner ear homeostasis. Disruption of the blood-labyrinth-barrier is closely associated with a number of hearing disorders. Many proteins of the blood-brain-barrier and blood-retinal-barrier have been identified, leading to significant advances in understanding their tissue specific functions. In contrast, capillaries in the ear are small in volume and anatomically complex. This presents a challenge for protein analysis studies, which has resulted in limited knowledge of the molecular and functional components of the blood-labyrinth-barrier. In this study, we developed a novel method for isolation of the stria vascularis capillary from CBA/CaJ mouse cochlea and provided the first database of protein components in the blood-labyrinth barrier as well as evidence that the interaction of Na(+/K(+-ATPase α1 (ATP1A1 with protein kinase C eta (PKCη and occludin is one of the mechanisms of loud sound-induced vascular permeability increase.Using a mass-spectrometry, shotgun-proteomics approach combined with a novel "sandwich-dissociation" method, more than 600 proteins from isolated stria vascularis capillaries were identified from adult CBA/CaJ mouse cochlea. The ion transporter ATP1A1 was the most abundant protein in the blood-labyrinth barrier. Pharmacological inhibition of ATP1A1 activity resulted in hyperphosphorylation of tight junction proteins such as occludin which increased the blood-labyrinth-barrier permeability. PKCη directly interacted with ATP1A1 and was an essential mediator of ATP1A1-initiated occludin phosphorylation. Moreover, this identified signaling pathway was involved in the breakdown of the blood-labyrinth-barrier resulting from loud sound trauma.The results presented here provide a novel method for

  6. Perceived barriers on mental health services by the family of patients with mental illness

    Directory of Open Access Journals (Sweden)

    Rr Dian Tristiana

    2018-01-01

    Conclusion: Families whose members suffered from mental illness still experienced barriers in relation to mental health services even with universal health coverage. Improved mental health services are related to the health insurance coverage, affordability, availability of mental health services and stigma reduction in the health professionals and wide community.

  7. Colorectal Cancer Screening: Knowledge, Perceived Benefits and Barriers, and Intentions among College and University Employees

    Science.gov (United States)

    Bajracharya, Srijana M.; Wigglesworth, Janet K.

    2013-01-01

    Background: Early detection through routine screening is critical in reducing the incidence rate of colorectal cancer (CRC). Purpose: The purpose of this study was to examine college and university employees' knowledge of CRC issues, their perceptions of the benefits of and barriers to CRC screening, and their intentions toward it. Methods: This…

  8. Perceived barriers by university students in the practice of physical activities.

    Science.gov (United States)

    Gómez-López, Manuel; Gallegos, Antonio Granero; Extremera, Antonio Baena

    2010-01-01

    The main goal of this research is to study in detail the main characteristics of university students in order to find out the reasons why they have adopted an inactive lifestyle. In order to do so, a questionnaire on the analysis of sports habits and lifestyle was given to 323 students. They were taken from a representative sample of 1834 students. These 323 students had pointed out at the moment of the fieldwork, not having practiced any sport in their spare time. Our findings point out that there are diverse reasons for this. On one hand, reasons referred to as external barriers such as lack of time, on the other hand, internal barriers such as not liking the physical activity, not seeing its practicality or usefulness, feeling lazy or with apathy, or thinking that they are not competent in this type of activities. Other reasons such as the lack of social support are grouped within the external barriers. Finally, it is important to stress that there are also differences based on gender with respect to motivation. Key pointsExternal barriers prevail in university students. The lack of time is among the most highlighted ones.Statistically significant results have been found regarding the gender variable.The results are very important since they are considered to be valuable information for university institutions when guiding and diversifying their offer of physical and sport activities. Also as a guide in the design of support policies and national sport management guidelines.

  9. Hispanic Community College Students: Acculturation, Family Support, Perceived Educational Barriers, and Vocational Planning

    Science.gov (United States)

    Fiebig, Jennifer Nepper; Braid, Barbara L.; Ross, Patricia A.; Tom, Matthew A.; Prinzo, Cara

    2010-01-01

    A multiple logistic regression model was used to determine the associations between the role of acculturation, perception of educational barriers, need for family kin support, vocational planning, and expectations for attaining future vocational goals against the demographic variables (gender, age, being the oldest child, the first to attend…

  10. Japanese Resident Physicians' Attitudes, knowledge, and Perceived Barriers on the Practice of Evidence Based Medicine: a Survey

    Directory of Open Access Journals (Sweden)

    Emura Sei SE

    2011-09-01

    Full Text Available Abstract Background Evidence based medicine plays a crucial role as a tool that helps integrate research evidence into clinical practice. However, few reports have yet to examine its application in daily practice among resident physicians in Japan. The aim of this study was to assess the attitudes towards and knowledge of EBM among resident physicians in Japanese and determine perceived barriers to its use. Findings A cross-sectional, self-administered anonymous questionnaire was distributed to 60 resident staffs at Saga University Hospital in Japan. Forty residents completed and returned the questionnaire. Fifty four percent of respondents understood the basic terminology of EBM, 3% could explain this to others, and 41% indicated they would like to understand the terminology more. Thirteen percent admitted having a good understanding of EBM basic skills. Fifty respondents indicated having read EBM sources, but only 3% indicated that they use these sources in clinical decision making. The most prominent barriers of EBM application revealed in this study were insufficient time to access the sources, a lack of native language references, and insufficient basic EBM skills, but not scepticism about the EBM concept. Conclusions In general, respondents positively welcomed EBM, and moderately understood and knew basic EBM skill; however, barriers in its application were shown to exist.

  11. Identifying Barriers and Pathways to Success for Renewable Energy Development on American Indian Lands

    Energy Technology Data Exchange (ETDEWEB)

    Necefer, Len Edward [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Univ. of Arizona, Tucson, AZ (United States); Jones, Thomas Elisha [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Carnegie Mellon Univ., Pittsburgh, PA (United States)

    2016-11-01

    American Indian tribes possess lands rich with renewable energy (RE) resources. Tribes have great potential and need to develop these resources, yet face a host of barriers that continue to impede development. Understanding these challenges as well as the pathways that can be taken to overcome them may facilitate more economic development to meet community needs and better position tribes to play a role in securing a low-carbon energy future for the United States. This paper presents the results of an expert elicitation of 24 tribal energy experts from federal, tribal, academic, and private industry backgrounds to identify barriers and opportunities for federally recognized tribes in the lower 48 states. Experts identified a number of unique challenges facing tribes including financing and funding, infrastructure, tribal leadership and staff, state-level influence, and partnerships. Cultural factors were seen only to be of concern with large-scale development. Tribal sovereignty is a significant motivation for RE development and has yet to be fully realized. Cultural considerations are critical to the success of future projects; smaller residential and community-scale projects may be a better fit. Improving partnerships between tribes and the private sector can increase RE deployment and overcome historical distrust. States can have a double-ended influence on projects within tribal lands through taxation.

  12. Identifying facilitators and barriers for implementation of interprofessional education: Perspectives from medical educators in the Netherlands.

    Science.gov (United States)

    de Vries-Erich, Joy; Reuchlin, Kirsten; de Maaijer, Paul; van de Ridder, J M Monica

    2017-03-01

    Patient care and patient safety can be compromised by the lack of interprofessional collaboration and communication between healthcare providers. Interprofessional education (IPE) should therefore start during medical training and not be postponed until after graduation. This case study explored the current situation in the Dutch context and interviewed experts within medical education and with pioneers of successful best practices to learn more about their experiences with IPE. Data analysis started while new data were still collected, resulting in an iterative, constant comparative process. Using a strengths, weaknesses, opportunities, and threats (SWOT) analysis framework, we identified barriers and facilitators such as lack of a collective professional language, insufficient time or budget, stakeholders' resistance, and hierarchy. Opportunities and strengths identified were developing a collective vision, more attention for patient safety, and commitment of teachers. The facilitators and barriers relate to the organisational level of IPE and the educational content and practice. In particular, communication, cohesiveness, and support are influenced by these facilitators. An adequate identification of the SWOT elements in the current situation could prove beneficial for a successful implementation of IPE within the healthcare educational system.

  13. Identifying barriers to chronic disease reporting in Chicago Public Schools: a mixed-methods approach.

    Science.gov (United States)

    Rivkina, Victoria; Tapke, David E; Cardenas, Lilliana D; Harvey-Gintoft, Blair; Whyte, Stephanie A; Gupta, Ruchi S

    2014-12-06

    Chronic disease among school-aged children is a public health concern, particularly for asthma and food allergy. In Chicago Public Schools (CPS), rates of asthma and food allergy among students are underreported. The aim of this study was to determine the barriers to chronic disease reporting as experienced by CPS parents and school nurses. A mixed-methods approach included focus groups and key informant interviews with parents and school nurses, and a cross-sectional survey was completed by parents. Qualitative data analysis was performed and survey data were analyzed to determine the significant demographic and knowledge variables associated with successfully completing the reporting process. The three main barriers identified were 1) a lack of parental process knowledge; 2) limited communication from schools; and 3) insufficient availability of school nurses. Parents were significantly more likely to successfully complete the reporting process if they knew about special accommodations for chronic diseases, understood the need for physician verification, and/or knew the school nurse. These findings suggest that increasing parental knowledge of the reporting process will allow schools to better identify and manage their students' chronic conditions. A parent-focused intervention informed by these results has been completed.

  14. Women with physical disability and the mammogram: An observational study to identify barriers and facilitators

    International Nuclear Information System (INIS)

    Poulos, Ann; Balandin, Susan; Llewellyn, Gwynnyth; McCarthy, Louella; Dark, Leigha

    2011-01-01

    Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening.

  15. Women with physical disability and the mammogram: An observational study to identify barriers and facilitators

    Energy Technology Data Exchange (ETDEWEB)

    Poulos, Ann, E-mail: ann.poulos@sydney.edu.a [University of Sydney, Faculty of Health Sciences, Discipline of Medical Radiation Sciences, PO Box 170, Lidcombe, NSW 1825 (Australia); Balandin, Susan [University of Sydney, Faculty of Health Sciences, Discipline of Speech Pathology, PO Box 170, Lidcombe, NSW 1825 (Australia); Avdeling for helse- og sosialfag, Hogskolen i Molde, Postboks 2110, 6402 Molde (Norway); Llewellyn, Gwynnyth; McCarthy, Louella [University of Sydney, Faculty of Health Sciences, Discipline of Occupational Therapy, PO Box 170, Lidcombe, NSW 1825 (Australia); Dark, Leigha [University of Sydney, Faculty of Health Sciences, Discipline of Speech Pathology, PO Box 170, Lidcombe, NSW 1825 (Australia)

    2011-02-15

    Purpose: To identify barriers and facilitators experienced by women with physical disability having a mammogram. Method: Direct observation of the mammography procedure for women with a range of physical disability at screening facilities of BreastScreen NSW Australia. Results: A volunteer sample of 13 women with varying degrees of physical disability participated in the study. The outcomes suggested that many barriers for women with physical disability can be ameliorated by environmental adaptations and guidelines for both radiographers and women. Some women however cannot be screened successfully, or can be screened only with a level of trauma and/or pain which militates against their continuation within the screening program. This study has identified physical limitations which preclude a successful outcome, those which increase the discomfort/pain of the procedure and aspects of the procedure which can be improved to minimise the experience of discomfort/pain. Conclusion: From the outcomes of the study the development of a decision tool is indicated as a method of providing information for women with physical disability and their doctors as to the likelihood of a successful outcome to participation in mammography screening.

  16. Swedish-Norwegian tradable green certificates: Scheme design flaws and perceived investment barriers

    International Nuclear Information System (INIS)

    Linnerud, Kristin; Simonsen, Morten

    2017-01-01

    The EU Commission recommends using market-based support schemes for renewable-electricity projects. One example is the Swedish-Norwegian tradable green certificate scheme. We examine whether design features in the Norwegian part of this scheme, specifically, the scheme's short duration and the way it is to be abruptly terminated, contribute to investors' perceptions of barriers. We apply econometric techniques on primary data collected in two surveys of Norwegian investors in hydropower, and we use real options theory to predict and interpret investors' responses. We show that: (1) immediately after the scheme was introduced, investors are eager to lock in future subsidies by investing immediately and concerned with factors that may delay the completion of their projects; (2) as the certificate deadline neared, investors have become increasingly pessimistic and concerned with economic and risk barriers. Investors in big hydropower plants with regulation reservoirs are particularly concerned with the risk of not completing their projects in time to gain the right to sell certificates. These findings are consistent with the predicted responses to the scheme design derived from real options theory. In contrast to earlier studies, we find no difference in responses to the scheme design across investor types. - Highlights: • The Swedish-Norwegian tradable green certificate scheme is intended to promote cost-efficiency. • We examine the optimism about and barriers against investing in new hydropower projects in Norway. • We find that scheme design may have contributed to barriers against Norwegian hydropower projects. • Thus, scheme design flaws may have prevented the scheme from working as intended. • These findings are consistent with real options theory predictions.

  17. PERCEIVED BARRIERS BY UNIVERSITY STUDENTS IN THE PRACTICE OF PHYSICAL ACTIVITIES

    Directory of Open Access Journals (Sweden)

    Manuel Gómez-López

    2010-09-01

    Full Text Available The main goal of this research is to study in detail the main characteristics of university students in order to find out the reasons why they have adopted an inactive lifestyle. In order to do so, a questionnaire on the analysis of sports habits and lifestyle was given to 323 students. They were taken from a representative sample of 1834 students. These 323 students had pointed out at the moment of the fieldwork, not having practiced any sport in their spare time. Our findings point out that there are diverse reasons for this. On one hand, reasons referred to as external barriers such as lack of time, on the other hand, internal barriers such as not liking the physical activity, not seeing its practicality or usefulness, feeling lazy or with apathy, or thinking that they are not competent in this type of activities. Other reasons such as the lack of social support are grouped within the external barriers. Finally, it is important to stress that there are also differences based on gender with respect to motivation.

  18. Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach.

    Science.gov (United States)

    Saligheh, Maryam; McNamara, Beverley; Rooney, Rosanna

    2016-06-02

    Postpartum women's recovery from birth can be assisted through increased physical activity (PA). However, women face substantial barriers to participating in exercise and require support to enable them to benefit from increased PA. This study sought to explore women's beliefs about and experiences of PA and exercise during the 6 weeks to 12 months postpartum period. A cohort of 14 postpartum women from a survey study of the barriers and enablers to exercise participation agreed to take part in interview sessions to provide an in-depth understanding of the women's perceptions of the postpartum period and their physical activity during this time. Findings are presented with reference to the social ecological framework and indicate postpartum women face substantial personal and environmental barriers to PA and exercise participation: fatigue, a lack of motivation and confidence, substantial time constraints, lack of access to affordable and appropriate activities and poor access to public transport. In contrast, enablers such as possessing greater social support, in particular partner support, improved PA and exercise participation. The findings encourage facilitation of exercise through mothers' groups, mothers' exercise clubs or postnatal classes suggesting behavioral and social change is needed. Interaction between individuals, community, organizations and policy makers is required. In addition, the provision of specifically tailored and appropriate exercise programs could potentially enable increased PA in postpartum women, thereby improving their health.

  19. Identifying Communication Barriers to Colorectal Cancer Screening Adherence among Appalachian Kentuckians.

    Science.gov (United States)

    Bachman, Audrey Smith; Cohen, Elisia L; Collins, Tom; Hatcher, Jennifer; Crosby, Richard; Vanderpool, Robin C

    2017-08-18

    Utilizing data from 40 in-depth interviews, this article identifies both barriers and facilitators to colorectal screening guideline adherence among Appalachian Kentucky adults recruited through a community-based research network. Key findings identify (a) varying levels of knowledge about screening guidelines, (b) reticence to engage in screening processes, and (c) nuanced communication with healthcare providers and family members regarding screening adherence. What participants knew about the screening process was often derived from personal stories or recalled stories from family members about their screening experiences. Reticence to engage in screening processes reflected reports of cumbersome preparation, privacy issues, embarrassment, medical mistrust, fear of receiving a cancer diagnosis, and lack of symptoms. Participants cited many ways to enhance patient-centered communication, and the findings from this study have implications for health communication message design and communication strategies for healthcare practices in Appalachian Kentucky clinics.

  20. Building America Guidance for Identifying and Overcoming Code, Standard, and Rating Method Barriers

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Pamala C.; Halverson, Mark A.

    2013-09-01

    The U.S. Department of Energy’s (DOE) Building America program implemented a new Codes and Standards Innovation (CSI) Team in 2013. The Team’s mission is to assist Building America (BA) research teams and partners in identifying and resolving conflicts between Building America innovations and the various codes and standards that govern the construction of residences. A CSI Roadmap was completed in September, 2013. This guidance document was prepared using the information in the CSI Roadmap to provide BA research teams and partners with specific information and approaches to identifying and overcoming potential barriers to Building America (BA) innovations arising in and/or stemming from codes, standards, and rating methods. For more information on the BA CSI team, please email: CSITeam@pnnl.gov

  1. Identifying profiles of actual and perceived motor competence among adolescents: associations with motivation, physical activity, and sports participation.

    Science.gov (United States)

    De Meester, An; Maes, Jolien; Stodden, David; Cardon, Greet; Goodway, Jacqueline; Lenoir, Matthieu; Haerens, Leen

    2016-11-01

    The present study identified adolescents' motor competence (MC)-based profiles (e.g., high actual and low perceived MC), and accordingly investigated differences in motivation for physical education (PE), physical activity (PA) levels, and sports participation between profiles by using regression analyses. Actual MC was measured with the Körperkoordinationstest für Kinder. Adolescents (n = 215; 66.0% boys; mean age = 13.64 ± .58 years) completed validated questionnaires to assess perceived MC, motivation for PE, PA-levels, and sports participation. Actual and perceived MC were only moderately correlated and cluster analyses identified four groups. Two groups of overestimators (low - overestimation, average - overestimation) were identified (51%), who particularly displayed better motivation for PE when compared to their peers who accurately estimated themselves (low - accurate, average - accurate). Moreover, adolescents with low actual MC, but high perceived MC were significantly more active than adolescents with low actual MC who accurately estimated themselves. Results pointed in the same direction for organised sports participation. Underestimators were not found in the current sample, which is positive as underestimation might negatively influence adolescents' motivation to achieve and persist in PA and sports. In conclusion, results emphasise that developing perceived MC, especially among adolescents with low levels of actual MC, seems crucial to stimulate motivation for PE, and engagement in PA and sports.

  2. Perceived barriers to healthcare for persons living in poverty in Quebec, Canada: the EQUIhealThY project.

    Science.gov (United States)

    Loignon, Christine; Hudon, Catherine; Goulet, Émilie; Boyer, Sophie; De Laat, Marianne; Fournier, Nathalie; Grabovschi, Cristina; Bush, Paula

    2015-01-17

    Ensuring access to timely and appropriate primary healthcare for deprived patients is an issue facing all countries, even those with universal healthcare systems. There is a paucity of information on how patients living in a context of material and social deprivation perceive barriers in the healthcare system. This study combines the perspectives of persons living in poverty and of healthcare providers to explore barriers to responsive care for underserved persons with a view to developing equity-focused primary care. In this participatory action research we used photovoice, together with a method known as 'merging of knowledge and practice' developed by ATD Fourth World, an international community organization working to eradicate poverty. The study was conducted in two teaching primary care practices in the Canadian province of Quebec. Participants consisted of 15 health professionals and six members of ATD Fourth World; approximately 60 group meetings were held. Data were analyzed through thematic analysis, in part with the involvement of persons living in poverty. Three main barriers to responsive care in a context of poverty were highlighted by all participants: the difficult living conditions of people living in poverty, the poor quality of interactions between providers and underserved patients, and the complexity of healthcare system organization and functioning. Our research revealed that unhealthy living conditions prevent persons living in poverty from accessing quality healthcare and maintaining good health. Also, the complexity of the healthcare system's organization and functioning has a negative impact on the interactions with healthcare providers. Changes in policy and practice are needed to address those barriers and to achieve greater equity and provide more responsive care for persons living in poverty.

  3. Residents' perceived barriers to communication skills learning: comparing two medical working contexts in postgraduate training.

