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Participant Observation (participant + observation)
Selected AbstractsThe global diversion of pharmaceutical drugsADDICTION, Issue 3 2009India: the third largest illicit opium producer? ABSTRACT Aims This paper explores India's role in the world illicit opiate market, particularly its role as a producer. India, a major illicit opiate consumer, is also the sole licensed exporter of raw opium: this unique status may be enabling substantial diversion to the illicit market. Methods Participant observation and interviews were carried out at eight different sites. Information was also drawn from all standard secondary sources and the analysis of about 180 drug-related criminal proceedings reviewed by Indian High Courts and the Supreme Court from 1985 to 2001. Findings Diversion from licit opium production takes place on such a large scale that India may be the third largest illicit opium producer after Afghanistan and Burma. With the possible exceptions of 2005 and 2006, 200,300 tons of India's opium may be diverted yearly. After estimating India's opiate consumption on the basis of UN-reported prevalence estimates, we find that diversion from licit production might have satisfied a quarter to more than a third of India's illicit opiate demand to 2004. Conclusions India is not only among the world's largest consumer of illicit opiates but also one of the largest illicit opium producers. In contrast to all other illicit producers, India owes the latter distinction not to blatantly illicit cultivation but to diversion from licit cultivation. India's experience suggests the difficulty of preventing substantial leakage, even in a relatively well-governed nation. [source] Insights from inside: the duties and activities of nurses at the psychiatric clinic Münsterlingen (CH).JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 7 2009A qualitative study In the German-speaking countries: Austria, Germany and Switzerland, which have a joint annual conference in psychiatric nursing, the process of academization of nursing has led to a discussion about which adaptations to make in psychiatric nursing in order to develop a profile, which is practicable in the future. Therefore, it was necessary to describe the current duties and activities of psychiatric nurses. With this, the knowledge and abilities of the nurses were to be made more explicit and their identity was to be strengthened. Data were generated by using participant observation and group discussions with the involved nurses to validate the observations and the emerging categories of activities. Participant observation took place in a psychiatric clinic in Switzerland over a period of 11 months on 14 psychiatric wards with different specializations. Data analysis followed a qualitative content analysis. Findings show that by means of descriptions of nursing situations the duties and activities of the nurses can be summarized into 12 categories. Many of the described activities can be found in psychiatric nursing textbooks. This concurrence suggests that there is something like a basic framework of psychiatric nursing. In addition, the findings illustrate how wide the variety of tasks are and how challenging psychiatric nursing is. [source] Teaching the Fuzzy Front End of Innovation: Experimenting with Team Learning and Cross-Organizational IntegrationCREATIVITY AND INNOVATION MANAGEMENT, Issue 3 2009Miia Martinsuo How can the extremely uncertain front end of innovation , managing the fuzzy front end , be taught to graduate students? This paper describes and analyses experiments with experiential, problem-based learning focused on the front end of innovation. The focus is on the learning and cross-organizational integration of student teams; factors that have been identified as central to the success of teams involved in the front end of innovation. An experiential course, ,From an idea to a business plan in product development', was developed in conjunction with an actual company, and piloted with four student groups in 2007 and 2008. Data on this novel course were collected through participant observation, team self-assessment and questionnaires. This paper reports favourable results for the effectiveness of the course design; it discusses the impact of team size and cross-organizational team composition on team performance; and identifies the implications for teaching the front end of innovation. [source] PHYSICAL TRAINING, ETHICAL DISCIPLINE, AND CREATIVE VIOLENCE: Zones of Self-Mastery in the Hindu Nationalist MovementCULTURAL ANTHROPOLOGY, Issue 1 2010ARAFAAT A. VALIANI ABSTRACT This essay advances understanding of how projects of self-mastery within neighborhood physical training programs associated with the Hindu Nationalist Movement produce subjects that are simultaneously ethically oriented and creatively violent. Such an analysis is contrasted with the conventional view that Hindu Nationalist volunteers are mere objects who blindly conform to a nationalist ideology or religious norms. Drawing on the author's participant observation of physical conditioning within the movement, the essay illustrates how combat training depends on an analytical sensibility by which techniques of drill are simultaneously learned and innovated by volunteers in a disciplinary zone of self-experimentation. Within such a zone, volunteers modify drill routines, enriching and refining them on an everyday basis. Thus, the evolution of physical techniques transforms training into an unfolding enterprise that is continually oriented toward attaining physical and moral self-mastery through the probing of bodily exercises. The essay underscores the social significance of such forms of physical self-exploration, in which movement volunteers understand the iterative probing of physical practice as driven by a resolve that deepens the volunteer's moral fortitude. The essay illuminates how a set of physical and moral processes are intertwined, processes through which militant subjects are culturally formed and routines of violence are sustained as a social and ethical practice. Physical training is connected to anti-Muslim pogroms in postcolonial Gujarat demonstrating how the evolving nature of physical training shapes, prolongs, and enables the improvisation of tactics