    Science.gov (United States)

    van den Eertwegh, Valerie; van Dalen, Jan; van Dulmen, Sandra; van der Vleuten, Cees; Scherpbier, Albert

    2014-04-01

    Contextual factors are known to influence the acquisition and application of communication skills in clinical settings. Little is known about residents' perceptions of these factors. This article aims to explore residents' perceptions of contextual factors affecting the acquisition and application of communication skills in the medical workplace. We conducted an exploratory study comprising seven focus groups with residents in two different specialities: general practice (n=23) and surgery (n=18). Residents perceive the use of summative assessment checklists that reduce communication skills to behavioural components as impeding the learning of their communication skills. Residents perceive encouragement to deliberately practise in an environment in which the value of communication skills is recognised and support is institutionalised with appropriate feedback from role models as the most important enhancing factors in communication skills learning. To gradually realise a clinical working environment in which the above results are incorporated, we propose to use transformative learning theory to guide further studies. Provided it is used continuously, an approach that combines self-directed learning with observation and discussion of resident-patient consultations seems an effective method for transformative learning of communication skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. PERCEIVED BARRIERS AND SUCCESS FACTORS OF FEMALE ENTREPRENEURS ENROLLED IN AN ENTREPRENEURIAL PROGRAMME

    Directory of Open Access Journals (Sweden)

    N. Meyer

    2016-01-01

    Full Text Available The promotion of entrepreneurship and small business development as possiblesolutions to job creation is a high priority for the government of South Africaas itplays a vital role in economic prosperity. Specifically, the focus is on empoweringwomen to become entrepreneurial. Entrepreneurship training is important duringall levelsof education, including at the tertiarylevel, but also to people who maynot be enrolled in a university. The purpose of this study is to provide an analysisof topics pertaining to fourteenfemale entrepreneurs enrolled in an adultentrepreneurship programme presented by a South African University. Theresearch methodology included a self-administered questionnaire developed bythe authors and compiled from an extensive literature review. Analysis was doneto identifythe success factors deemed importantbytherespondentsas well asperceived barriers to business success. The study revealedinadequate funding andfinance and the inability to clarify business goals asthe main barriers restricting thesuccess of the business.In addition, customer care, quality of products or servicesand business skills were considered most favourable success factors. The resultsprovide valuable insight into areas of concern as well as recommendations forfurther research and development in the field of female entrepreneurial growthand policy development.

  5. Perceived Parental Barriers to and Strategies for Supporting Physical Activity and Healthy Eating among Head Start Children.

    Science.gov (United States)

    Ling, Jiying; B Robbins, Lorraine; Hines-Martin, Vicki

    2016-06-01

    Despite the need for parents to support their children's healthy behaviors, knowledge of factors preventing parents from doing so is still rudimentary. This study primarily aimed to explore perceived parental barriers to and strategies for supporting physical activity and healthy eating among Head Start children. A semi-structured interview format was used with four focus groups conducted at two urban Head Start centers in the Midwestern U.S. A qualitative content analysis of audio-recorded sessions was facilitated using ATLAS.ti7. A convenience sample of 32 parents (Mage = 34.97 years) participated. Over half were female (78.1 %), African Americans (65.6 %), and single (65.6 %). About 61.3 % reported an annual family income parent): lack of time and cooking skills and a tight family budget; and (3) environmental: inaccessible programs, lack of age-appropriate education, electronic media use, and unsafe environment. Parents across all groups expressed high interest in enrolling in a program with their children. Recommendations included: parents' support team; family outings at parks; taking a walk or enrolling in a class with children; and planting a garden. Many parents showed their preference for face-to-face meetings and a support group, but repulsion of counseling. To promote parental support in future interventions with Head Start children, their perceived intrapersonal, interpersonal, and environmental barriers should be considered as intervention targets. Involving parents through a support group and face-to-face meetings is recommended.

  6. Novel Active Learning Experiences for Students to Identify Barriers to Independent Living for People with Disabilities.

    Science.gov (United States)

    McArthur, Polly; Burch, Lillian; Moore, Katherine; Hodges, Mary Sue

    2016-07-01

    This article describes interactive learning about independent living for people with disabilities and features the partnership of the College of Nursing and a Center for Independent Living (CIL). Using qualitative descriptive approach, students' written reflections were analyzed. Through "Xtreme Challenge," 82 undergraduate nursing students participated in aspects of independent living as well as identifying barriers. Students were engaged and learned to consider the person before the disability. Moreover, students valued the activity leaders' openness, which facilitated understanding the point of view of a person with disability. The value of partnership was evident as it allowed students to participate in active learning, which led to growth in the affective domain. Students became aware of potential education resources through the CIL. This article will guide educators in designing experiences that teach nursing care at the individual, family, and community level for people living with disabilities. © 2015 Association of Rehabilitation Nurses.

  7. Damming the Flow: Cultural Barriers to Perceived ‘Procedural Justice’ in Wonthaggi, Victoria

    Directory of Open Access Journals (Sweden)

    Tanya J. King

    2010-03-01

    Full Text Available Drier conditions in Australia have compelled governments to implement projects such as the desalination plant in the South Gippsland town of Wonthaggi. The desalination plant is still under construction, but South Gippsland is already host to wind turbines and marine protected areas, reflecting public pressure to develop renewable energy sources and conserve resources. However, all projects have been met with vocal opposition. Using the desalination project as a case study, this paper will address public concerns about a perceived lack of procedural justice in implementing such projects. Drawing on data from a pilot survey of 320 residents, we argue that procedural shortcomings of the project include inattention to past political disputes in the region and to the culturally entrenched sense of division between city and country. Attention to political and cultural histories is vital to the successful and ethical implementation of projects in regional areas.

  8. Perceived barriers to and drivers of community participation in protected-area governance.

    Science.gov (United States)

    Ward, Caroline; Holmes, George; Stringer, Lindsay

    2018-04-01

    Protected areas (PAs) are a frequently used conservation strategy, yet their socioeconomic impacts on local communities remain contentious. A shift toward increased participation by local communities in PA governance seeks to deliver benefits for human well-being and biodiversity. Although participation is considered critical to the success of PAs, few researchers have investigated individuals' decisions to participate and what this means for how local people experience the costs and benefits of conservation. We explored who participates in PA governance associations and why; the perceived benefits and costs to participation; and how costs and benefits are distributed within and between communities. Methods included 3 focus groups, 37 interviews, and 217 questionnaire surveys conducted in 3 communities and other stakeholders (e.g., employees of a nongovernmental organization and government officials) in PA governance in Madagascar. Our study design was grounded in the theory of planned behavior (TPB), the most commonly applied behavior model in social psychology. Participation in PA governance was limited by miscommunication and lack of knowledge about who could get involved and how. Respondents perceived limited benefits and high costs and uneven distribution of these within and between communities. Men, poorer households, and people in remote villages reported the highest costs. Our findings illustrate challenges related to comanagement of PAs: understanding the heterogeneous nature of communities; ensuring all households are represented in governance participation; understanding differences in the meaning of forest protection; and targeting interventions to reach households most in need to avoid elite capture. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  9. The Future of Basic Science in Academic Surgery: Identifying Barriers to Success for Surgeon-scientists.

    Science.gov (United States)

    Keswani, Sundeep G; Moles, Chad M; Morowitz, Michael; Zeh, Herbert; Kuo, John S; Levine, Matthew H; Cheng, Lily S; Hackam, David J; Ahuja, Nita; Goldstein, Allan M

    2017-06-01

    The aim of this study was to examine the challenges confronting surgeons performing basic science research in today's academic surgery environment. Multiple studies have identified challenges confronting surgeon-scientists and impacting their ability to be successful. Although these threats have been known for decades, the downward trend in the number of successful surgeon-scientists continues. Clinical demands, funding challenges, and other factors play important roles, but a rigorous analysis of academic surgeons and their experiences regarding these issues has not previously been performed. An online survey was distributed to 2504 members of the Association for Academic Surgery and Society of University Surgeons to determine factors impacting success. Survey results were subjected to statistical analyses. We also reviewed publicly available data regarding funding from the National Institutes of Health (NIH). NIH data revealed a 27% decline in the proportion of NIH funding to surgical departments relative to total NIH funding from 2007 to 2014. A total of 1033 (41%) members responded to our survey, making this the largest survey of academic surgeons to date. Surgeons most often cited the following factors as major impediments to pursuing basic investigation: pressure to be clinically productive, excessive administrative responsibilities, difficulty obtaining extramural funding, and desire for work-life balance. Surprisingly, a majority (68%) did not believe surgeons can be successful basic scientists in today's environment, including departmental leadership. We have identified important barriers that confront academic surgeons pursuing basic research and a perception that success in basic science may no longer be achievable. These barriers need to be addressed to ensure the continued development of future surgeon-scientists.

  10. Physiotherapists' perceived motivators and barriers for organizing physical activity for older long-term care facility residents.

    Science.gov (United States)

    Baert, Veerle; Gorus, Ellen; Guldemont, Nele; De Coster, Sofie; Bautmans, Ivan

    2015-05-01

    Information regarding factors that hinder or stimulate older adults in long-term care facilities (LTCF) for being physically active is available in the literature, but much less is known regarding perceived motivators and barriers among physiotherapists (PTs) to organize physical activity (PA) in LTCF. The main purpose of this study was to examine factors influencing PTs to organize PA in LTCF for older adults. A secondary goal was to examine the PTs' knowledge about and their barriers at the PA guidelines for older adults of the World Health Organization (WHO). A mixed qualitative and quantitative study was carried out using semistructured interviews (n = 24) followed by an online survey (n = 254). As a frame the social-ecological model (McLeroy) was used, distinguishing factors at the intrapersonal, interpersonal, and community level. In the qualitative component the PTs reported 41 motivators and 35 barriers for organizing PA in LTCF. The survey revealed that although the majority of the respondents (71%) are convinced of the usefulness of PA in LTCF, 84% are not familiar with the WHO-guidelines. Seventy-five percent of the respondents believe that the WHO-guidelines are not feasible for LTCF-residents. The strongest motivators on the intrapersonal level were maintaining the independence of the residents (98%), reducing the risk of falling (98%), and improving the physical (93%) and psychological (90%) wellbeing of LTCF-residents. The social interaction among LTCF-residents (91%) during PA was the strongest motivator on the interpersonal level. Motivators on the community level are the belief that PA is the basis of their physiotherapeutic work (89%) and that offering varied activities avoids PA becoming monotonous (71%). Barriers on the intra- and interpersonal level were of less influence. On the community level, they felt hindered to organize PA because of lack of time (38%) and the overload of paperwork (33%). This study described different motivators

  11. Doctors' traits perceived by Japanese nurses as communication barriers: a questionnaire survey.

    Science.gov (United States)

    Morinaga, Kyoko; Ohtsubo, Yohsuke; Yamauchi, Keiko; Shimada, Yasuhiro

    2008-05-01

    Studies addressing nurses' traits to improve the quality of nurse-physician communication exist, whereas only a few studies exploring physicians' traits as communication barriers are conducted. The purpose of this research is to determine what types of physicians do nurses find difficult to communicate with. To this end, we conducted a pilot study, consisting of semi-structured interviews, with nine nurses. A questionnaire survey was then conducted to test the generalizability of the interviewees' opinions about physician traits that impede effective nurse-physician communication. A within-respondent factorial design was employed. Each respondent answered questions about two physicians whom she or he has found most difficult or easiest to communicate with. The order of physician type (easy vs. difficult) was counterbalanced. The main study, a questionnaire survey, was administered at four Japanese hospitals. Participants were 310 nurses. The questionnaires were mailed to the person in charge of each hospital. The questionnaires were handed to the nurses by the person in charge. Three out of the four hospitals reported that a majority of their nurses answered the questionnaires. The questionnaire asked respondents to evaluate how well various statements (e.g., Is the doctor moody?) fit a particular physician whom she or he has found most difficult or easiest to communicate with. A series of repeated-measures ANOVAs revealed that every statement was judged as fitting the description of doctors they found difficult better than that of doctors they found easy to talk to. An exploratory cluster analysis was conducted and it revealed that difficult characteristics of physicians can be divided into three subtypes. The questionnaire survey confirmed that opinions provided by interviewees in the pilot study were widely shared by other Japanese nurses. The study revealed that communication barriers between nurses and physicians are caused by the physicians' reluctance to

  12. Implementing Domestic Violence Gun Confiscation Policy in Rural and Urban Communities: Assessing the Perceived Risk, Benefits, and Barriers.

    Science.gov (United States)

    Lynch, Kellie R; Logan, T K

    2017-07-01

    The purpose of this study was to gain a deeper understanding of why communities differing in culture and resources are willing and able to implement gun confiscation as part of a protective order in the absence of a uniform statewide gun law. Specifically, the perceived risk of intimate partner homicide and gun violence, effectiveness of implementing gun confiscation, and the barriers to implementing gun confiscation were assessed. Interviews were conducted with key community professionals ( N = 133) who worked in victim services and the justice system in one urban community and four rural, under-resourced communities. Analyses revealed that professionals in the rural communities viewed the risk of intimate partner homicide and gun violence as lower, and the process of implementing gun confiscation as less effective than professionals in the urban community. In addition, urban justice system professionals, in comparison with all other professionals, reported fewer barriers to enforcing the gun confiscation police and were more likely to downplay law enforcement limitations in the community. The results have implications for developing more effective regional strategies in states that lack domestic violence gun laws as a means to increase a community's ability to enforce gun policies and initiatives.

  13. "It's a small price to pay for life": faecal occult blood test (FOBT) screening for colorectal cancer, perceived barriers and facilitators.

    Science.gov (United States)

    Reeder, Anthony I

    2011-03-25

    To clarify perceptions influencing FOBT screening participation among the NZ European target population. Participants (30 female, 20 male; 50-71 years) recruited through urban (Auckland, Wellington, Christchurch) GP surgeries for in-depth, face-to-face interviews (digitally recorded and professionally transcribed verbatim). A pragmatic approach focused on aggregating transcript content. Participants believed early CRC lacked distinguishing signs and symptoms, but was treatable and suitable for screening, although slow development may undermine any sense of urgency. FOBT inaccuracies caused concern, particularly false negatives, but ongoing testing could reduce anxiety. Specimen collection was awkward, challenged social norms and individual squeamishness, but provided peace of mind, was painless, simple and private without high cost technological or professional involvement. Lacking preventive attitudes and experience of health responsibilities and screening, men were less likely to participate than women. CRC lacked public profile, highlighting government responsibility, before programme implementation, to resource high-profile education, largely through TV. General practitioner support and promotion was seen as critical. Inadequate health system capacity and resourcing was problematic. Despite challenging barriers, participants identified opportunities to increase FOBT screening participation, especially promotion to raise CRC profile, overcome perceived normative barriers and build self-efficacy. Adequate resourcing is essential to support appropriate promotion and timely programme delivery.

  14. Evidence-based practice in radiology: Knowledge, attitude and perceived barriers to practice among residents in radiology

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    Anuradha, Chandramohan, E-mail: anuradhachandramohan@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Jacob, K.S., E-mail: ksjacob@cmcvellore.ac.in [Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Specialist Mental Health Service for Older People, Suite 106, 64–68 Derby Street, Kingswood, Penrith 2750 (Australia); Shyamkumar, N.K., E-mail: aparnashyam@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India); Sridhar, Gibikote, E-mail: gibikote@cmcvellore.ac.in [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632 004 (India)

    2013-05-15

    Aim: We examinted the attitude, knowledge and perceived barriers to evidence-based practice of radiology (EBPR) among residents in radiology. Study design and setting: We used the McColl questionnaire (1) and the BARRIERS scale (2) to assess the issues among radiology trainees attending an annual refresher course. Ninety six residents from 32 medical colleges from Southern India attended the course. Results: Eighty (83.3%) residents, 55 male and 25 female of age range 24–34 years, consented and returned the questionnaire. The majority of the participants had a positive attitude towards EBPR. However, 45% were unaware of sources for evidence based literature although many had access to Medline (45%) and the internet (80%). The majority (70%) were aware of the common technical terms (e.g. odds ratio, absolute and relative risk) but other complex details (e.g. meta-analysis, clinical effectiveness, confidence interval, publication bias and number needed to treat) were poorly understood. Though majority of residents (59%) were currently following guidelines and protocols laid by colleagues within their departments, 70% of residents were interested in learning the skills of EBPR and were willing to appraise primary literature or systematic reviews by themselves. Insufficient time on the job to implement new ideas (70.1%); relevant literature is not being complied in one place (68.9%); not being able to understand statistical methods (68.5%) were considered to be the major barriers to EBPR. Training in critical appraisal significantly influence usage of bibliographic databases (p < 0.0001). Attitude of collegues (p = 0.006) influenced attitude of the trainees towards EBPR. Those with higher knowledge scores (p = 0.02) and a greater awareness of sources for seeking evidence based literature (p = 0.05) held stronger beliefs that EBPR significantly improved patient care. Conclusions: The large knowledge gap related to EBPR suggests the need to incorporate structured

  15. Evidence-based practice in radiology: Knowledge, attitude and perceived barriers to practice among residents in radiology

    International Nuclear Information System (INIS)

    Anuradha, Chandramohan; Jacob, K.S.; Shyamkumar, N.K.; Sridhar, Gibikote

    2013-01-01

    Aim: We examinted the attitude, knowledge and perceived barriers to evidence-based practice of radiology (EBPR) among residents in radiology. Study design and setting: We used the McColl questionnaire (1) and the BARRIERS scale (2) to assess the issues among radiology trainees attending an annual refresher course. Ninety six residents from 32 medical colleges from Southern India attended the course. Results: Eighty (83.3%) residents, 55 male and 25 female of age range 24–34 years, consented and returned the questionnaire. The majority of the participants had a positive attitude towards EBPR. However, 45% were unaware of sources for evidence based literature although many had access to Medline (45%) and the internet (80%). The majority (70%) were aware of the common technical terms (e.g. odds ratio, absolute and relative risk) but other complex details (e.g. meta-analysis, clinical effectiveness, confidence interval, publication bias and number needed to treat) were poorly understood. Though majority of residents (59%) were currently following guidelines and protocols laid by colleagues within their departments, 70% of residents were interested in learning the skills of EBPR and were willing to appraise primary literature or systematic reviews by themselves. Insufficient time on the job to implement new ideas (70.1%); relevant literature is not being complied in one place (68.9%); not being able to understand statistical methods (68.5%) were considered to be the major barriers to EBPR. Training in critical appraisal significantly influence usage of bibliographic databases (p < 0.0001). Attitude of collegues (p = 0.006) influenced attitude of the trainees towards EBPR. Those with higher knowledge scores (p = 0.02) and a greater awareness of sources for seeking evidence based literature (p = 0.05) held stronger beliefs that EBPR significantly improved patient care. Conclusions: The large knowledge gap related to EBPR suggests the need to incorporate structured

  16. Barriers to Access to Sterile Syringes as Perceived by Pharmacists and Injecting Drug Users: Implications for Harm Reduction in Lebanon.

    Science.gov (United States)

    Ghaddar, Ali; Nassar, Karine; Elsoury, Ghadier

    2017-09-19

    Access to sterile syringes to injecting drug users (IDU) reduces sharing behavior and prevents the transmission of HIV. To describe the barriers to access to sterile syringes for IDUs in Lebanon from the perspectives of pharmacists and IDUs. in this qualitative study conducted in Lebanon, data were collected from 72 syringe purchase tests at pharmacies, 64 interviewees with pharmacists and 2 focus groups with injecting drug users. Two independent researchers analyzed the verbatim transcripts. Results revealed that pharmacists often deny access to sterile syringes to IDUs who are frequently stigmatized and intimidated at pharmacies. While no large gender differences in pharmacists' attitudes and practices were observed, inequalities in syringe access were noticed with men IDUs more often denied purchase. Pharmacists had several barriers to sell syringes to IDUs including fear of disease spread, increased drug use, inappropriately discarded syringes, staff and customer safety, and business concerns. IDUs had several challenges to purchase syringes including stigmatization, intimidation, physical harassment, concern to reveal identity, fear of arrest and syringe price abuse. Identifying the barriers to and facilitators of access to sterile syringes to IDUs is important to guide the development of efficient policies. Findings implicate the importance of empowering IDUs to purchase syringes at pharmacies through reducing the negative attitude towards IDUs and strengthening pharmacists' role in the promotion of health of IDUs. Findings also suggest that the habit of syringe sharing would decrease if the legal and cultural barriers to access are reduced.

  17. Paediatric palliative home care by general paediatricians: a multimethod study on perceived barriers and incentives

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    Fischbach Thomas

    2010-06-01

    Full Text Available Abstract Background Non-specialist palliative care, as it is delivered by general practitioners, is a basic component of a comprehensive palliative care infrastructure for adult patients with progressive and far advanced disease. Currently palliative care for children and adolescents is recognized as a distinct entity of care, requiring networks of service providers across different settings, including paediatricians working in general practice. In Germany, the medical home care for children and adolescents is to a large extent delivered by general paediatricians working in their own practice. However, these are rarely confronted with children suffering from life-limiting diseases. The aim of this study was therefore to examine potential barriers, incentives, and the professional self-image of general paediatricians with regard to paediatric palliative care. Methods Based on qualitative expert interviews, a questionnaire was designed and a survey among general paediatricians in their own practice (n = 293 was undertaken. The survey has been developed and performed in close cooperation with the regional professional association of paediatricians. Results The results showed a high disposition on part of the paediatricians to engage in palliative care, and the majority of respondents regarded palliative care as part of their profile. Main barriers for the implementation were time restrictions (40.7% and financial burden (31.6%, sole responsibility without team support (31.1%, as well as formal requirements such as forms and prescriptions (26.6%. Major facilitations were support by local specialist services such as home care nursing service (83.0%, access to a specialist paediatric palliative care consultation team (82.4%, as well as an option of exchange with colleagues (60.1%. Conclusions Altogether, the high commitment to this survey reflects the relevance of the issue for paediatricians working in general practice. Education in basic palliative

  18. Exiting homelessness: perceived changes, barriers, and facilitators among formerly homeless adults with mental disorders.

    Science.gov (United States)

    Patterson, Michelle L; Currie, Lauren; Rezansoff, Stefanie; Somers, Julian M

    2015-03-01

    This study examines key themes from narrative interviews conducted with 43 homeless adults with mental disorders 18 months after random assignment to Housing First with intensive supports or to treatment as usual (no housing or supports through the study). Coding and thematic analysis of semistructured interviews was based on 2 research questions from participants' perspectives: (a) What changes were perceived over time? (b) What factors facilitated or hindered change? The majority of participants assigned to Housing First reported positive change across multiple domains as a result of stable housing; whereas the majority of treatment as usual participants reported negative or neutral change. Key themes included feelings of security and pride; adjusting to living alone; housing as a learning process; and developing meaningful activity. The sense of security associated with stable housing was the most influential factor that supported change. Factors that helped or hindered change clustered into 4 key themes: the type and quality of services; the cumulative effects of trauma; social ties; and concurrent substance use. Our findings provide important context to the emerging body of quantitative research on Housing First and recovery from homelessness. Participants' experiences of recovery, particularly as it relates to housing and supports, shifts in identity, and meaningful activity must be acknowledged and incorporated into the design and evaluation of public services, and policy and service reforms. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  19. Cosmetic dermatologic surgical training in US dermatology residency programs: identifying and overcoming barriers.

    Science.gov (United States)

    Bauer, Bruce; Williams, Erin; Stratman, Erik J

    2014-02-01

    The public and other medical specialties expect dermatologists who offer cosmetic dermatology services to provide competent care. There are numerous barriers to achieving cosmetic dermatology competency during residency. Many dermatology residents enter the workforce planning to provide cosmetic services. If a training gap exists, this may adversely affect patient safety. To identify resources available for hands-on cosmetic dermatology training in US dermatology residency training programs and to assess program director (PD) attitudes toward cosmetic dermatology training during residency and strategies, including discounted pricing, used by training programs to overcome barriers related to resident-performed cosmetic dermatology procedures. An online survey in academic dermatology practices among PDs of US dermatology residency programs. Frequency of cosmetic dermatology devices and injectables used for dermatology resident hands-on cosmetic dermatology training, categorizing PD attitudes toward cosmetic dermatology training during residency and describing residency-related discounted pricing models. Responses from PDs were received from 53 of 114 (46%) US dermatology residency programs. All but 3 programs (94%) offered hands-on cosmetic dermatology training using botulinum toxin, and 47 of 53 (89%) provided training with hyaluronic acid fillers. Pulsed dye lasers represented the most common laser use experienced by residents (41 of 52 [79%]), followed by Q-switched Nd:YAG (30 of 52 [58%]). Discounted procedures were offered by 32 of 53 (60%) programs, with botulinum toxin (30 of 32 [94%]) and fillers (27 of 32 [84%]) most prevalent and with vascular lasers (17 of 32 [53%]) and hair removal lasers (12 of 32 [38%]) less common. Various discounting methods were used. Only 20 of 53 (38%) PDs believed that cosmetic dermatology should be a necessary aspect of residency training; 14 of 52 (27%) PDs thought that residents should not be required to perform any cosmetic

  20. Knowledge of, beliefs about, and perceived barriers to the use of the emergency contraception pill among women aged 18-51 in Nova Scotia

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    Whelan AM

    2011-09-01

    Full Text Available Objectives: To investigate women in Nova Scotia (NS, Canada with respect to their knowledge of, beliefs about, and perceptions of barriers to accessing emergency contraception pills (ECP.Methods: A random digit dialing approach was used to survey a representative sample of NS women aged 18-51. Analyses described the knowledge, beliefs, and perceived barriers associated with ECP access among participants. Particular focus was given to differences between younger (age 18-31 and older (age 32-51 women.Results: The survey response rate of 49% achieved the desired sample size of 770. Overall, women in NS appeared to be poorly informed about ECP with regards to effectiveness, proper timing of administration, how it works, as well as how to access Plan B®. Younger women (age 18-31 were significantly more likely than older women (age 32-51 to know that ECP does not always prevent pregnancy (p<0.01, that it can be taken more than 12 hours after unprotected intercourse (p<0.01, and that it is available without a prescription in pharmacies (p<0.01. Thirty percent of women agreed that ECP will cause an abortion, with older women (p<0.01 being more likely than younger women to agree. Cost and lack of privacy in pharmacies were identified as potential barriers to access.Conclusions: Lack of knowledge and the perception that ECP causes an abortion may influence a woman’s ability to consider ECP as an option should she find herself at risk of an unplanned pregnancy. To address this, efforts should be made to educate women (including older women about ECP and its availability in pharmacies.

  1. Collaborate across silos: Perceived barriers to integration of care for the elderly from the perspectives of service providers.

    Science.gov (United States)

    Lau, Janice Ying-Chui; Wong, Eliza Lai-Yi; Chung, Roger Y; Law, Stephen C K; Threapleton, Diane; Kiang, Nicole; Chau, Patsy; Wong, Samuel Y S; Woo, Jean; Yeoh, Eng-Kiong

    2018-04-27

    To examine the barriers that hinder collaboration between health care and social care services and to report recommendations for effective collaboration to meet the growing support and care needs of our ageing population. Data for this qualitative study were obtained from interviews with 7 key informants (n = 42) and 22 focus groups (n = 117) consisting of service providers who were from the health care or social care sectors and supporting elderly patients with multiple chronic diseases or long-term care needs. Data collection was conducted from 2015 to 2016. The data were analysed using an inductive approach on the basis of thematic analysis. Qualitative analysis reviewed a number of factors that play a significant role in setting up barriers at the operational level, including fragmentation and lack of sustainability of discharge programmes provided by non-governmental organisations, lack of capacity of homes for the elderly, limitation of time and resources, and variation of roles in supporting end-of-life care decisions between the medical and social sectors. Other barriers are those of communication to be found at the structural level and perceptual ones that exist between professionals. Of these, perceptual barriers affect attitudes and create mistrust and interprofessional stereotypes and a hierarchy between the health care and social care sectors. Health care and social care service providers recognise the need for collaborative work to enhance continuity of care and ageing in place; however, their efforts are hindered by the identified barriers that need to be dealt with in practical terms and by a change of policy. Copyright © 2018 John Wiley & Sons, Ltd.

  2. Grunt language versus accent: the perceived communication barriers between international medical graduates and patients in Central Wheatbelt catchments.

    Science.gov (United States)

    Sommer, Jessica; Macdonald, William; Bulsara, Caroline; Lim, David

    2012-01-01

    Due to the chronic shortages of GPs in Australian rural and remote regions, considerable numbers of international medical graduates (IMG) have been recruited. IMG experience many difficulties when relocating to Australia with one of the most significant being effective GP-patient communication. Given that this is essential for effective consultation it can have a substantial impact on health care. A purposive sample of seven practising GPs (five IMG, two Australian-trained doctors (ATD)) was interviewed using a semistructured face-to-face interviewing technique. GPs from Nigeria, Egypt, United Kingdom, India, Singapore and Australia participated. Interviews were transcribed and then coded. The authors used qualitative thematic analysis of interview transcripts to identify common themes. IMG-patient communication barriers were considered significant in the Wheatbelt region as identified by both IMG and ATD. ATD indicated they were aware of IMG-patient communication issues resulting in subsequent consults with patients to explain results and diagnoses. Significantly, a lack of communication between ATD and IMG also emerged, creating a further barrier to effective communication. Analysis of the data generated several important findings that rural GP networks should consider when integrating new IMG into the community. Addressing the challenges related to cross-cultural differences should be a priority, in order to enable effective communication. More open communication between ATD and IMG about GP-patient communication barriers and education programs around GP-patient communication would help both GP and patient satisfaction.

  3. Perceived Barriers, Facilitators and Benefits for Regular Physical Activity and Exercise in Patients with Rheumatoid Arthritis: A Review of the Literature.

    Science.gov (United States)

    Veldhuijzen van Zanten, Jet J C S; Rouse, Peter C; Hale, Elizabeth D; Ntoumanis, Nikos; Metsios, George S; Duda, Joan L; Kitas, George D

    2015-10-01

    Rheumatoid arthritis (RA) is an autoimmune disease, which not only affects the joints but can also impact on general well-being and risk for cardiovascular disease. Regular physical activity and exercise in patients with RA have numerous health benefits. Nevertheless, the majority of patients with RA are physically inactive. This indicates that people with RA might experience additional or more severe barriers to physical activity or exercise than the general population. This narrative review provides an overview of perceived barriers, benefits and facilitators of physical activity and exercise in RA. Databases were searched for articles published until September 2014 using the terms 'rheumatoid arthritis', 'physical activity', 'exercise', 'barriers', 'facilitators', 'benefits', 'motivation', 'motivators' and 'enablers'. Similarities were found between disease-specific barriers and benefits of physical activity and exercise, e.g. pain and fatigue are frequently mentioned as barriers, but reductions in pain and fatigue are perceived benefits of physical activity and exercise. Even though exercise does not influence the existence of barriers, physically active patients appear to be more capable of overcoming them. Therefore, exercise programmes should enhance self-efficacy for exercise in order to achieve long-term physical activity and exercise behaviour. Encouragement from health professionals and friends/family are facilitators for physical activity and exercise. There is a need for interventions that support RA patients in overcoming barriers to physical activity and exercise and help sustain this important health behaviour.

  4. Perceived benefits and barriers to exercise among persons with physical disabilities or chronic health conditions within action or maintenance stages of exercise.

    Science.gov (United States)

    Malone, Laurie A; Barfield, J P; Brasher, Joel D

    2012-10-01

    Information regarding factors that affect the initial step to exercise behavior change among persons with physical disabilities or chronic health conditions is available in the literature but much less is known regarding perceived benefits and barriers to exercise among those who are regularly active. The purpose of this study was to examine the perceived benefits and barriers to exercise among persons with physical disabilities or chronic health conditions within action or maintenance stages of exercise. Participants (n = 152) completed the Exercise Benefits and Barriers Scale (EBBS). For data analyses, disabilities and health conditions were grouped as neuromuscular, orthopedic, cardiovascular/pulmonary, or multiple conditions. Multivariate analysis of variance (MANOVA) was conducted to determine if mean differences on EBBS benefits and barriers scores existed among disability types, between sexes, among age groups, and between physical activity levels. Sum scores were computed to determine the strongest benefit and barrier responses. No significant mean differences in EBBS scores were found between disability types, sexes, age groups, or physical activity levels (p > 0.05). Strongest benefit responses varied by group. Strongest barrier responses were the same for all demographic groups: "Exercise tires me," "Exercise is hard work for me," and "I am fatigued by exercise." EBBS scores were similar across disability/health condition, sex, age, and physical activity level. Primary benefits reported were in the areas of improved physical performance and psychological outlook whereas the primary barriers were in the area of physical exertion. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China.

    Science.gov (United States)

    Lin, Lavinia; Brown, Katherine B; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M; Bodomo, Adams B; Yang, Ligang; Yang, Bin; Nehl, Eric J; Tucker, Joseph D; Wong, Frank Y

    2015-10-01

    Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.

  6. Barriers and strategies for identifying and managing risk factors of cardiovascular diseases in levels of preventing, screening, and treating

    Directory of Open Access Journals (Sweden)

    Saber Azami Aghdash

    2015-11-01

    Full Text Available Introduction: Cardiovascular diseases (CVD are of the main causes of mortality in the world and impose a heavy economic, social, and health burden on society. Therefore, the objective of this study was to determine the barriers and strategies for identifying and managing risk factors of CVD in levels of preventing, screening, and treating. Methods: During present qualitative study with phenomenological approach, 60 subjects of cardiologists, nurses, patients, and their relatives were selected based on purposive sampling from educational-medical cardiothoracic subspecialty centers. Data were collected using an open-ended questionnaire and was extracted and analyzed with content analysis method. Results: Barriers were divided into three groups of individual barriers (low awareness, delay in referring for treatment and screening, incorrect beliefs, and not caring about health, socio-economic barriers (high costs, lack of resources, mental and psychological pressures, and health care barriers (non-alignment of doctors, being therapy-oriented, managerial and planning weaknesses, and lack of health care facilities. The most important presenting strategies are: providing public educations, improving family physician program, reduction of costs, cooperation of patients, and using functional indices to evaluate and improve the quality of services. Conclusion: Low awareness of people, high costs of services, lack of health care facilities, socio-cultural problems of people, and delay in referring of people, for treatment and screening are of the most important barriers of proper identifying and managing risk factors of CVD. Strategies provided in this study to overcome these barriers could be used.

  7. The Effects of Perceived Barriers, Role Models, and Acculturation on the Career Self-Efficacy and Career Consideration of Hispanic Women

    Science.gov (United States)

    Rivera, Lourdes M.; Blumberg, Fran; Chen, Eric C.; Ponterotto, Joseph G.; Flores, Lisa Y.

    2007-01-01

    This study used path analysis to examine the relationship between perceived barriers, acculturation, and role model influence on the career self-efficacy and career considerations of a sample of Hispanic women. Two path models were examined. The male-dominated model accounted for 15% of the variance, and the female-dominated model accounted for…

  8. Perceived Barriers and Facilitators of Exercise and Healthy Dietary Choices: A Study of Employees and Managers within a Large Transport Organisation

    Science.gov (United States)

    Donaldson-Feilder, Emma; Lewis, Rachel; Pavey, Louisa; Jones, Bethan; Green, Melanie; Webster, Angela

    2017-01-01

    Objective: The objective of this study was to examine employees' perceived barriers and facilitators of physical activity and healthy dietary choices, and managers' perceptions of how best to facilitate physical activity and healthy dietary choices among their team members. Design: Single time-point survey with categorical and open-ended…

  9. Perceived barriers to physical activity in adolescent students from a Southern Brazilian city. 10.5007/1980-0037.2011v13n6p422

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    Daniela Dressler Dambros

    2011-11-01

    Full Text Available The purpose of this study was to analyze physical activity (PA habits and perceived barriers to PA in high school students from the municipality of Santa Maria, state of Rio Grande do Sul, Brazil. A total of 424 students with a mean age of 15.69 (±0.9 years, 54.72% of them male and 45.28% female, took part in the study. The third part of the COMPAC questionnaire was used to assess physical activity habits, and the questionnaire developed by Martins and Petroski (2000, adapted for this study population, to investigate perceived barriers to physical activity. The main perceived barriers were time devoted to studies, absence of an exercise partner, poor weather and long work hours. Girls perceived more barriers than boys. Nearly one-third of participants (32.35% were considered insufficiently active. Engagement in moderate to vigorous PA differed significantly (p<0.05 between genders, girls being less active. Walking was the most widely practiced activity among girls (76.04%, whereas boys favored soccer (71.90%. There were significant differences in PA between private and public school students; those enrolled in state-run schools were most active. Our results can serve as a reference for specific actions designed to promote physical activity and health.

  10. First-Generation Female College Students' Financial Literacy: Real and Perceived Barriers to Degree Completion

    Science.gov (United States)

    Eitel, Susan J.; Martin, Jennifer

    2009-01-01

    First-generation female college students (FGFCS) make up a large portion of the diversity in higher education. Unfortunately "access" to education does not translate to success. Persistence and degree completion for these students is often undermined by seemingly insurmountable obstacles. The purposes of this study were to identify the financial…

  11. Perceived Facilitators and Barriers to Local Health Department Workers' Participation in Infectious Disease Emergency Responses.

    Science.gov (United States)

    Rutkow, Lainie; Paul, Amy; Taylor, Holly A; Barnett, Daniel J

    Local health departments play a key role in emergency preparedness and respond to a wide range of threats including infectious diseases such as seasonal influenza, tuberculosis, H1N1, Ebola virus disease, and Zika virus disease. To successfully respond to an infectious disease outbreak, local health departments depend upon the participation of their workforce; yet, studies indicate that sizable numbers of workers would not participate in such a response. The reasons why local health department workers participate, or fail to participate, in infectious disease responses are not well understood. To understand why local health department workers are willing, or not willing, to report to work during an infectious disease response. From April 2015 to January 2016, we conducted 28 semistructured interviews with local health department directors, preparedness staff, and nonpreparedness staff. Interviews were conducted with individuals throughout the United States. We interviewed 28 individuals across 3 groups: local health department directors (n = 8), preparedness staff (n = 10), and nonpreparedness staff (n = 10). Individuals' descriptions of why local health department workers are willing, or not willing, to report to work during an infectious disease response. Factors that facilitate willingness to respond to an infectious disease emergency included availability of vaccines and personal protective equipment; flexible work schedule and childcare arrangements; information sharing via local health department trainings; and perceived commitments to one's job and community. Factors that hinder willingness to respond to an infectious disease emergency included potential disease exposure for oneself and one's family; logistical considerations for care of children, the elderly, and pets; and perceptions about one's role during an infectious disease response. Our findings highlight opportunities for local health departments to revisit their internal policies and engage in

  12. "[Drinking is] Like a Rule That You Can't Break": Perceived Barriers and Facilitators to Reduce Alcohol Use and Improve Antiretroviral Treatment Adherence Among People Living with HIV and Alcohol Use Disorder in Vietnam.

    Science.gov (United States)

    Hershow, Rebecca B; Zuskov, Diana S; Vu Tuyet Mai, Nguyen; Chander, Geetanjali; Hutton, Heidi E; Latkin, Carl; Vuong, Nguyen Duc; Sripaipan, Teerada; Lancaster, Kathryn E; Ha, Tran Viet; Go, Vivian F

    2018-03-14

    Alcohol use, a highly normative behavior in Vietnam that is associated with high rates of HIV infection and lower antiretroviral treatment (ART) adherence, has been largely overlooked by HIV prevention efforts. Using the risk environment framework, this qualitative study aims to explore the perceived microenvironmental (community-level) and endogenous (individual-level) barriers and facilitators to alcohol reduction among people living with HIV (PLHIV) with alcohol use disorders (AUDs) in Vietnam. From June-July 2014, semi-structured interviews were conducted with thirty PLHIV (18 men; 12 women) recruited from an outpatient ART clinic in Thai Nguyen province, Vietnam. All participants had scores of ≥8 on the Alcohol Use Disorders Identification Test and ten of the 30 participants were currently using injection drugs. Interviews were transcribed, translated, and analyzed to identify perceived barriers and facilitators to alcohol reduction. Most participants reported a spike in alcohol consumption at the time of HIV diagnosis. Most perceived barriers existed at the microenvironmental level, including perceived inability to refuse alcohol in the context of community-level social norms and lack of alcohol treatment programs. Two commonly mentioned endogenous barriers were compensatory behaviors when reducing injection drug use and using alcohol as a coping strategy for HIV-related sadness. Those who were able to successfully reduce alcohol use and adhere to ART reported having social support to buffer community-level social pressure and cope with sadness. It may be effective to introduce targeted alcohol reduction interventions in health care centers to address individual risk practices and microenvironmental social norms.

  13. Health care providers' perceived barriers to and need for the implementation of a national integrated health care standard on childhood obesity in the Netherlands - a mixed methods approach.

    Science.gov (United States)

    Schalkwijk, Annemarie A H; Nijpels, Giel; Bot, Sandra D M; Elders, Petra J M

    2016-03-08

    In 2010, a national integrated health care standard for (childhood) obesity was published and disseminated in the Netherlands. The aim of this study is to gain insight into the needs of health care providers and the barriers they face in terms of implementing this integrated health care standard. A mixed-methods approach was applied using focus groups, semi-structured, face-to-face interviews and an e-mail-based internet survey. The study's participants included: general practitioners (GPs) (focus groups); health care providers in different professions (face-to-face interviews) and health care providers, including GPs; youth health care workers; pediatricians; dieticians; psychologists and physiotherapists (survey). First, the transcripts from the focus groups were analyzed thematically. The themes identified in this process were then used to analyze the interviews. The results of the analysis of the qualitative data were used to construct the statements used in the e-mail-based internet survey. Responses to items were measured on a 5-point Likert scale and were categorized into three outcomes: 'agree' or 'important' (response categories 1 and 2), 'disagree' or 'not important'. Twenty-seven of the GPs that were invited (51 %) participated in four focus groups. Seven of the nine health care professionals that were invited (78 %) participated in the interviews and 222 questionnaires (17 %) were returned and included in the analysis. The following key barriers were identified with regard to the implementation of the integrated health care standard: reluctance to raise the subject; perceived lack of motivation and knowledge on the part of the parents; previous negative experiences with lifestyle programs; financial constraints and the lack of a structured multidisciplinary approach. The main needs identified were: increased knowledge and awareness on the part of both health care providers and parents/children; a social map of effective intervention; structural

  14. Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

    Directory of Open Access Journals (Sweden)

    Findlay-Reece Barbara

    2010-01-01

    Full Text Available Abstract Background Integrative health care (IHC is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics. To investigate these challenges, we initiated a further study in 2008, to explore the reasons why IHC clinics are not conducting outcomes research and to identify strategies for conducting successful in-house outcomes research programs. The results of the latter study are reported here. Methods A total of 25 qualitative interviews were conducted with key participants from 19 IHC clinics across Canada. Basic content analysis was used to identify key themes from the transcribed interviews. Results Barriers identified by participants fell into four categories: organizational culture, organizational resources, organizational environment and logistical challenges. Cultural challenges relate to the philosophy of IHC, organizational leadership and practitioner attitudes and beliefs. Participants also identified significant issues relating to their organization's lack of resources such as funding, compensation, infrastructure and partnerships/linkages. Environmental challenges such as the nature of a clinic's patient population and logistical issues such as the actual implementation of a research program and the applicability of research data also posed challenges to the conduct of research. Embedded research leadership, integration of personal and professional values about research, alignment of research activities and clinical workflow processes are some of the factors identified by participants that support IHC clinics' ability to conduct outcomes research. Conclusions Assessing and enhancing the broader

  15. Barriers to home care for terminally ill Turkish and Moroccan migrants, perceived by GPs and nurses: a survey

    Directory of Open Access Journals (Sweden)

    de Graaff Fuusje M

    2009-01-01

    Full Text Available Abstract Background Previous qualitative research proved that relatives of elderly terminally ill Turkish and Moroccan immigrants experience several barriers to the use of Dutch professional home care. The aim of this study was to explore how general practitioners and home care nurses perceive the home care for terminally ill Turkish and Moroccan migrants and their families in the Netherlands. Methods Questionnaires were sent to home care organizations and GPs working in areas where most of these migrants are living. 93 nurses and 78 GPs provided information about their experiences and opinions regarding home care for this group of patients. The data were analyzed by descriptive statistics. Results GPs refer relatively few patients from these migrant groups to home care. They often find it difficult to assess the needs of these patients and their families. In 40% of the GPs' cases in which terminally ill Turkish and Moroccan migrants were not referred to home care, the GP regretted this afterwards: the patients had not received sufficient qualified care, and their informal carers had often become overburdened. In addition, home care nurses often express dissatisfaction with the home care given to terminally ill Turkish or Moroccan patients, because of communication problems, the patients' lack of knowledge of the disease, or difficulties in making suitable appointments with the patient or with the family. Conclusion Nurses and GPs cite chiefly similar factors influencing access to and use of home care as family members did in a previous study. However, according to GPs and nurses, the main barrier to the use of home care concerns communication problems, while relatives cited the preference for family care as the main reason for abstaining from the use of home care.

  16. Validating the Modified Drug Adherence Work-Up (M-DRAW) Tool to Identify and Address Barriers to Medication Adherence.

    Science.gov (United States)

    Lee, Sun; Bae, Yuna H; Worley, Marcia; Law, Anandi

    2017-09-08

    Barriers to medication adherence stem from multiple factors. An effective and convenient tool is needed to identify these barriers so that clinicians can provide a tailored, patient-centered consultation with patients. The Modified Drug Adherence Work-up Tool (M-DRAW) was developed as a 13-item checklist questionnaire to identify barriers to medication adherence. The response scale was a 4-point Likert scale of frequency of occurrence (1 = never to 4 = often). The checklist was accompanied by a GUIDE that provided corresponding motivational interview-based intervention strategies for each identified barrier. The current pilot study examined the psychometric properties of the M-DRAW checklist (reliability, responsiveness and discriminant validity) in patients taking one or more prescription medication(s) for chronic conditions. A cross-sectional sample of 26 patients was recruited between December 2015 and March 2016 at an academic medical center pharmacy in Southern California. A priming question that assessed self-reported adherence was used to separate participants into the control group of 17 "adherers" (65.4%), and into the intervention group of nine "unintentional and intentional non-adherers" (34.6%). Comparable baseline characteristics were observed between the two groups. The M-DRAW checklist showed acceptable reliability (13 item; alpha = 0.74) for identifying factors and barriers leading to medication non-adherence. Discriminant validity of the tool and the priming question was established by the four-fold number of barriers to adherence identified within the self-selected intervention group compared to the control group (4.4 versus 1.2 barriers, p tool will include construct validation.

  17. Validating the Modified Drug Adherence Work-Up (M-DRAW Tool to Identify and Address Barriers to Medication Adherence

    Directory of Open Access Journals (Sweden)

    Sun Lee

    2017-09-01

    Full Text Available Barriers to medication adherence stem from multiple factors. An effective and convenient tool is needed to identify these barriers so that clinicians can provide a tailored, patient-centered consultation with patients. The Modified Drug Adherence Work-up Tool (M-DRAW was developed as a 13-item checklist questionnaire to identify barriers to medication adherence. The response scale was a 4-point Likert scale of frequency of occurrence (1 = never to 4 = often. The checklist was accompanied by a GUIDE that provided corresponding motivational interview-based intervention strategies for each identified barrier. The current pilot study examined the psychometric properties of the M-DRAW checklist (reliability, responsiveness and discriminant validity in patients taking one or more prescription medication(s for chronic conditions. A cross-sectional sample of 26 patients was recruited between December 2015 and March 2016 at an academic medical center pharmacy in Southern California. A priming question that assessed self-reported adherence was used to separate participants into the control group of 17 “adherers” (65.4%, and into the intervention group of nine “unintentional and intentional non-adherers” (34.6%. Comparable baseline characteristics were observed between the two groups. The M-DRAW checklist showed acceptable reliability (13 item; alpha = 0.74 for identifying factors and barriers leading to medication non-adherence. Discriminant validity of the tool and the priming question was established by the four-fold number of barriers to adherence identified within the self-selected intervention group compared to the control group (4.4 versus 1.2 barriers, p < 0.05. The current study did not investigate construct validity due to small sample size and challenges on follow-up with patients. Future testing of the tool will include construct validation.

  18. Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

    Science.gov (United States)

    Jankowski, Irene M; Nadzam, Deborah Morris

    2011-06-01

    Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

  19. Using collective intelligence to identify barriers to teaching 12–19 year olds about the ocean in Europe

    DEFF Research Database (Denmark)

    Fauville, Géraldine; McHugh, Patricia; Domegan, Christine

    2018-01-01

    Since the degradation of the marine environment is strongly linked to human activities, having citizens who appreciate the ocean's influence on them and their influence on the ocean is important. Research has shown that citizens have a limited understanding of the ocean and it is this lack of ocean...... the ocean, highlighting how these barriers are interconnected and influence one another in a European Influence Map. The influence map shows 8 themes: Awareness and Perceived knowledge; Policies and Strategies; Engagement, formal education sector; the Ocean itself; Collaboration; Connections between humans...... and the ocean and the Blue Economy, having the greatest influence and impact on marine education. “Awareness and Perceived knowledge” in Stage 1, exerts the highest level of overall influence in teaching 12–19 year olds about the ocean. This map and study serves as a roadmap for policy makers to implement...

  20. Tissue plasminogen activator; identifying major barriers related to intravenous injection in ischemic acute cerebral infraction

    Directory of Open Access Journals (Sweden)

    Fariborz Khorvash

    2017-01-01

    Full Text Available Background: According to previous publications, in patients with acute ischemic cerebral infarction, thrombolytic therapy using intravenous tissue plasminogen activator (IV-tPA necessitates precise documentation of symptoms' onset. The aim of this study was to identify major barriers related to the IV-tPA injection in such patients. Materials and Methods: Between the year 2014-2015, patients with definitive diagnosis of acute cerebral infarction (n = 180 who attended the neurology ward located at the Isfahan Alzahra Hospital were studied. To investigate barriers related to door to IV-tPA needle time, personal reasons, and criteria for inclusion or exclusion of patients, three questionnaire forms were designed based on the Food and Drug Administration-approved indications or contraindications. Results: The mean age of males versus females was 60 versus 77.5 years (ranged 23–93 vs. 29–70 years, respectively. Out of total population, only 10.7% transferred to hospital in <4.5 h after the onset of symptoms. Regarding to eligibility for IV-tPA, 68.9% of total population have had criteria for such treatment. Concerning to both items such as transferring to hospital in <4.5 h after the onset of symptoms and eligibility for IV-tPA, only 6.6% of total population met the criteria for such management. There was ignorance or inattention to symptoms in 75% of population studied. There was a mean of 195.92 ± 6.65 min (182.8–209.04 min for door to IV-tPA needle time. Conclusion: Despite the international guidelines for IV-tPA injection within 3–4.5 h of ischemic stroke symptoms' onset, the results of this study revealed that falling time due to ignorance of symptoms, literacy, and living alone might need further attention. As a result, to decrease death and disability, educational programs related to the symptoms' onset by consultant neurologist in Isfahan/Iran seem to be advantageous.

  1. Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

    Science.gov (United States)

    Rantakokko, Merja; Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Kauppinen, Markku; Rantanen, Taina

    2017-08-01

    The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period. Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorized into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the 'Impact on Participation and Autonomy' (IPA) questionnaire using the autonomy outdoors subscale (score range 0-20, higher scores indicating more restricted autonomy). Scores for autonomy in participation outdoors were available for 848 participants at baseline (mean 6.2, SD = 3.8) and for 748 participants at the two-year follow-up (mean 6.7, SD = 3.9). At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy (p autonomy in participation outdoors declined more among those reporting multiple environmental barriers compared to those reporting none (age- and sex-adjusted group*time β = .629, s.e. = .277, p = .023). Adjustment for cognitive functioning, education, number of chronic conditions and change in walking difficulty did not influence the association. Perceived environmental barriers to outdoor mobility accelerate the decline in autonomy in participation outdoors among older community-dwelling people. Understanding factors affecting autonomy can help in finding ways to support the sense of autonomy as people age.

  2. Diabetes in homeless persons: barriers and enablers to health as perceived by patients, medical, and social service providers.

    Science.gov (United States)

    Elder, Nancy C; Tubb, Matthew R

    2014-01-01

    The ways homelessness and diabetes affect each other is not well known. The authors sought to understand barriers and enablers to health for homeless people with diabetes as perceived by homeless persons and providers. The authors performed semistructured interviews with a sample of participants (seven homeless persons, six social service providers, and five medical providers) in an urban Midwest community. Data analysis was performed with the qualitative editing method. Participants described external factors (chaotic lifestyle, diet/food availability, access to care, and medications) and internal factors (competing demands, substance abuse, stress) that directly affect health. Social service providers were seen as peripheral to diabetes care, although all saw their primary functions as valuable. These factors and relationships are appropriately modeled in a complex adaptive chronic care model, where the framework is bottom up and stresses adaptability, self-organization, and empowerment. Adapting the care of homeless persons with diabetes to include involvement of patients and medical and social service providers must be emergent and responsive to changing needs.

  3. Perceived Effectiveness of Identified Methods and Techniques Teachers Adopt in Prose Literature Lessons in some Secondary Schools in Owerri

    Directory of Open Access Journals (Sweden)

    F. O. Ezeokoli

    2016-07-01

    Full Text Available The study determined the methods adopted by teachers in prose literature-in-English classrooms, activities of teachers and students, teachers’ perceived effectiveness of techniques used. It also examined the objectives of teaching prose literature that teachers should address and the extent teachers believe in student-identified difficulties of studying prose literature. The study adopted the descriptive survey research design. Purposive sampling technique was used to select 85 schools in Owerri metropolis and in each school, all literature teachers of senior secondary I and II were involved. In all, 246 literature teachers participated out of which 15 were purposively selected for observation. The two instruments were: Teachers’ Questionnaire (r = 0.87 and Classroom Observation Schedule (r = 0.73. Data were analysed using frequency counts and percentages. Results revealed that teachers adopted lecture (28.4%, reading (10.9% and discussion (7.3% methods. Teacher’s activities during the lesson include: giving background information, summarizing, dictating notes, reading aloud and explaining and asking questions. The adopted techniques include: questioning, oral reading, silent reading and discussion. Teachers’ perceived questioning as the most effective technique followed by debating and summarizing. Teachers identified development of students’ critical faculties and analytical skills, literary appreciation and language skills to be of utmost concern. It was concluded that the methods adopted by teachers are not diverse enough to cater for the needs and backgrounds of students. Keywords: Methods, Techniques, Perceived Effectiveness, Objectives, Literature-in-English

  4. Identifying and Overcoming Barriers to Diabetes Management in the Elderly: An Intervention Study

    National Research Council Canada - National Science Library

    Munshi, Medha

    2008-01-01

    .... The interventions are now being implemented with help of a geriatric life specialist (GLS). Intervention by GDT includes focused strategies to overcome barriers in the areas of clinical care, education, social environment, and finances...

  5. The influence of acculturation and breast cancer-specific distress on perceived barriers to genetic testing for breast cancer among women of African descent.

    Science.gov (United States)

    Sussner, Katarina M; Thompson, Hayley S; Jandorf, Lina; Edwards, Tiffany A; Forman, Andrea; Brown, Karen; Kapil-Pair, Nidhi; Bovbjerg, Dana H; Schwartz, Marc D; Valdimarsdottir, Heiddis B

    2009-09-01

    Rising health disparities are increasingly evident in relation to use of genetic services (including genetic counseling and testing) for breast cancer risk, with women of African descent less likely to use genetic services compared with Whites. Meanwhile, little is known regarding potential within-group acculturation and psychological differences underlying perceived barriers to genetic testing among women of African descent. Hypothesized contributions of acculturation factors and breast cancer-specific distress to perceived barriers to genetic testing were examined with a statistical analysis of baseline data from 146 women of African descent (56% US born and 44% foreign born) meeting genetic breast cancer risk criteria and participating in a larger longitudinal study that included the opportunity for free genetic counseling and testing. Perceived barriers assessed included: (1) anticipation of negative emotional reactions, (2) stigma, (3) confidentiality concerns, (4) family-related worry, and (5) family-related guilt associated with genetic testing. In multivariate analyses, being foreign born was a significant predictor of anticipated negative emotional reactions about genetic testing (beta=0.26; SE=0.11; p=0.01). Breast cancer-specific distress scores (avoidance symptoms) were positively related to anticipated negative emotional reactions (beta=0.02; SE=0.005; p=barriers to genetic testing among women of African descent. The potential utility of culturally tailored genetic counseling services taking into account such influences and addressing emotional and psychological concerns of women considering genetic testing for breast cancer should be investigated.

  6. 'Before reaching the last mile'- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: A mixed method study.

    Science.gov (United States)

    Singh, Akash Ranjan; Pakhare, Abhijit; Kokane, Arun M; Shewade, Hemant Deepak; Chauhan, Ashish; Singh, Abhishek; Gangwar, Arti; Thakur, Prahlad Singh

    2017-12-01

    Community-based direct observed treatment (DOT) providers are an important bridge for the national tuberculosis programme in India to reach the unreached. The present study has explored the knowledge, attitude, practice and barriers perceived by the community-based DOT providers. Mixed-methods study design was used among 41 community-based DOT providers (Accredited Social Health Activist (ASHAs)) working in 67 villages from a primary health center in Raisen district of Madhya Pradesh, India. The cross-sectional quantitative component assessed the knowledge and practices and three focus-group discussions explored the attitude and perceived barriers related to DOT provision. 'Adequate knowledge' and 'satisfactory practice' related to DOT provision was seen in 14 (34%) and 13 (32%) ASHAs respectively. Only two (5%) received any amount of honorarium for completion of DOT in last 3years. The focus-group discussions revealed unfavourable attitude; inadequate training and supervision, non-payment of honorarium, issues related to assured services after referral and patient related factors as the barriers to satisfactory practice of DOT. Study revealed inadequate knowledge and unsatisfactory practice related to DOT provision among ASHAs. Innovations addressing the perceived barriers to improve practice of DOT provision by ASHAs are urgently required. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  7. Identifying and Overcoming Critical Barriers to Widespread Second Use of PEV Batteries

    Energy Technology Data Exchange (ETDEWEB)

    Neubauer, J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Smith, K. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wood, E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Pesaran, A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-02-01

    Both the market penetration of plug-in electric vehicles (PEVs) and deployment of grid-connected energy storage systems are presently restricted by the high cost of batteries. Battery second use (B2U) strategies--in which a single battery first serves an automotive application, then is redeployed into a secondary market--could help address both issues by reducing battery costs to the primary (automotive) and secondary (electricity grid) users. This study investigates the feasibility of and major barriers to the second use of lithium-ion PEV batteries by posing and answering the following critical B2U questions: 1. When will used automotive batteries become available, and how healthy will they be? 2. What is required to repurpose used automotive batteries, and how much will it cost? 3. How will repurposed automotive batteries be used, how long will they last, and what is their value? Advanced analysis techniques are employed that consider the electrical, thermal, and degradation response of batteries in both the primary (automotive) and secondary service periods. Second use applications are treated in detail, addressing operational requirements, economic value, and market potential. The study concludes that B2U is viable and could provide considerable societal benefits due to the large possible supply of repurposed automotive batteries and substantial remaining battery life following automotive service. However, the only identified secondary market large enough to consume the supply of these batteries (utility peaker plant replacement) is expected to be a low margin market, and thus B2U is not expected to affect the upfront cost of PEVs.

  8. Perceived Barriers to the Use of High-Fidelity Hands-On Simulation Training for Contrast Reaction Management: Why Programs are Not Using It.

    Science.gov (United States)

    Chinnugounder, Sankar; Hippe, Daniel S; Maximin, Suresh; O'Malley, Ryan B; Wang, Carolyn L

    2015-01-01

    Although subjective and objective benefits of high-fidelity simulation have been reported in medicine, there has been slow adoption in radiology. The purpose of our study was to identify the perceived barriers in the use of high-fidelity hands-on simulation for contrast reaction management training. An IRB exempt 32 questions online web survey was sent to 179 non-military radiology residency program directors listed in the Fellowship and Residency Electronic Interactive Database Access system (FREIDA). Survey questions included the type of contrast reaction management training, cost, time commitment of residents and faculty, and the reasons for not using simulation training. Responses from the survey were summarized as count (percentage), mean ± standard deviation (SD), or median (range). 84 (47%) of 179 programs responded, of which 88% offered CRM training. Most (72%) conducted the CRM training annually while only 4% conducted it more frequently. Didactic lecture was the most frequently used training modality (97%), followed by HFS (30%) and computer-based simulation (CBS) (19%); 5.5% used both HFS and CBS. Of the 51 programs that offer CRM training but do not use HFS, the most common reason reported was insufficient availability (41%). Other reported reasons included cost (33%), no access to simulation centers (33%), lack of trained faculty (27%) and time constraints (27%). Although high-fidelity hands-on simulation training is the best way to reproduce real-life contrast reaction scenarios, many institutions do not provide this training due to constraints such as cost, lack of access or insufficient availability of simulation labs, and lack of trained faculty. As a specialty, radiology needs to better address these barriers at both an institutional and national level. Copyright © 2015 Mosby, Inc. All rights reserved.

  9. Perceived and normative needs, utilization of oral healthcare services, and barriers to utilization of dental care services at peripheral medical centre: Poonjeri, Mamallapuram, India

    Directory of Open Access Journals (Sweden)

    Prabhu Subramani

    2017-01-01

    Full Text Available Introduction: Dental care utilization is limited, and teeth are often left untreated or extracted in India. Several barriers exist for the utilization of dental services. The present study was undertaken to assess the oral healthcare needs, utilization pattern of oral healthcare services, and barriers to utilization of oral healthcare services among the outpatients of Peripheral Medical Centre, Poonjeri, Mamallapuram, India. Materials and Methods: Simple random sampling was conducted among outpatients and their attenders reporting to the health centre; demographic profile of the patients were recorded followed by interviewer-administered questionnaire for recording the self-perceived dental needs and barriers in utilizing dental care services followed by Type II clinical examination to assess normative dental treatment needs. Results: N =282 study participants participated in the present study; majority of the study participants were from upper lower class and lower middle class. Among the study subjects n = 124 (44% have not accessed any dentist, n = 112 (39.7% had visited dentist for toothache. Common reason cited as Self – perceived barriers for dental care are n = 184 (65.2% – 'Unaware of the dental problems' and n = 118 (41.8% 'Fear of dental treatment'. Logistic regression showed that significant difference was seen in gender, socioeconomic status, and barriers to dental care (P < 0.05 in influencing the utilization pattern of dental care. Conclusion: Perceived and normative dental needs were high among the study population due to problem-oriented care, and it is influenced by various barriers such as unawareness of dental problems, fear, cost, accessibility, and time.

  10. Different Combinations of Perceived Autonomy Support and Control: Identifying the Most Optimal Motivating Style

    Science.gov (United States)

    Haerens, L.; Vansteenkiste, M.; De Meester, A.; Delrue, J.; Tallir, I.; Vande Broek, G.; Goris, W.; Aelterman, N.

    2018-01-01

    Background: According to Self-Determination Theory, teachers and sport coaches can differ in the motivating style they rely upon to motivate young people. When endorsing an autonomy-supportive motivating style, instructors try to identify, vitalize, and nurture youngsters' inner motivational resources. In contrast, instructors with a dominant…

  11. Identifying the Correlates and Barriers of Future Planning among Parents of Individuals with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Burke, Meghan; Arnold, Catherine; Owen, Aleksa

    2018-01-01

    Although individuals with intellectual and developmental disabilities (IDD) are living longer lives, fewer than half of parents of individuals with IDD conduct future planning. The correlates and barriers to future planning must be identified to develop targeted interventions to facilitate future planning. In this study, 388 parents of individuals…

  12. Identifying Knowledge Sharing Barriers in the Collaboration of Traditional and Western Medicine Professionals in Chinese Hospitals: A Case Study

    Science.gov (United States)

    Zhou, Lihong; Nunes, Miguel Baptista

    2012-01-01

    This paper reports on a research project that aims at identifying knowledge sharing (KS) barriers between traditional and western medicine practitioners co-existing and complementing each other in Chinese healthcare organisations. The study focuses on the tacit aspects of patient knowledge, rather than the traditional technical information shared…

  13. Understanding low levels of physical activity in people with intellectual disabilities : A systematic review to identify barriers and facilitators

    NARCIS (Netherlands)

    Bossink, Leontien; van der Putten, Annette; Vlaskamp, Carla

    2017-01-01

    Background: People with intellectual disabilities (ID) undertake extremely low levels of physical activity. Aims: To enhance understanding concerning low levels of physical activity in people with ID, this study has three aims: (1) to identify barriers to and facilitators of physical activity in

  14. Facilitating out-of-home caregiving through health information technology: survey of informal caregivers' current practices, interests, and perceived barriers.

    Science.gov (United States)

    Zulman, Donna M; Piette, John D; Jenchura, Emily C; Asch, Steven M; Rosland, Ann-Marie

    2013-07-10

    Many patients with chronic conditions are supported by out-of-home informal caregivers-family members, friends, and other individuals who provide care and support without pay-who, if armed with effective consumer health information technology, could inexpensively facilitate their care. We sought to understand caregivers' use of, interest in, and perceived barriers to health information technology for out-of-home caregiving. We conducted 2 sequential Web-based surveys with a national sample of individuals who provide out-of-home caregiving to an adult family member or friend with a chronic illness. We queried respondents about their use of health information technology for out-of-home caregiving and used multivariable regression to investigate caregiver and care-recipient characteristics associated with caregivers' technology use for caregiving. Among 316 out-of-home caregiver respondents, 34.5% (109/316) reported using health information technology for caregiving activities. The likelihood of a caregiver using technology increased significantly with intensity of caregiving (as measured by number of out-of-home caregiving activities). Compared with very low intensity caregivers, the adjusted odds ratio (OR) of technology use was 1.88 (95% CI 1.01-3.50) for low intensity caregivers, 2.39 (95% CI 1.11-5.15) for moderate intensity caregivers, and 3.70 (95% CI 1.62-8.45) for high intensity caregivers. Over 70% (149/207) of technology nonusers reported interest in using technology in the future to support caregiving. The most commonly cited barriers to technology use for caregiving were health system privacy rules that restrict access to care-recipients' health information and lack of familiarity with programs or websites that facilitate out-of-home caregiving. Health information technology use for out-of-home caregiving is common, especially among individuals who provide more intense caregiving. Health care systems can address the mismatch between caregivers' interest

  15. Nurse retention in a correctional facility: a study of the relationship between the nurses' perceived barriers and benefits.

    Science.gov (United States)

    Chafin, W Sue; Biddle, Wendy L

    2013-04-01

    Retention of nursing staff is more complex in a correctional facility. After a period of 3 years, only 20% of the staff remained employed at this study facility. Without retention of qualified correctional nurses, there are decreases in access to care, gaps in continuity of care, and less time for mentorship. Trained correctional nurses improve patient and staff safety, provide more education, and are more team-oriented. The purpose of this study was to identify barriers and benefits to nursing staff satisfaction with their job and the likelihood that they will continue to work in correctional settings. Practice and patient care will be favorably impacted if correctional nurses are provided with services such as new hire orientation, clinical ladder programs to recruit and retain nursing staff, and teambuilding.

  16. User-identified gel characteristics: a qualitative exploration of perceived product efficacy of topical vaginal microbicides.

    Science.gov (United States)

    Morrow, Kathleen M; Underhill, Kristen; van den Berg, Jacob J; Vargas, Sara; Rosen, Rochelle K; Katz, David F

    2014-10-01

    Research has demonstrated that certain vaginal gel products--microbicides containing antiretroviral drugs--may reduce HIV infection risk among women. But for vaginal gels to avert HIV and other sexually transmitted infections (STIs), at-risk women must be willing to use them as directed. These products must therefore be "acceptable" to women and an important component of acceptability is users' perception that the product will work to prevent infection. We sought to understand how women's perceptions of vaginal gel properties may shape their understanding of product efficacy for HIV and STI prevention. Sixteen women completed two in-depth qualitative interviews (k = 32) to identify the range and types of sensory perceptions they experienced when using two vaginal gels. We identified emergent themes and linkages between users' sensory perceptions and their beliefs about product efficacy. Users' predictions about product efficacy for preventing infection corresponded to measurable physical properties, including gel volume, location in the vagina, coating behavior, sensation of the gel in the vagina, leakage, and gel changes during coital acts. Although the women described similar sensory experiences (e.g., gel leaked from the vagina), they interpreted these experiences to have varying implications for product efficacy (e.g., leakage was predicted to increase or decrease efficacy). To improve microbicide acceptability, gel developers should investigate and deliberately incorporate properties that influence users' perceptions of efficacy. When a microbicide is approved for use, providers should educate users to anticipate and understand their sensory experiences; improving users' experience can maximize adherence and product effectiveness.

  17. Through the Eyes of Nurse Managers in Long-Term Care: Identifying Perceived Competencies and Skills.

    Science.gov (United States)

    Dever, Kathleen H

    2018-05-01

    Nurse managers (NMs) in long-term care supervise health care services for individuals with high acuity levels and numerous comorbidities. There is minimal research identifying NMs' skills and competencies as unit leaders within the long-term care environment. The current mixed-methods study identified NMs' leadership skills and competencies. Nineteen NMs with ≥5 years' long-term care management experience completed the Nurse Manager Inventory Tool and were individually interviewed. They rated their clinical skills at the competent level and their financial/strategic management skills at the novice level. All other skill categories, including leadership reflective practice, diversity, human resource leadership/management, relationship management, performance improvement, and problem solving, were rated at a competent level. Emergent interview qualitative themes included their visibility on the unit, trial and error learning, a sense of "aloneness" due to the absence of other RNs, NM position being a tough job, need for peer support, role modeling, and importance of supporting the resident through their "final journey." [Journal of Gerontological Nursing, 44(5), 32-38.]. Copyright 2018, SLACK Incorporated.

  18. Identifying the Barriers and Facilitators to Participation in Physical Activity for Children with Down Syndrome

    Science.gov (United States)

    Barr, M.; Shields, N.

    2011-01-01

    Background: Many children with Down syndrome do not undertake the recommended amount of daily physical activity. The aim of this study was to explore the barriers and facilitators to physical activity for this group. Methods: Eighteen in-depth interviews were conducted with 20 parents (16 mothers, 4 fathers) of children with Down syndrome aged…

  19. Sustaining Teen Pregnancy Prevention Programs in Schools: Needs and Barriers Identified by School Leaders

    Science.gov (United States)

    Craft, Lesley R.; Brandt, Heather M.; Prince, Mary

    2016-01-01

    Background: To reduce teen pregnancy rates, prevention programs must be consistently available to large numbers of youth. However, prevention efforts have been historically conducted with little emphasis on ensuring program sustainability. This study examined the needs and barriers to sustaining teen pregnancy prevention (TPP) programming in…

  20. Parents’ Perceived Barriers to Accessing Sports and Recreation Facilities in Ontario, Canada: Exploring the Relationships between Income, Neighbourhood Deprivation, and Community

    OpenAIRE

    Harrington, Daniel W.; Jarvis, Jocelyn W.; Manson, Heather

    2017-01-01

    Sports and recreation facilities provide places where children can be physically active. Previous research has shown that availability is often worse in lower-socioeconomic status (SES) areas, yet others have found inverse relationships, no relationships, or mixed findings. Since children’s health behaviours are influenced by their parents, it is important to understand parents’ perceived barriers to accessing sports and recreation facilities. Data from computer assisted telephone interviews ...

  1. The effect of a multifaceted evidence-based practice programme for nurses on knowledge, skills, attitudes, and perceived barriers: A cohort study.

    Science.gov (United States)

    van der Goot, Wieke E; Keers, Joost C; Kuipers, Ruud; Nieweg, Roos M B; de Groot, Martijn

    2018-04-01

    The Dutch professional nursing standard of 2012 stipulates that Dutch nursing practices are to be evidence-based. Not all practicing nurses can satisfy these requirements, therefore, an educational programme about Evidence-Based Practice (EBP) was developed for a Dutch teaching hospital. The aim of this study was to measure the effects of a six month in-house EBP programme on knowledge, skills, attitudes, and perceived barriers of nurses (four European Credits equals two US Credit Hours). A multiple-cohort study was conducted with a pre-post-test design. In the period of 2011-2015, a total of 58 nurses (9 cohorts) followed the programme. Baseline and follow-up assessments consisted of three questionnaires each: the Dutch Modified Fresno, the two subscales of the McColl questionnaire, and the BARRIER scale to assess knowledge and skills, attitudes, and perceived barriers, respectively. Fifty nurses completed both assessments. The results demonstrated that actual knowledge and skills significantly increased by approximately 40%. Self-perceived knowledge increased significantly, while attitudes towards EBP remained (moderately) positive. Perceived barriers did not notably change except for the Research subscale which received many "no opinion" responses prior to the programme but fewer afterwards. Our multifaceted in-house EBP programme led to a significant improvement of approximately 40% in EBP knowledge and skills of participating nurses. Most nurses who followed the EBP programme are currently applying their knowledge and skills in practice. Managerial support and allocated time for EBP are important facilitators for its implementation. Furthermore, to maintain and expand nurses' EBP knowledge and skills and translate them into practice, follow-up interventions, such as journal clubs, may well be beneficial. Based on the positive results of our programme, we will implement it throughout the hospital with an emphasis on training more groups of nurses. Copyright

  2. Assessment of Nurses’ Knowledge, Attitude, and Perceived Barriers to Expressed Pressure Ulcer Prevention Practice in Addis Ababa Government Hospitals, Addis Ababa, Ethiopia, 2015

    OpenAIRE

    Abebe Dilie; Daniel Mengistu

    2015-01-01

    Background. Although pressure ulcer development is now generally considered as an indicator for quality of nursing care, questions and concerns about situations in which they are unavoidable remain. Awareness about the significance of the problem, positive attitude towards prevention, and an adequate level of knowledge are cornerstones to effectively prevent pressure ulcers. Objective. To assess nurses’ knowledge, attitudes, and perceived barriers to expressed pressure ulcer prevention practi...

  3. Identifying barriers to recovery from work related upper extremity disorders: use of a collaborative problem solving technique.

    Science.gov (United States)

    Shaw, William S; Feuerstein, Michael; Miller, Virginia I; Wood, Patricia M

    2003-08-01

    Improving health and work outcomes for individuals with work related upper extremity disorders (WRUEDs) may require a broad assessment of potential return to work barriers by engaging workers in collaborative problem solving. In this study, half of all nurse case managers from a large workers' compensation system were randomly selected and invited to participate in a randomized, controlled trial of an integrated case management (ICM) approach for WRUEDs. The focus of ICM was problem solving skills training and workplace accommodation. Volunteer nurses attended a 2 day ICM training workshop including instruction in a 6 step process to engage clients in problem solving to overcome barriers to recovery. A chart review of WRUED case management reports (n = 70) during the following 2 years was conducted to extract case managers' reports of barriers to recovery and return to work. Case managers documented from 0 to 21 barriers per case (M = 6.24, SD = 4.02) within 5 domains: signs and symptoms (36%), work environment (27%), medical care (13%), functional limitations (12%), and coping (12%). Compared with case managers who did not receive the training (n = 67), workshop participants identified more barriers related to signs and symptoms, work environment, functional limitations, and coping (p Problem solving skills training may help focus case management services on the most salient recovery factors affecting return to work.

  4. Parents' Perceived Barriers to Accessing Sports and Recreation Facilities in Ontario, Canada: Exploring the Relationships between Income, Neighbourhood Deprivation, and Community.

    Science.gov (United States)

    Harrington, Daniel W; Jarvis, Jocelyn W; Manson, Heather

    2017-10-23

    Sports and recreation facilities provide places where children can be physically active. Previous research has shown that availability is often worse in lower-socioeconomic status (SES) areas, yet others have found inverse relationships, no relationships, or mixed findings. Since children's health behaviours are influenced by their parents, it is important to understand parents' perceived barriers to accessing sports and recreation facilities. Data from computer assisted telephone interviews with parents living in Ontario, Canada were merged via postal codes with neighbourhood deprivation data. Multivariable logistic regression modeling was used to estimate the likelihood that parents reported barriers to accessing local sports and recreation facilities. Parents with lower household incomes were more likely to report barriers to access. For each unit increase in deprivation score (i.e., more deprived), the likelihood of reporting a barrier increased 16% (95% CI: 1.04, 1.28). For parents, the relationships between household income, neighbourhood-level deprivation, and barriers are complex. Understanding these relationships is important for research, policy and planning, as parental barriers to opportunities for physical activity have implications for child health behaviours, and ultimately childhood overweight and obesity.

  5. Parents’ Perceived Barriers to Accessing Sports and Recreation Facilities in Ontario, Canada: Exploring the Relationships between Income, Neighbourhood Deprivation, and Community

    Directory of Open Access Journals (Sweden)

    Daniel W. Harrington

    2017-10-01

    Full Text Available Sports and recreation facilities provide places where children can be physically active. Previous research has shown that availability is often worse in lower-socioeconomic status (SES areas, yet others have found inverse relationships, no relationships, or mixed findings. Since children’s health behaviours are influenced by their parents, it is important to understand parents’ perceived barriers to accessing sports and recreation facilities. Data from computer assisted telephone interviews with parents living in Ontario, Canada were merged via postal codes with neighbourhood deprivation data. Multivariable logistic regression modeling was used to estimate the likelihood that parents reported barriers to accessing local sports and recreation facilities. Parents with lower household incomes were more likely to report barriers to access. For each unit increase in deprivation score (i.e., more deprived, the likelihood of reporting a barrier increased 16% (95% CI: 1.04, 1.28. For parents, the relationships between household income, neighbourhood-level deprivation, and barriers are complex. Understanding these relationships is important for research, policy and planning, as parental barriers to opportunities for physical activity have implications for child health behaviours, and ultimately childhood overweight and obesity.

  6. Ethnic, racial and cultural identity and perceived benefits and barriers related to genetic testing for breast cancer among at-risk women of African descent in New York City.

    Science.gov (United States)

    Sussner, K M; Edwards, T A; Thompson, H S; Jandorf, L; Kwate, N O; Forman, A; Brown, K; Kapil-Pair, N; Bovbjerg, D H; Schwartz, M D; Valdimarsdottir, H B

    2011-01-01

    Due to disparities in the use of genetic services, there has been growing interest in examining beliefs and attitudes related to genetic testing for breast and/or ovarian cancer risk among women of African descent. However, to date, few studies have addressed critical cultural variations among this minority group and their influence on such beliefs and attitudes. We assessed ethnic, racial and cultural identity and examined their relationships with perceived benefits and barriers related to genetic testing for cancer risk in a sample of 160 women of African descent (49% self-identified African American, 39% Black-West Indian/Caribbean, 12% Black-Other) who met genetic risk criteria and were participating in a larger longitudinal study including the opportunity for free genetic counseling and testing in New York City. All participants completed the following previously validated measures: (a) the multi-group ethnic identity measure (including ethnic search and affirmation subscales) and other-group orientation for ethnic identity, (b) centrality to assess racial identity, and (c) Africentrism to measure cultural identity. Perceived benefits and barriers related to genetic testing included: (1) pros/advantages (including family-related pros), (2) cons/disadvantages (including family-related cons, stigma and confidentiality concerns), and (3) concerns about abuses of genetic testing. In multivariate analyses, several ethnic identity elements showed significant, largely positive relationships to perceived benefits about genetic testing for breast and/or ovarian cancer risk, the exception being ethnic search, which was positively associated with cons/disadvantages, in general, and family-related cons/disadvantages. Racial identity (centrality) showed a significant association with confidentiality concerns. Cultural identity (Africentrism) was not related to perceived benefits and/or barriers. Ethnic and racial identity may influence perceived benefits and barriers

  7. IDENTIFYING AND ANALYZING THE TRANSIENT AND PERMANENT BARRIERS FOR BIG DATA

    OpenAIRE

    SARFRAZ NAWAZ BROHI; MERVAT ADIB BAMIAH; MUHAMMAD NAWAZ BROHI

    2016-01-01

    Auspiciously, big data analytics had made it possible to generate value from immense amounts of raw data. Organizations are able to seek incredible insights which assist them in effective decision making and providing quality of service by establishing innovative strategies to recognize, examine and address the customers’ preferences. However, organizations are reluctant to adopt big data solutions due to several barriers such as data storage and transfer, scalability, data quality, data c...

  8. Perceived exercise barriers are reduced and benefits are improved with lifestyle modification in overweight and obese women with polycystic ovary syndrome: a randomised controlled trial.

    Science.gov (United States)

    Thomson, Rebecca L; Buckley, Jonathan D; Brinkworth, Grant D

    2016-03-09

    This study assessed the perceived benefits and barriers to exercise participation in overweight and obese women with polycystic ovary syndrome (PCOS) and monitored changes in response to a lifestyle intervention. Forty-three overweight/obese PCOS women (Age, 30.3(6.2) yrs; BMI, 36.4(5.6) kg/m(2)) were randomised to one of three 20-week lifestyle programs: diet only (DO, n = 13), diet and aerobic exercise (DA, n = 11) and diet and combined aerobic-resistance exercise (DC, n = 19). Exercise Benefits/Barriers Scale (EBBS), weight, aerobic fitness, depression and PCOS specific health-related quality of life were measured. Barriers score was related to depression (r = 0.45, P = 0.002) and aerobic fitness (r = -0.32, P = 0.04), while benefits score was related to aerobic fitness (r = 0.41, P = 0.007). EBBS, benefits and barriers scores improved overtime (P ≤ 0.001). Benefits subscales psychological outlook and social interaction increased (P ≤ 0.001) and life enhancement and preventative health did not change (P ≥ 0.3). Physical performance increased only in DA (P = 0.009). There were no differences between treatments for any of the other subscales (P ≥ 0.2). Barriers subscales exercise milieu, time expenditure and physical exertion reduced (P ≤ 0.003) and family discouragement did not change (P = 0.6). This study demonstrated that lifestyle modification consisting of an energy-restricted diet with or without exercise training improved the perceived benefits from and barriers to exercise. Australian New Zealand Clinical Trials Register ACTRN12606000198527, registered 26 May 2006.

  9. Identifying Facilitators and Barriers for Patient Safety in a Medicine Label Design System Using Patient Simulation and Interviews

    DEFF Research Database (Denmark)

    Dieckmann, Peter; Clemmensen, Marianne Hald; Sørensen, Trine Kart

    2016-01-01

    Objectives Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. Methods The study design is qualitative and explora......Objectives Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. Methods The study design is qualitative...... of the system and some inconsistencies (different meaning of colors) posed challenges, when considered with the actual application context, in which there is little time to get familiar with the design features. Conclusions For optimizing medicine labels and obtaining the full benefit of label design features...

  10. Older adults are mobile too!Identifying the barriers and facilitators to older adults' use of mHealth for pain management.

    Science.gov (United States)

    Parker, Samantha J; Jessel, Sonal; Richardson, Joshua E; Reid, M Cary

    2013-05-06

    Mobile health (mHealth) is a rapidly emerging field with the potential to assist older adults in the management of chronic pain (CP) through enhanced communication with providers, monitoring treatment-related side effects and pain levels, and increased access to pain care resources. Little is currently known, however, about older adults' attitudes and perceptions of mHealth or perceived barriers and facilitators to using mHealth tools to improve pain management. We conducted six focus groups comprised of 41 diverse older adults (≥60 years of age) with CP. Participants were recruited from one primary care practice and two multiservice senior community day-visit centers located in New York City that serve older adults in their surrounding neighborhoods. Focus group discussions were recorded and transcribed, and transcriptions were analyzed using direct content analysis to identify and quantify themes. Focus group discussions generated 38 individual themes pertaining to the use of mHealth to help manage pain and pain medications. Participants had low prior use of mHealth (5% of participants), but the vast majority (85%) were highly willing to try the devices. Participants reported that mHealth devices might help them reach their healthcare provider more expeditiously (27%), as well as help to monitor for falls and other adverse events in the home (15%). Barriers to device use included concerns about the cost (42%) and a lack of familiarity with the technology (32%). Facilitators to device use included training prior to device use (61%) and tailoring devices to the functional needs of older adults (34%). This study suggests that older adults with CP are interested and willing to use mHealth to assist in the management of pain. Participants in our study reported important barriers that medical professionals, researchers, and mHealth developers should address to help facilitate the development and evaluation of age-appropriate, and function-appropriate, m

  11. Identifying Barriers in the Use of Electronic Health Records in Hawai‘i

    Science.gov (United States)

    Hamamura, Faith D; Hughes, Kira

    2017-01-01

    Hawai‘i faces unique challenges to Electronic Health Record (EHR) adoption due to physician shortages, a widespread distribution of Medically Underserved Areas and Populations (MUA/P), and a higher percentage of small independent practices. However, research on EHR adoption in Hawai‘i is limited. To address this gap, this article examines the current state of EHR in Hawai‘i, the barriers to adoption, and the future of Health Information Technology (HIT) initiatives to improve the health of Hawai‘i's people. Eight focus groups were conducted on Lana‘i, Maui, Hawai‘i Island, Kaua‘i, Moloka‘i, and O‘ahu. In these groups, a total of 51 diverse health professionals were asked about the functionality of EHR systems, barriers to use, facilitators of use, and what EHRs would look like in a perfect world. Responses were summarized and analyzed based on constant comparative analysis techniques. Responses were then clustered into thirteen themes: system compatibility, loss of productivity, poor interface, IT support, hardware/software, patient factors, education/training, noise in the system, safety, data quality concerns, quality metrics, workflow, and malpractice concerns. Results show that every group mentioned system compatibility. In response to these findings, the Health eNet Community Health Record initiative — which allows providers web-based access to patient health information from the patient's provider network— was developed as a step toward alleviating some of the barriers to sharing information between different EHRs. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation will introduce a new payment model in 2017 that is partially based on EHR utilization. Therefore, more research should be done to understand EHR adoption and how this ruling will affect providers in Hawai‘i. PMID:28435756

  12. A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis.

    Science.gov (United States)

    Egerton, T; Diamond, L E; Buchbinder, R; Bennell, K L; Slade, S C

    2017-05-01

    Primary care management of osteoarthritis (OA) is variable and often inconsistent with clinical practice guidelines (CPGs). This study aimed to identify and synthesize available qualitative evidence on primary care clinicians' views on providing recommended management of OA. Eligibility criteria included full reports published in peer-reviewed journals, with data collected directly from primary care clinicians using qualitative methods for collection and analysis. Five electronic databases (MEDLINE, Cochrane Central Register, EMBASE, CINAHL and PsychInfo) were searched to August 2016. Two independent reviewers identified eligible reports, conducted critical appraisal (based on Critical Appraisal Skills Programme (CASP) criteria), and extracted data. Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive new themes. The Confidence in Evidence from Reviews of Qualitative research (CERQual) approach was used to determine a confidence profile for each finding. Eight studies involving approximately 83 general practitioners (GPs), 24 practice nurses, 12 pharmacists and 10 physical therapists, from Australia, France, United Kingdom, Germany and Mexico were included. Four barriers were identified as themes 1) OA is not that serious, 2) Clinicians are, or perceive they are, under-prepared, 3) Personal beliefs at odds with providing recommended practice, and 4) Dissonant patient expectations. No themes were enablers. Confidence ratings were moderate or low. Synthesising available data revealed barriers that collectively point towards a need to address clinician knowledge gaps, and enhance clinician communication and behaviour change skills to facilitate patient adherence, enable effective conversations and manage dissonant patient expectations. PROSPERO (http://www.crd.york.ac.uk/PROSPERO) [4/11/2015, CRD42015027543]. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  13. Identifying and intervening on barriers to healthcare access among members of a small Korean community in the southern USA.

    Science.gov (United States)

    Rhodes, Scott D; Song, Eunyoung; Nam, Sang; Choi, Sarah J; Choi, Seungyong

    2015-04-01

    We used community-based participatory research (CBPR) to explore barriers to healthcare access and utilization and identify potentially effective intervention strategies to increase access among members of the Korean community in North Carolina (NC). Our CBPR partnership conducted 8 focus groups with 63 adult Korean immigrants in northwest NC and 15 individual in-depth interviews and conducted an empowerment-based community forum. We identified 20 themes that we organized into four domains, including practical barriers to health care, negative perceptions about care, contingencies for care, and provider misconceptions about local needs. Forum attendees identified four strategies to improve Korean community health. Despite the implementation of the Patient Protection and Affordable Care Act (ACA), many Korean community members will continue to remain uninsured, and among those who obtain insurance, many barriers will remain. It is imperative to ensure the health of this highly neglected and vulnerable community. Potential strategies include the development of (1) low-literacy materials to educate members of the Korean community about how to access healthcare services, (2) lay health advisor programs to support navigation of service access and utilization, (3) church-based programming, and (4) provider education to reduce misconceptions about Korean community needs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Identifying the barriers to affirmative action training: Perceptions of affirmative action appointees in Mpumalanga public hospitals

    Directory of Open Access Journals (Sweden)

    Edward Rankhumise

    2010-11-01

    Research purpose: The aim of this study is to gauge the perceptions about existing barriers in the implementation of affirmative action (AA training interventions at public hospitals in the Mpumalanga Province. Motivations for the study: The research conducted in this study provides valuable information which would enable the Mpumalanga health department and public hospital management to develop improved interventions associated with AA training interventions. Research design, approach and method: The population of the study consists of two groups of participants which are AA appointees and AA mentors. The study mixed qualitative and quantitative research methodological processes. Main findings: Results of this study show that there are differences in perceptions between Black respondents who believe that mentors should be held liable for the failure of the mentees and White respondents who disagreed. The findings suggest that employees are of the opinion that internal policy guidelines on the implementation of AA are not communicated to all employees. Practical implications: Public hospital management should articulate the purpose of AA interventions and its targets to both mentors and mentees and continuously review the implementation thereof. Contribution: The study contributes towards explaining the importance of training interventions that are useful for the success of AA appointees in their respective duties and also give account of barriers that are experienced by these appointees.

  15. Influence of gender and race/ethnicity on perceived barriers to help-seeking for alcohol or drug problems.

    Science.gov (United States)

    Verissimo, Angie Denisse Otiniano; Grella, Christine E

    2017-04-01

    This study examines reasons why people do not seek help for alcohol or drug problems by gender and race/ethnicity using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey. Multivariate models were fit for 3 barriers to seeking help (structural, attitudinal, and readiness for change) for either alcohol or drug problems, controlling for socio-demographic characteristics and problem severity. Predicted probabilities were generated to evaluate gender differences by racial/ethnic subgroups. Over three quarters of the samples endorsed attitudinal barriers related to either alcohol or drug use. Generally, women were less likely to endorse attitudinal barriers for alcohol problems. African Americans and Latina/os were less likely than Whites to endorse attitudinal barriers for alcohol problems, Latina/os were less likely than Whites to endorse readiness for change barriers for alcohol and drug problems, however, African Americans were more likely to endorse structural barriers for alcohol problems. Comparisons within racial/ethnic subgroups by gender revealed more complex findings, although across all racial/ethnic groups women endorsed attitudinal barriers for alcohol problems more than men. Study findings suggest the need to tailor interventions to increase access to help for alcohol and drug problems that take into consideration both attitudinal and structural barriers and how these vary across groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Brief Report: Need for Autonomy and Other Perceived Barriers Relating to Adolescents' Intentions to Seek Professional Mental Health Care

    Science.gov (United States)

    Wilson, Coralie J.; Deane, Frank P.

    2012-01-01

    The current study examined the relationship between belief-based barriers to seeking professional mental health care and help-seeking intentions in a sample of 1037 adolescents. From early adolescence to adulthood, for males and females, the need for autonomy was a strong barrier to seeking professional mental health care. Help-seeking fears were…

  17. Examining emergency department communication through a staff-based participatory research method: identifying barriers and solutions to meaningful change.

    Science.gov (United States)

    Cameron, Kenzie A; Engel, Kirsten G; McCarthy, Danielle M; Buckley, Barbara A; Mercer Kollar, Laura Min; Donlan, Sarah M; Pang, Peter S; Makoul, Gregory; Tanabe, Paula; Gisondi, Michael A; Adams, James G

    2010-12-01

    We test an initiative with the staff-based participatory research (SBPR) method to elicit communication barriers and engage staff in identifying strategies to improve communication within our emergency department (ED). ED staff at an urban hospital with 85,000 ED visits per year participated in a 3.5-hour multidisciplinary workshop. The workshop was offered 6 times and involved: (1) large group discussion to review the importance of communication within the ED and discuss findings from a recent survey of patient perceptions of ED-team communication; (2) small group discussions eliciting staff perceptions of communication barriers and best practices/strategies to address these challenges; and (3) large group discussions sharing and refining emergent themes and suggested strategies. Three coders analyzed summaries from group discussions by using latent content and constant comparative analysis to identify focal themes. A total of 127 staff members, including attending physicians, residents, nurses, ED assistants, and secretaries, participated in the workshop (overall participation rate 59.6%; range 46.7% to 73.3% by staff type). Coders identified a framework of 4 themes describing barriers and proposed interventions: (1) greeting and initial interaction, (2) setting realistic expectations, (3) team communication and respect, and (4) information provision and delivery. The majority of participants (81.4%) reported that their participation would cause them to make changes in their clinical practice. Involving staff in discussing barriers and facilitators to communication within the ED can result in a meaningful process of empowerment, as well as the identification of feasible strategies and solutions at both the individual and system levels. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  18. Dentist-Perceived Barriers and Attractors to Cognitive-Behavioral Treatment Provided by Mental Health Providers in Dental Practices.

    Science.gov (United States)

    Heyman, R E; Wojda, A K; Eddy, J M; Haydt, N C; Geiger, J F; Slep, A M Smith

    2018-02-01

    Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials-with 2 meta-analyses finding strong average effect sizes ( d > 1)-CBT has received almost no dissemination beyond the specialty clinics that tested it. The challenge, then, is not how to treat dental fear but how to disseminate and implement such an evidence-based treatment in a way that recognizes the rewards and barriers in the US health care system. This mixed-method study investigated the potential of disseminating CBT through care from a mental health provider from within the dental home, a practice known as evidence-based collaborative care (EBCC). Two preadoption studies were conducted with practicing dentists drawn from a self-organized Practice-Based Research Network in the New York City metropolitan area. The first comprised 3 focus groups ( N = 17), and the second involved the administration of a survey ( N = 46). Focus group participants agreed that CBT for dental fear is worthy of consideration but identified several concerns regarding its appeal, feasibility, and application in community dental practices. Survey participants indicated endorsement of factors promoting the use of EBCC as a mechanism for CBT dissemination, with no factors receiving less than 50% support. Taken together, these findings indicate that EBCC may be a useful framework through which an evidence-based treatment for dental fear treatment can be delivered.

  19. Perceived experiences of discrimination in health care: a barrier for cancer screening among American Indian women with type 2 diabetes.

    Science.gov (United States)

    Gonzales, Kelly L; Harding, Anna K; Lambert, William E; Fu, Rongwei; Henderson, William G

    2013-01-01

    Breast and cervical cancer-mortality disparities are prominent among American Indian women. These disparities, in part, may result from patients perceived experiences of discrimination in health care. This report evaluates the impact of perceived discrimination on screening for breast and cervical cancer in a sample of 200 American Indian women with type 2 diabetes. Data were collected from patient report and medical records. Prevalence of breast and cervical cancer screening were assessed. Unadjusted and adjusted logistic regression analyses were used to assess associations between perceived discrimination, cancer screening status, and patients' health care-seeking behaviors. Substantial proportions of AI women in our sample were behind the recommended schedules of screening for breast and cervical cancer. Adjusted estimates revealed that perceived discrimination was significantly associated with not being current for clinical breast examination and Pap test, and was close to statistical significance with not being current for mammography. The number of suboptimal health care-seeking behaviors increased with higher mean levels of perceived discrimination. Among AI women, perceived discrimination in health care may negatively influence use of breast and cancer screening services, and health care-seeking behaviors. More research is needed among AIs to examine features of health care systems related to the phenomenon patients perceived experience of discrimination. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  20. How physicians identify with predetermined personalities and links to perceived performance and wellness outcomes: a cross-sectional study.

    Science.gov (United States)

    Lemaire, Jane B; Wallace, Jean E

    2014-11-29

    these personalities enhance professional performance may reinforce the harmful behaviors associated with poor wellness outcomes. Future research should further explore links between physician personality, perceptions of performance and actual performance, and more definitively address whether the perceived benefits offered by identifying with the workaholic personality are enough to counter the potential costs to physician wellness.

  1. Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.

    Science.gov (United States)

    Bank, Ilana; Snell, Linda; Bhanji, Farhan

    2014-12-01

    Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients. Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop. Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P < 0.008), delegating tasks appropriately (P < 0.009), and ability to ensure closed-loop communication (P < 0.008). There was a significant improvement in identification of CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P < 0.006). The pediatric CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.

  2. People who perceive themselves as active cannot identify the intensity recommended by the international physical activity guidelines

    Directory of Open Access Journals (Sweden)

    Prokop NW

    2014-10-01

    Full Text Available Neal W Prokop,1 Travis JR Hrubeniuk,1 Martin Sénéchal,2,3 Danielle R Bouchard1,4 1Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada; 2Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada; 3Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; 4Health, Leisure, and Human Performance Research Institute, Winnipeg, Manitoba, Canada Background: Many national and international organizations recommend that adults achieve at least 150 minutes of aerobic physical activity (PA weekly, at a minimum moderate intensity to optimize health benefits. It is unknown if people who consider themselves as active have the ability to identify what is considered moderate intensity. Methods: Fifty-one participants who reported achieving a minimum 150 minutes per week at a minimum of moderate intensity PA were recruited through a local fitness facility. All participants underwent a single assessment involving questionnaires, clinical measures, and a treadmill test to measure the ability to perceive moderate intensity. Following the visit, participants' PA level was evaluated by heart rate monitor, while exercising, for 7 consecutive days. Results: Eighty percent of participants overestimated moderate intensity on the treadmill test; they were at vigorous intensity compared to what is considered moderate. Only 11.8% of participants accurately identified moderate intensity; all of them were women (P=0.03, had a high level of education (P=0.04, and knew that moderate intensity was the minimum intensity recommended by health organizations (P<0.01. Only 69.2% of participants reached the aerobic component of the International Physical Activity Guidelines with no significant advantage for those correctly identifying moderate intensity. Conclusion: Most people who perceive themselves as active are exercising at vigorous intensity while believing they are

  3. Applying an Evidence-Based Assessment Model to Identify Students at Risk for Perceived Academic Problems following Concussion.

    Science.gov (United States)

    Ransom, Danielle M; Burns, Alison R; Youngstrom, Eric A; Vaughan, Christopher G; Sady, Maegan D; Gioia, Gerard A

    2016-11-01

    The aim of this study was to demonstrate the utility of an evidence-based assessment (EBA) model to establish a multimodal set of tools for identifying students at risk for perceived post-injury academic problems. Participants included 142 students diagnosed with concussion (age: M=14.95; SD=1.80; 59% male), evaluated within 4 weeks of injury (median=16 days). Demographics, pre-injury history, self- and parent-report measures assessing symptom severity and executive functions, and cognitive test performance were examined as predictors of self-reported post-injury academic problems. Latent class analysis categorized participants into "high" (44%) and "low" (56%) levels of self-reported academic problems. Receiver operating characteristic analyses revealed significant discriminative validity for self- and parent-reported symptom severity and executive dysfunction and self-reported exertional response for identifying students reporting low versus high academic problems. Parent-reported symptom ratings [area under the receiver operating characteristic curve (AUC)=.79] and executive dysfunction (AUC=.74), and self-reported ratings of executive dysfunction (AUC=.84), symptoms (AUC=.80), and exertional response (AUC=.70) each classified students significantly better than chance (psperspective in the management of concussion by applying traditional strengths of neuropsychological assessment to clinical decision making. (JINS, 2016, 22, 1038-1049).

  4. Overcoming barriers to work participation for patients with postpoliomyelitis syndrome

    NARCIS (Netherlands)

    ten Katen, Kim; Beelen, Anita; Nollet, Frans; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2011-01-01

    Purpose. This study aimed to explore the perceived work ability of patients with postpoliomyelitis syndrome (PPS), to identify barriers and factors that are impeding or conducive, respectively, to work participation, and to identify possible interventions. Methods. Qualitative cross-sectional

  5. Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan.

    Science.gov (United States)

    Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza

    2015-03-06

    A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.

  6. Perceived Barriers to Utilizing Maternal and Neonatal Health Services in Contracted-Out Versus Government-Managed Health Facilities in the Rural Districts of Pakistan

    Directory of Open Access Journals (Sweden)

    Atif Riaz

    2015-05-01

    Full Text Available Background A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted. Methods A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies.

  7. Perceived barriers and enablers to participation in a community-tailored physical activity program with Indigenous Australians in a regional and rural setting: a qualitative study.

    Science.gov (United States)

    Sushames, Ashleigh; Engelberg, Terry; Gebel, Klaus

    2017-09-18

    Aboriginal and Torres Strait Islander people have higher rates of chronic disease and a lower life expectancy than non-Indigenous Australians. In non-urban areas these health disparities are even larger. The aim of this qualitative study was to explore perceived barriers and enablers to attending an eight-week physical activity program in a rural and regional setting which aimed to improve health outcomes, but had a low attendance rate. Thirty-four Indigenous Australians participated in the intervention from the rural (n = 12) and the regional (n = 22) community. Qualitative semi-structured individual interviews were conducted at the follow-up health assessments with 12 participants. A thematic network analysis was undertaken to examine the barriers and enablers to participation in the program. Overall, there were positive attitudes to, and high levels of motivation towards, the physical activity program. Enablers to participation were the inclusion of family members, no financial cost and a good relationship with the principal investigator, which was strengthened by the community-based participatory approach to the program design. Barriers to program attendance were mostly beyond the control of the individuals, such as 'sorry business', needing to travel away from the community and lack of community infrastructure. More consideration is needed prior to implementation of programs to understand how community-specific barriers and enablers will affect attendance to the program. ACTRN12616000497404 . Registered 18 April 2016.

  8. Sexually Transmitted Infection Services for Adolescents and Youth in Low- and Middle-Income Countries: Perceived and Experienced Barriers to Accessing Care.

    Science.gov (United States)

    Newton-Levinson, Anna; Leichliter, Jami S; Chandra-Mouli, Venkatraman

    2016-07-01

    Access to sexual and reproductive health (SRH) services is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001 and 2014 with a study population of youth (aged 10-24 years) and/or health service providers. Nineteen studies were identified for inclusion from 15 countries. Thematic analyses identified key themes across the studies. Findings suggest that youth lacked knowledge about STIs and services. In addition, youth experienced barriers related to service availability and a lack of integration of services. The most reported barriers were related to acceptability of services. Youth reported avoiding services or having confidentiality concerns based on provider demographics and some behaviors. Finally, experiences of shame and stigma were common barriers to seeking care. Adolescents in low- and middle-income countries experience significant barriers in obtaining STI and SRH services. Improving uptake may require efforts to address clinic systems and provider attitudes, including confidentiality issues. Moreover, addressing barriers to STI services may require addressing cultural norms related to adolescent sexuality. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

  9. Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

    Science.gov (United States)

    Mishra, Mark V; Bennett, Michele; Vincent, Armon; Lee, Olivia T; Lallas, Costas D; Trabulsi, Edouard J; Gomella, Leonard G; Dicker, Adam P; Showalter, Timothy N

    2013-01-01

    Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS. English-language ICs regarding prostate cancer (PC) treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI) was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC)-(#Negative IC/#Total IC) x 100]. A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS. This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS.

  10. Born to roam? Surveying cat owners in Tasmania, Australia, to identify the drivers and barriers to cat containment.

    Science.gov (United States)

    McLeod, Lynette J; Hine, Donald W; Bengsen, Andrew J

    2015-12-01

    Free-roaming domestic cats, Felis catus, are a major public nuisance in neighbourhoods across the world, and have been linked to biodiversity loss and a host of community health problems. Owners who let their cats roam, also place their cats at risk of serious injury. One management strategy that is gaining considerable support involves encouraging cat owners to contain their pets within their property. Contemporary behaviour change models highlight the importance of identifying drivers and barriers that encourage and discourage target behaviours such as cat containment. Results from a random dial phone survey of 356 cat owners in northern Tasmania identified four distinct cat containment profiles: owners who contained their cat all the time, owners who only contained their cat at night, owners who sporadically contained their cat with no set routine, and owners who made no attempt to contain their pet. Our results indicated that cat-owners' decisions to contain or not contain their cats were guided by a range of factors including owners' beliefs about their ability to implement an effective containment strategy and their views about the physical and psychological needs of their cats. The results are discussed in terms of improving the behavioural effectiveness of cat containment interventions by selecting appropriate behavioural change tools for the identified drivers and barriers, and developing targeted engagement strategies and messaging. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Psychological distress in student nurses undertaking an educational programme with professional registration as a nurse: Their perceived barriers and facilitators in seeking psychological support.

    Science.gov (United States)

    Mitchell, A E P

    2018-05-01

    student population by focusing on student nurses. It quantitatively assesses psychological distress with comparative norms and investigates service uptake in a single study. Aim The aim of this study was to investigate the level of psychological distress in students and compare this with population norms and highlight potential facilitators and barriers to help seeking. Methods This study recruited N = 121 student nurses from one university in a cross-sectional design. Data were analysed using descriptive statistics, independent t tests and one-way ANOVAs. Findings The key findings show high levels of psychological distress, which is above levels seen in the general population. The main barriers to seeking support were fear of disclosure and the perceived impact on their suitability as a student nurse. Discussion The study highlights that high levels of distress identified in the literature are seen in student nurses and that fear of disclosure may account for some not seeking support. Relevance The fear of disclosure and low levels of seeking support suggest there is a need for mental health nurses and academics to play a key role in mental health literacy and evidence-based interventions such as mindfulness to combat these issues. © 2018 John Wiley & Sons Ltd.

  12. Perceived barriers and facilitators to physical activity in men with prostate cancer: possible influence of androgen deprivation therapy.

    Science.gov (United States)

    Keogh, J W L; Patel, A; MacLeod, R D; Masters, J

    2014-03-01

    While physical activity is beneficial for men with prostate cancer, too few perform sufficient activity for such benefit. This study examined perceptions of men with prostate cancer of their barriers and facilitators to physical activity, and how androgen deprivation therapy (ADT) may influence these perceptions. Two focus groups were conducted, involving six ADT and eight non-ADT patients respectively. Data were transcribed verbatim and themes developed using a general inductive thematic approach. Facilitators to physical activity common to both groups of cancer survivors included clinician and spousal involvement, with pre-existing co-morbidities and increased age cited as barriers by both groups. The ADT subgroup cited personal involvement as a facilitator to physical activity, with fatigue, reduced motivation and a relative lack of specific advice from their clinician as additional barriers. The non-ADT subgroup had no additional facilitators to physical activity but cited time constraints as a barrier. These results highlight the important role that cancer clinicians and spouses play in promoting physical activity for men with prostate cancer and how ADT may influence their other facilitators and barriers. As physical activity is beneficial for prostate cancer survivors, especially those on ADT, cancer clinicians should regularly discuss physical activity with their patients. © 2013 John Wiley & Sons Ltd.

  13. What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Reardon, Tessa; Harvey, Kate; Baranowska, Magdalena; O'Brien, Doireann; Smith, Lydia; Creswell, Cathy

    2017-06-01

    A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.

  14. Combination HIV Prevention Strategy Implementation in El Salvador: Perceived Barriers and Adaptations Reported by Outreach Peer Educators and Supervisors

    Directory of Open Access Journals (Sweden)

    Meredith Buck

    2017-04-01

    Full Text Available El Salvador was one of three countries to receive funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria to conduct a combination HIV prevention intervention among transwomen (TW, men who have sex with men (MSM, and commercial sex workers (CSW. Program evaluation revealed that prevention activities reached only 50% of the target population. The purpose of this study is to examine the barriers that Salvadoran educators faced in implementing the peer education as designed and adaptations made as a result. Between March and June 2015, 18 in-depth interviews with educators were conducted. Violence was reported as the biggest barrier to intervention implementation. Other barriers differed by subpopulation. The level of violence and discrimination calls into question the feasibility and appropriateness of peer-led interventions in the Salvadoran context and demonstrates the importance of implementation research when translating HIV prevention interventions developed in high-income countries to low- and middle-income countries.

  15. Seeking Sepsis in the Emergency Department- Identifying Barriers to Delivery of the Sepsis 6.

    Science.gov (United States)

    Bentley, James; Henderson, Susan; Thakore, Shobhan; Donald, Michael; Wang, Weijie

    2016-01-01

    The Sepsis 6 is an internationally accepted management bundle that, when initiated within one hour of identifying sepsis, can reduce morbidity and mortality. This management bundle was advocated by the Scottish Patient Safety Programme as part of its Acute Adult campaign launched in 2008 and adopted by NHS Tayside in 2012. Despite this, the Emergency Department (ED) of Ninewells Hospital, a tertiary referral centre and major teaching hospital in Scotland, was displaying poor success in the Sepsis 6. We therefore set out to improve compliance by evaluating the application of all aspects of the NHS Tayside Sepsis 6 bundle within one hour of ED triage time, to identify what human factors may influence achieving the one hour The Sepsis 6 bundle. This allowed us to tailor a number of specific interventions including educational sessions, regular audit and personal feedback and check list Sepsis 6 sticker. These interventions promoted a steady increase in compliance from an initial rate of 51.0% to 74.3%. The project highlighted that undifferentiated patients create a challenge in initiating the Sepsis 6. Pyrexia is a key human factor-trigger for recognising sepsis with initial nursing assessment being vital in recognition and identifying the best area (resus) of the department to manage severely septic patients. EDs need to recognise these challenges and develop educational and feedback plans for staff and utilise available resources to maximise the Sepsis 6 compliance.

  16. Breaking barriers to interoperability: assigning spatially and temporally unique identifiers to spaces and buildings.

    Science.gov (United States)

    Pyke, Christopher R; Madan, Isaac

    2013-08-01

    The real estate industry routinely uses specialized information systems for functions, including design, construction, facilities management, brokerage, tax assessment, and utilities. These systems are mature and effective within vertically integrated market segments. However, new questions are reaching across these traditional information silos. For example, buyers may be interested in evaluating the design, energy efficiency characteristics, and operational performance of a commercial building. This requires the integration of information across multiple databases held by different institutions. Today, this type of data integration is difficult to automate and propone to errors due, in part, to the lack of generally accepted building and spaces identifiers. Moving forward, the real estate industry needs a new mechanism to assign identifiers for whole buildings and interior spaces for the purpose of interoperability, data exchange, and integration. This paper describes a systematic process to identify activities occurring at building or within interior spaces to provide a foundation for exchange and interoperability. We demonstrate the application of the approach with a prototype Web application. This concept and demonstration illustrate the elements of a practical interoperability framework that can increase productivity, create new business opportunities, and reduce errors, waste, and redundancy. © 2013 New York Academy of Sciences.

  17. Identifying role of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

    Science.gov (United States)

    Karim, Rizwanul M; Abdullah, Mamun S; Rahman, Anisur M; Alam, Ashraful M

    2016-06-24

    Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 community clinics. Since most of the outcome indicators focus mainly on women and children, women having children less than 2 years of age were randomly assigned and interviewed for the study purpose. Data were collected through FGD, Key informants interview and a pretested semi- structured questionnaire. About 95 % of the respondents were Muslims and 5 % were Hindus. The average age of the respondents was 23.38 (SD 4.15) and almost all of them are home makers. The average monthly expenditure of their family was 95US $ (SD 32US$). At the beginning of the study, two psychometric research instruments; 24 items perceived quality of primary care services PQPCS scale (chronbach's α = .89) and 22 items community clinic service satisfaction CCSS scale (chronbach's α = .97), were constructed and validated. This study showed less educated, poor, landless mothers utilized the community clinic services more than their educated and wealthier counterpart. Women who lived in their own residence used the community clinic services more frequently than those who lived in a rental house. Perceptions concerning skill and competence of the health care provider and satisfaction indicating interpersonal communication and attitude of the care provider were important predictors for community clinic service utilization

  18. Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: a case study in Zambia.

    Science.gov (United States)

    Ridge, Anna L; Bero, Lisa A; Hill, Suzanne R

    2010-12-16

    Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4) should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. A 'fishbone' (Ishikawa) diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical practice. A better understanding of the supply system and of the pattern

  19. Identifying barriers to the availability and use of Magnesium Sulphate Injection in resource poor countries: A case study in Zambia

    Directory of Open Access Journals (Sweden)

    Hill Suzanne R

    2010-12-01

    Full Text Available Abstract Background Pre-eclampsia and eclampsia are serious complications of pregnancy and major causes of maternal mortality and morbidity worldwide. According to systematic reviews and WHO guidelines magnesium sulphate injection (MgSO4 should be the first -line treatment for severe pre-eclampsia and eclampsia. Studies have shown that this safe and effective medicine is unavailable and underutilized in many resource poor countries. The objective of this study was to identify barriers to the availability and use of MgSO4 in the Zambian Public Health System. Methods A 'fishbone' (Ishikawa diagram listing probable facilitators to the availability and use of MgSO4 identified from the literature was used to develop an assessment tool. Barriers to availability and use of MgSO4 were assessed at the regulatory/government, supply, procurement, distribution, health facility and health professional levels. The assessment was completed during August 2008 using archival data, and observations at a pragmatic sample of health facilities providing obstetric services in Lusaka District, Zambia. Results The major barrier to the availability of MgSO4 within the public health system in Zambia was lack of procurement by the Ministry of Health. Other barriers identified included a lack of demand by health professionals at the health centre level and a lack of in-service training in the use of MgSO4. Where there was demand by obstetricians, magnesium sulphate injection was being procured from the private sector by the hospital pharmacy despite not being registered and licensed for use for the treatment of severe pre-eclampsia and eclampsia by the national Pharmaceutical Regulatory Authority. Conclusions The case study in Zambia highlights the complexities that underlie making essential medicines available and used appropriately. The fishbone diagram is a useful theoretical framework for illustrating the complexity of translating research findings into clinical

  20. Anxiety sensitivity explains associations between anxious arousal symptoms and smoking abstinence expectancies, perceived barriers to cessation, and problems experienced during past quit attempts among low-income smokers.

    Science.gov (United States)

    Zvolensky, Michael J; Paulus, Daniel J; Langdon, Kirsten J; Robles, Zuzuky; Garey, Lorra; Norton, Peter J; Businelle, Michael S

    2017-05-01

    Disproportionately more smokers report low-income and mental health problems relative to non-smokers. Low-income smokers may use smoking to alleviate negative emotional states resulting from exposure to multiple stressors. Yet, little work has been devoted to elucidating mechanisms that may explain the association between negative emotional states and smoking-related processes among low-income smokers. The present study sought to address this gap by examining anxiety sensitivity, a transdiagnostic factor related to both anxiety and smoking, as a potential mediator for the influence of anxiety symptoms on smoking-related processes, including threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. Participants included treatment-seeking daily cigarette smokers (n=101; 68.3% male; M age =47.1; SD=10.2). Results indicated that anxiety symptoms exerted a significant indirect effect through anxiety sensitivity for threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. The present results provide empirical support that anxiety sensitivity may be an underlying mechanism that partially explains the relation between anxiety symptoms and smoking processes among low-income treatment-seeking smokers. Findings broaden current theoretical understanding of pathways through which anxiety symptoms contribute to maladaptive smoking processes and cognitions among socioeconomically disadvantaged smokers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. A qualitative exploration of participants' experiences of taking part in a walking programme: Perceived benefits, barriers, choices and use of intervention resources.

    Science.gov (United States)

    Mitchell, Fiona; Stalker, Kirsten; Matthews, Lynsay; Mutrie, Nanette; Melling, Chris; McConnachie, Alex; Murray, Heather; Melville, Craig A

    2018-01-01

    Adults with intellectual disabilities (ID) experience significant inequalities and tend to be more sedentary and less physically active than the wider population. Walking programmes are an effective way to increase physical activity (PA) but have not been used in studies involving adults with intellectual disabilities. Nineteen adults with intellectual disabilities participated in semistructured interviews or focus groups exploring their experiences of taking part in a walking programme (Walk Well). Data were coded using thematic analysis. Four overarching themes emerged: perceived benefits of taking part in the programme, perceived drawbacks/ barriers, walking choices and using the Walk Well resources. While there was not a significant increase in walking for all, the participants reported positive experiences of taking part in the programme. Self-monitoring proved difficult for some, particularly reading the daily step count recorded on the pedometer and writing it in the diary. Carers also played an important role in facilitating and preventing behaviour change in adults with intellectual disabilities. Additional barriers prevent many adults with intellectual disabilities from participating in PA. Capturing participant experiences provides important information for designing effective and equitable health improvement programmes. © 2016 John Wiley & Sons Ltd.

  2. Stuck in tradition-A qualitative study on barriers for implementation of evidence-based nutritional care perceived by nursing staff.

    Science.gov (United States)

    O Connell, Malene Barfod; Jensen, Pia Søe; Andersen, Signe Lindgård; Fernbrant, Cecilia; Nørholm, Vibeke; Petersen, Helle Vendel

    2018-02-01

    To explore the barriers for nutritional care as perceived by nursing staff at an acute orthopaedic ward, aiming to implement evidence-based nutritional care. Previous studies indicate that nurses recognise nutritional care as important, but interventions are often lacking. These studies show that a range of barriers influence the attempt to optimise nutritional care. Before the implementation of evidence-based nutritional care, we examined barriers for nutritional care among the nursing staff. Qualitative study. Four focus groups with thirteen members of the nursing staff were interviewed between October 2013-June 2014. The interview guide was designed according to the Theoretical Domains Framework. The interviews were analysed using qualitative content analysis. Three main categories emerged: lacking common practice, failing to initiate treatment and struggling with existing resources. The nursing staff was lacking both knowledge and common practice regarding nutritional care. They felt they protected patient autonomy by accepting patient's reluctance to eat or getting a feeding tube. The lack of nutritional focus from doctors decreased the nursing staffs focus leading to nonoptimal nutritional treatment. Competing priorities, physical setting and limited nutritional supplements were believed to hinder nutritional care. The results suggest that nutritional care is in a transitional state from experience- to evidence-based practice. Barriers for nutritional care are grounded in lack of knowledge among nursing staff and insufficient collaboration between nursing staff and the doctors. There is a need for nutritional education for the nursing staff and better support from the organisation to help nursing staff provide evidence-based nutritional care. This study contributes with valuable knowledge before the implementation of evidence-based nutritional care. The study provides an understanding of barriers for nutritional care and presents explanations to why

  3. Should I Stay or Should I Go? Perceived Barriers to Pursuing a University Education for Persons in Rural Areas

    Science.gov (United States)

    Friesen, Laura; Purc-Stephenson, R. J.

    2016-01-01

    A university education can provide an individual with greater employment options, higher income potential, and improved health and quality of life, yet young persons from rural areas remain less likely to attend university than their urban counterparts. This study explores the perceived personal, social, and cultural factors that might create…

  4. Perceived Advantages of 3D Lessons in Constructive Learning for South African Student Teachers Encountering Learning Barriers

    Science.gov (United States)

    de Jager, Thelma

    2017-01-01

    Research shows that three-dimensional (3D)-animated lessons can contribute to student teachers' effective learning and comprehension, regardless of the learning barriers they experience. Student teachers majoring in the subject Life Sciences in General Subject Didactics viewed 3D images of the heart during lectures. The 3D images employed in the…

  5. Perceived barriers to and facilitators of physical activity in young adults with childhood-onset physical disabilities

    NARCIS (Netherlands)

    Buffart, L.M.; Westendorp, T.; Berg-Emons, van den R.J.; Stam, H.; Roebroeck, M.E.

    2009-01-01

    OBJECTIVE: To explore the main barriers to and facilitators of physical activity in young adults with childhood-onset physical disabilities. DESIGN: Qualitative study using focus groups. PARTICIPANTS: Sixteen persons (12 men and 4 women) aged 22.4 (standard deviation 3.4) years, of whom 50% were

  6. The Impact of Perceived Barriers, Academic Anxiety, and Resource Management Strategies on Achievement in First-Year Community College Students

    Science.gov (United States)

    Heller, Monica L.; Cassady, Jerrell C.

    2017-01-01

    The current study explored the impact of internal and external barriers (e.g., academic anxiety, employment) that place subgroups of college students at risk for academic failure in the first year. The mitigating potential of academic resource management strategies (e.g., time-study environment) was also examined. In a sample of 885 first-semester…

  7. Identifying Barriers and Enablers in the Dietary Management of Type 2 Diabetes in M'Bour, Senegal.

    Science.gov (United States)

    Foley, Evan; BeLue, Rhonda

    2017-07-01

    The purpose of this study was to identify cultural enablers and barriers to dietary management of type 2 diabetes in M'Bour, Senegal. This qualitative study used the PEN-3 cultural model to explore diabetes dietary management within a cultural framework. Content analysis identified emergent themes based on the PEN-3 model. Forty-one individuals completed interviews. Themes reflecting ways that culture affects adherence to the diabetic diet included (a) having a different diet or eating separately from the communal family plate creates feelings of social isolation; (b) forgoing the diabetic diet sometimes occurs so that family members have enough food; (c) reducing servings of traditional foods feels like abandoning culture; and (d) women being responsible for preparing food, while men typically manage money for purchasing food yet do not provide input on what food is purchased. Results suggest that educating family units on the dietary management of diabetes may be more effective than individual education.

  8. Combining clinical practice and academic work in nursing: A qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

    Science.gov (United States)

    van Oostveen, Catharina J; Goedhart, Nicole S; Francke, Anneke L; Vermeulen, Hester

    2017-12-01

    To obtain in-depth insight into the perceptions of nurse academics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Combining clinical practice and academic work facilitates the use of research findings for high-quality patient care. However, nurse academics move away from the bedside because clinical academic careers for nurses have not yet been established in the Netherlands. This qualitative study was conducted in two Dutch university hospitals and their affiliated medical faculties and universities of applied sciences. Data were collected between May 2015 and August 2016. We used purposive sampling for 24 interviews. We asked 14 participants in two focus groups for their perceptions of importance, facilitators and barriers in nurses' combined clinical and academic work in education and research. We audiotaped, transcribed and thematically analysed the interviews and focus groups. Three themes related to perceived importance, facilitators and barriers: culture, leadership and infrastructure. These themes represent deficiencies in facilitating clinical academic careers for nurses. The current nursing culture emphasises direct patient care, which is perceived as an academic misfit. Leadership is lacking at all levels, resulting in the underuse of nurse academics and the absence of supporting structures for nurses who combine clinical and academic work. The present nursing culture appears to be the root cause of the dearth of academic positions and established clinical academic posts. A culture change would require a show of leadership that would promote and enable combined research, teaching and clinical practice and that would introduce clinical academic career pathways for nurses. Meanwhile, nurse academics should collaborate with established medical academics for whom combined roles are mainstream, and they should take advantage of their established infrastructure

  9. Perceived Social-Ecological Barriers of Generalist Pre-Service Teachers towards Teaching Physical Education: Findings from the GET-PE Study

    Science.gov (United States)

    Hyndman, Brendon P.

    2017-01-01

    Identifying and understanding the perceptions of pre-service teachers (PSTs) is vital to informing teaching practices. The purpose of the "Generalist Entry into Teaching Physical Education" (GET-PE) study was to investigate Australian generalist PSTs' perceptions of the barriers to teaching physical education (PE) classes. A…

  10. The Genomic Landscape of Renal Oncocytoma Identifies a Metabolic Barrier to Tumorigenesis

    Directory of Open Access Journals (Sweden)

    Shilpy Joshi

    2015-12-01

    Full Text Available Oncocytomas are predominantly benign neoplasms possessing pathogenic mitochondrial mutations and accumulation of respiration-defective mitochondria, characteristics of unknown significance. Using exome and transcriptome sequencing, we identified two main subtypes of renal oncocytoma. Type 1 is diploid with CCND1 rearrangements, whereas type 2 is aneuploid with recurrent loss of chromosome 1, X or Y, and/or 14 and 21, which may proceed to more aggressive eosinophilic chromophobe renal cell carcinoma (ChRCC. Oncocytomas activate 5′ adenosine monophosphate-activated protein kinase (AMPK and Tp53 (p53 and display disruption of Golgi and autophagy/lysosome trafficking, events attributed to defective mitochondrial function. This suggests that the genetic defects in mitochondria activate a metabolic checkpoint, producing autophagy impairment and mitochondrial accumulation that limit tumor progression, revealing a novel tumor-suppressive mechanism for mitochondrial inhibition with metformin. Alleviation of this metabolic checkpoint in type 2 by p53 mutations may allow progression to eosinophilic ChRCC, indicating that they represent higher risk.

  11. Identifying influence of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

    Science.gov (United States)

    Karim, R M; Abdullah, M S; Rahman, A M; Alam, A M

    2015-04-01

    Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire. About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD ± 4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD ± 2545) BDT equivalent to 95 (SD ± 32) US$. To measure lay peoples' perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad's 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach's α =0.89) and 22-items Community Clinic

  12. A concept mapping approach to identifying the barriers to implementing an evidence-based sports injury prevention programme.

    Science.gov (United States)

    Donaldson, Alex; Callaghan, Aisling; Bizzini, Mario; Jowett, Andrew; Keyzer, Patrick; Nicholson, Matthew

    2018-01-20

    Understanding the barriers to programme use is important to facilitate implementation of injury prevention programmes in real-word settings. This study investigated the barriers to coaches of adolescent female soccer teams, in Victoria, Australia, implementing the evidence-based FIFA 11+ injury prevention programme. Concept mapping with data collected from 19 soccer coaches and administrators. Brainstorming generated 65 statements as barriers to 11+ implementation. After the statements were synthesised and edited, participants sorted 59 statements into groups (mean, 6.2 groups; range, 3-10 groups). Multidimensional scaling and hierarchical cluster analysis identified a six-cluster solution: Lack of 11+ knowledge among coaches (15 statements), Lack of player enjoyment and engagement (14), Lack of link to football-related goals (11), Lack of facilities and resources (8), Lack of leadership (6) and Lack of time at training (5). Statements in the 'Lack of 11+ knowledge among coaches' cluster received the highest mean importance (3.67 out of 5) and feasibility for the Football Federation to address (3.20) rating. Statements in the 'Lack of facilities and resources' cluster received the lowest mean importance rating (2.23), while statements in the 'Lack of time at training' cluster received the lowest mean feasibility rating (2.19). A multistrategy, ecological approach to implementing the 11+-with specific attention paid to improving coach knowledge about the 11+ and how to implement it, linking the 11+ to the primary goal of soccer training, and organisational leadership-is required to improve the uptake of the 11+ among the targeted coaches. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. STI Services for Adolescents and Youth in Low and Middle Income Countries: Perceived and Experienced Barriers to Accessing Care

    OpenAIRE

    Newton-Levinson, Anna; Leichliter, Jami S.; Chandra-Mouli, Venkatraman

    2016-01-01

    Access to sexual and reproductive health services (SRH) is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001?2014 with a study population of youth (aged 10?24 years) an...

  14. Building resilience into practical conservation: identifying local management responses to global climate change in the southern Great Barrier Reef

    Science.gov (United States)

    Maynard, J. A.; Marshall, P. A.; Johnson, J. E.; Harman, S.

    2010-06-01

    Climate change is now considered the greatest long-term threat to coral reefs, with some future change inevitable despite mitigation efforts. Managers must therefore focus on supporting the natural resilience of reefs, requiring that resilient reefs and reef regions be identified. We develop a framework for assessing resilience and trial it by applying the framework to target management responses to climate change on the southern Great Barrier Reef. The framework generates a resilience score for a site based on the evaluation of 19 differentially weighted indicators known or thought to confer resilience to coral reefs. Scores are summed, and sites within a region are ranked in terms of (1) their resilience relative to the other sites being assessed, and (2) the extent to which managers can influence their resilience. The framework was applied to 31 sites in Keppel Bay of the southern Great Barrier Reef, which has a long history of disturbance and recovery. Resilience and ‘management influence potential’ were both found to vary widely in Keppel Bay, informing site selection for the staged implementation of resilience-based management strategies. The assessment framework represents a step towards making the concept of resilience operational to reef managers and conservationists. Also, it is customisable, easy to teach and implement and effective in building support among local communities and stakeholders for management responses to climate change.

  15. Using the ecological framework to identify barriers and enablers to implementing Namaste Care in Canada's long-term care system.

    Science.gov (United States)

    Hunter, Paulette V; Kaasalainen, Sharon; Froggatt, Katherine A; Ploeg, Jenny; Dolovich, Lisa; Simard, Joyce; Salsali, Mahvash

    2017-10-01

    Higher acuity of care at the time of admission to long-term care (LTC) is resulting in a shorter period to time of death, yet most LTC homes in Canada do not have formalized approaches to palliative care. Namaste Care is a palliative care approach specifically tailored to persons with advanced cognitive impairment who are living in LTC. The purpose of this study was to employ the ecological framework to identify barriers and enablers to an implementation of Namaste Care. Six group interviews were conducted with families, unlicensed staff, and licensed staff at two Canadian LTC homes that were planning to implement Namaste Care. None of the interviewees had prior experience implementing Namaste Care. The resulting qualitative data were analyzed using a template organizing approach. We found that the strongest implementation enablers were positive perceptions of need for the program, benefits of the program, and fit within a resident-centred or palliative approach to care. Barriers included a generally low resource base for LTC, the need to adjust highly developed routines to accommodate the program, and reliance on a casual work force. We conclude that within the Canadian LTC system, positive perceptions of Namaste Care are tempered by concerns about organizational capacity to support new programming.

  16. Identifying motivators and barriers to older community-dwelling people participating in resistance training: A cross-sectional study.

    Science.gov (United States)

    Burton, Elissa; Lewin, Gill; Pettigrew, Simone; Hill, Anne-Marie; Bainbridge, Liz; Farrier, Kaela; Langdon, Trish; Airey, Phil; Hill, Keith D

    2017-08-01

    Participation rates of older people in resistance training (RT) are low despite increasing research showing many health benefits. To increase the number of older people participating in RT it is important to know what would motivate people to become involved, what motivates those who participate to continue, and the factors preventing many older people from commencing participation. To investigate these issues, a questionnaire was mailed to three groups of older people: (1) those receiving home care services, (2) members of a peak non-government seniors' organisation and (3) those participating in a specific gym-based RT programme. In total, 1327 questionnaires were returned (response rate = 42.5%). To feel good physically and mentally were the main reasons motivating participation among all three groups, and falls prevention was identified as an important motivator for the home care respondents. Pain, injury and illness were the main barriers to participating, or continuing to participate. However, medical advice was a factor influencing participation commencement. The results suggest organisations providing RT programmes for older people should tailor the promotion and delivery of programmes to address key motivators and barriers specific to each group to increase the proportion of older people initiating and continuing to engage in RT.

  17. Merging electricity and environment politics of Hong Kong: Identifying the barriers from the ways that sustainability is defined

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Alex Y.H. [Department of Geography, The University of Hong Kong, Hui Oi Chow Science Building, Pokfulam Road, Hong Kong SAR (China)

    2008-04-15

    The present paper presents a study of the electricity policy of Hong Kong in an environmental-political context. Through a critical review of the policy structure and rationale, it identifies the barriers to developing a truly sustainable electricity policy system and is expected to shed light on the forthcoming electricity market reform in the territory. The barriers stem from the path-dependent institutional set-ups that restrict a timely transformation of the roles of the actors. And this is coupled with the government's treatment that does not look beyond these structural constraints, overly appreciating scientific and economic rationalities than communicative actions. The author is of the view that these are intensified by the sharp changes in the local political economy. Positive signs of change are dampened by the minimal progress in democratic development in the near future and the extension of the power companies' monopolist status that will ruin the 'trust' between the stakeholders compounding the guilt of those rigid regulatory constraints. (author)

  18. A House Full of Trap Doors. Identifying barriers to resilient drylands in the toolbox of pastoral development

    Science.gov (United States)

    Krätli, Saverio; Kaufmann, Brigitte; Roba, Hassan; Hiernaux, Pierre; Li, Wenjun; Easdale, Marcos H.; Huelsebusch, Christian

    2016-04-01

    The theoretical understanding of drylands and pastoral systems has long undergone a U-turn from the initial perspective rooted in classical ecology. The shift has hinged on the way to represent asymmetric variability, from a disturbance in an ecosystem that naturally tends towards uniformity and stability, to a constitutive part of a dynamic ecosystem. Operationalising the new reversed perspective, including the need to update the methodological infrastructure to plan around drylands and pastoral development, remains a challenge. Underlying assumptions about stability and uniformity, that are a legacy of equilibrium thinking, remain embedded in the toolbox of pastoral development, starting from the technical language to talk about the subject. This effectively gets in the way of operationalizing state of the art understanding of pastoral systems and the drylands. Unless these barriers are identified, unpacked and managed, even the present calls for increasing the rigour and intensity of data collection - for example as part of the ongoing global process to revise and improve agricultural data - cannot deliver a realistic representation of pastoral systems in statistics and policy making. This contribution presents the case for understanding variability as an asset, and provides a range of examples of methodological barriers, including classifications of livestock systems, scale of observation, key parameters in animal production, indicators in the measurement of ecological efficiency, concepts of ecological fragility, natural resources, and pastoral risk. The need to update this legacy is a pressing challenge for policy makers concerned with both modernisation and resilience in the drylands.

  19. Merging electricity and environment politics of Hong Kong: Identifying the barriers from the ways that sustainability is defined

    International Nuclear Information System (INIS)

    Lo, Alex Y.H.

    2008-01-01

    The present paper presents a study of the electricity policy of Hong Kong in an environmental-political context. Through a critical review of the policy structure and rationale, it identifies the barriers to developing a truly sustainable electricity policy system and is expected to shed light on the forthcoming electricity market reform in the territory. The barriers stem from the path-dependent institutional set-ups that restrict a timely transformation of the roles of the actors. And this is coupled with the government's treatment that does not look beyond these structural constraints, overly appreciating scientific and economic rationalities than communicative actions. The author is of the view that these are intensified by the sharp changes in the local political economy. Positive signs of change are dampened by the minimal progress in democratic development in the near future and the extension of the power companies' monopolist status that will ruin the 'trust' between the stakeholders compounding the guilt of those rigid regulatory constraints

  20. Identifying barriers to receiving preventive dental services: expanding access to preventive dental hygiene services through affiliated practice.

    Science.gov (United States)

    Gross-Panico, Michelle L; Freeman, Wilbur K

    2012-01-01

    Minority children and children from lower income families are more likely to experience the burden of oral disease. Since oral disease reduces quality of life, it is a priority to utilize preventive dental services. The research questions ask if affiliated practice increases utilization of preventive dental services by underserved children from birth to 18 years of age, and what the barriers to receiving preventive dental services are and their level of importance. A survey was administered to parents/guardians of patients from birth to 18 years of age who received preventive dental services from Catholic Healthcare West East Valley Children's Dental Clinic, an affiliated practice dental clinic in Chandler, Arizona. Thirty-four surveys were completed: 21 completed in English and 13 completed in Spanish. The data was analyzed to provide descriptive statistics and non-parametrically analyzed using the Friedman's, Kendall's W and Wilcoxon Signed Ranks Tests. The cost of preventive dental services is more important to this population than both convenience of appointment time and distance traveled. As the cost increases for preventive dental services, this population will utilize preventive dental services less frequently. The study indicated that the increase of self-reported utilization of preventive dental services by underserved children, ranging in age from birth to 18 years old, in Arizona affiliated practice dental clinics, was primarily impacted by perceived reduced costs of receiving care. Funding efforts, reimbursement mechanisms and legislative policies should support this dental care delivery model to provide care to underserved children, adults and seniors throughout the U.S.

  1. Identifying Barriers to Delivering the Awakening and Breathing Coordination, Delirium, and Early Exercise/Mobility Bundle to Minimize Adverse Outcomes for Mechanically Ventilated Patients: A Systematic Review.

    Science.gov (United States)

    Costa, Deena Kelly; White, Matthew R; Ginier, Emily; Manojlovich, Milisa; Govindan, Sushant; Iwashyna, Theodore J; Sales, Anne E

    2017-08-01

    Improved outcomes are associated with the Awakening and Breathing Coordination, Delirium, and Early exercise/mobility bundle (ABCDE); however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and to provide a resource to guide clinicians in overcoming barriers to implementation. We searched MEDLINE via PubMed, CINAHL, and Scopus for original research articles from January 1, 2007, to August 31, 2016, that identified barriers to ABCDE implementation for adult patients in the ICU. Two reviewers independently reviewed studies, extracted barriers, and conducted thematic content analysis of the barriers, guided by the Consolidated Framework for Implementation Research. Discrepancies were discussed, and consensus was achieved. Our electronic search yielded 1,908 articles. After applying our inclusion/exclusion criteria, we included 49 studies. We conducted thematic content analysis of the 107 barriers and identified four classes of ABCDE barriers: (1) patient-related (ie, patient instability and safety concerns); (2) clinician-related (ie, lack of knowledge, staff safety concerns); (3) protocol-related (ie, unclear protocol criteria, cumbersome protocols to use); and, not previously identified in past reviews, (4) ICU contextual barriers (ie, interprofessional team care coordination). We provide the first, to our knowledge, systematic differential diagnosis of barriers to ABCDE delivery, moving beyond the conventional focus on patient-level factors. Our analysis offers a differential diagnosis checklist for clinicians planning ABCDE implementation to improve patient care and outcomes. Copyright © 2017 American College of Chest Physicians. All rights reserved.

  2. Patients' reports of barriers to expressing concerns during cancer consultations.

    Science.gov (United States)

    Brandes, Kim; Linn, Annemiek J; Smit, Edith G; van Weert, Julia C M

    2015-03-01

    To identify cancer patients' most influential barriers to expressing concerns during cancer consultations in a new manner by examining patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Two online focus groups (N=16) and an online survey (N=236) were conducted among cancer patients and cancer survivors. The online focus groups and survey were used to examine two elements of patients' barriers, i.e., patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Composite scores of these two elements were calculated to determine influential barriers. Results showed that the most influential barriers were related to providers' behavior (e.g., providers do not explicitly invite patients to express concerns) and the environment where the consultation takes place (e.g., perceived lack of time). The results of this study indicate that influential barriers to expressing concerns are barriers that patients cannot overcome themselves (i.e., they are related to providers' behavior or the environment of the consultation). A collaborative approach between researchers, providers and policy makers is needed to overcome these barriers. The results of this study can be used to develop strategies to overcome barriers to patients expressing concerns. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. A qualitative study to identify barriers to deployment and student training in the use of automated external defibrillators in schools

    DEFF Research Database (Denmark)

    Zinckernagel, Line; Hansen, Carolina Malta; Rod, Morten Hulvej

    2017-01-01

    such as delayed access have been reported. The purpose of this study was to identify barriers to the implementation of defibrillator training of students and deployment of defibrillators in schools. Methods: A qualitative study based on semi-structured individual interviews and focus groups with a total of 25......Background: Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. Low implementation rates have been observed, and even at schools with a defibrillator, challenges...... to their perception of student training but not for their considerations on the relevance of their placement at schools. Conclusions: It is crucial for implementation of automated external defibrillators in schools to inform staff about how they work and are operated and that students are an appropriate target group...

  4. Identifying Configurations of Perceived Teacher Autonomy Support and Structure: Associations with Self-Regulated Learning, Motivation and Problem Behavior

    Science.gov (United States)

    Vansteenkiste, Maarten; Sierens, Eline; Goossens, Luc; Soenens, Bart; Dochy, Filip; Mouratidis, Athanasios; Aelterman, Nathalie; Haerens, Leen; Beyers, Wim

    2012-01-01

    Grounded in self-determination theory, the aim of this study was (a) to examine naturally occurring configurations of perceived teacher autonomy support and clear expectations (i.e., a central aspect of teacher structure), and (b) to investigate associations with academic motivation, self-regulated learning, and problem behavior. Based on…

  5. Perceived Promoters of and Barriers to Use of a Learning Management System in an Undergraduate Nursing Program

    Directory of Open Access Journals (Sweden)

    Fuad Alhosban

    2018-02-01

    Full Text Available Effective presentation of information is essential in teaching and learning. We assessed the promoters of and barriers to utilization of a learning man-agement system, namely Blackboard (Blackboard Inc., Washington DC, USA, by undergraduate nursing students. We investigated their utilization of Blackboardand provided recommendations to improve their teaching and learning. We conducted a cross-sectional survey of 304 women in their second to fourth years of study using a validated questionnaire that evalu-ated their perceptions of Blackboard utilization. Data were collected be-tween January and February 2017 and analyzed using descriptive and com-parative statistics. The response rate was 67.5%. The most frequently report-ed promoters of Blackboard utilization were factors related to obtaining course specifications, materials, and grades (means: 3.54  1.18, 3.54  1.25, and 3.55  1.34, respectively. The most commonly mentioned barriers to Blackboard utilization were factors related to loss of communication and feedback from educators (mean: 4.21  1.05. Our results revealed that students experiences of using such systems are often negative, especially in terms of communication, interaction, and feedback. Investment in staff training and creation of new roles to monitor, maintain, and audit the quali-ty of such systems are recommended.

  6. Integration of health into urban spatial planning through impact assessment: Identifying governance and policy barriers and facilitators

    International Nuclear Information System (INIS)

    Carmichael, Laurence; Barton, Hugh; Gray, Selena; Lease, Helen; Pilkington, Paul

    2012-01-01

    This article presents the results of a review of literature examining the barriers and facilitators in integrating health in spatial planning at the local, mainly urban level, through appraisals. Our literature review covered the UK and non UK experiences of appraisals used to consider health issues in the planning process. We were able to identify four main categories of obstacles and facilitators including first the different knowledge and conceptual understanding of health by different actors/stakeholders, second the types of governance arrangements, in particular partnerships, in place and the political context, third the way institutions work, the responsibilities they have and their capacity and resources and fourth the timeliness, comprehensiveness and inclusiveness of the appraisal process. The findings allowed us to draw some lessons on the governance and policy framework regarding the integration of health impact into spatial planning, in particular considering the pros and cons of integrating health impact assessment (HIA) into other forms of impact assessment of spatial planning decisions such as environmental impact assessment (EIA) and strategic environment assessment (SEA). In addition, the research uncovered a gap in the literature that tends to focus on the mainly voluntary HIA to assess health outcomes of planning decisions and neglect the analysis of regulatory mechanisms such as EIA and SEA. - Highlights: ► Governance and policy barriers and facilitators to the integration of health into urban planning. ► Review of literature on impact assessment methods used across the world. ► Knowledge, partnerships, management/resources and processes can impede integration. ► HIA evaluations prevail uncovering research opportunities for evaluating other techniques.

  7. Food provision among food relief agencies in rural Australia, and perceived barriers and enablers to provide healthy food.

    Science.gov (United States)

    Bortolin, Natalia; Priestly, Jaqueline; Sangster, Janice

    2018-04-01

    Food insecurity affects 4-14% of Australians, and up to 82% of vulnerable groups. Food relief agencies commonly provide food parcels or food vouchers. Little research has been undertaken on food relief agencies within rural Australia. This study determined the type of food assistance provided by rural food relief agencies, and barriers and enablers to provide healthy food. Cross-sectional study, using telephone questionnaires with qualitative and quantitative aspects. Data were analysed using descriptive statistics and thematic analysis. Rural New South Wales, Australia. Representatives of 10 food relief agencies. Types of food assistance and food provided, and the barriers and enablers to provide healthy food to clients. Most agencies provided food hampers and perishable and non-perishable food. Rural food relief agencies had a greater capacity to provide non-perishable compared to perishable food. Grains, breads and cereals, and canned fruit and vegetables were most popular. Nine key themes emerged including 'Ability to purchase and provide healthy food', 'Ability to regulate food purchased or chosen by clients', 'Financial constraints of the agency' and 'Lack of storage'. There are many variables to consider in order to understand the capacity of rural food relief agencies to provide healthy food. There are also opportunities for food relief agencies to appraise current practices and make changes. Initiatives to improve storage facilities and food availability are key and include networking with local businesses, community organisations and government. Rural food relief agency clients could benefit from accessing food literacy and health programs like FoodREDi, OzHarvest NEST and SecondBite Fresh NED. © 2017 National Rural Health Alliance Inc.

  8. Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results

    Science.gov (United States)

    Rubin, Jennifer K.; Hesketh, Rachel; Martin, Adam; Herman, William H.; Rubino, Francesco

    2016-01-01

    Despite increasing recognition of the efficacy, safety, and cost-effectiveness of bariatric/metabolic surgery in the treatment of type 2 diabetes, few patients who may be appropriate candidates and may benefit from this type of surgery avail themselves of this treatment option. To identify conceptual and practical barriers to appropriate use of surgical procedures, a Policy Lab was hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes on 29 September 2015. Twenty-six stakeholders participated in the Policy Lab, including academics, clinicians, policy-makers, industry leaders, and patient representatives. Participants were provided with a summary of available evidence about the cost-effectiveness of bariatric/metabolic surgery and the costs of increasing the use of bariatric/metabolic surgery, using U.K. and U.S. scenarios as examples of distinct health care systems. There was widespread agreement among this group of stakeholders that bariatric/metabolic surgery is a legitimate and cost-effective approach to the treatment of type 2 diabetes in obese patients. The following four building blocks were identified to facilitate policy changes: 1) communicating the scale of the costs and harms associated with rising prevalence of type 2 diabetes; 2) properly articulating the role of bariatric/metabolic surgery for certain population groups; 3) identifying new funding sources for bariatric/metabolic surgery; and 4) incorporating bariatric/metabolic surgery into the appropriate clinical pathways. Although more research is needed to identify specific clinical scenarios for the prioritization of bariatric/metabolic surgery, the case appears to be strong enough to engage relevant policy-makers and practitioners in a concerted discussion of how to better use metabolic surgical resources in conjunction with other interventions in good diabetes practice. PMID:27222554

  9. Gender-differences in risk factors for suicidal behaviour identified by perceived burdensomeness, thwarted belongingness and acquired capability: cross-sectional analysis from a longitudinal cohort study.

    Science.gov (United States)

    Donker, Tara; Batterham, Philip J; Van Orden, Kimberly A; Christensen, Helen

    2014-01-01

    The Interpersonal-Psychological Theory of Suicidal Behavior (IPT) is supported by recent epidemiological data. Unique risk factors for the IPT constructs have been identified in community epidemiological studies. Gender differences in these risk factors may contribute substantially to our understanding of suicidal risk, and require further investigation. The present study explores gender differences in the predictors and correlates of perceived burdensomeness, thwarted belongingness and acquired capability for suicide. Participants (547 males, 739 females) aged 32-38 from the PATH through Life study, an Australian population-based longitudinal cohort study (n=1,177) were assessed on perceived burdensomeness, thwarted belongin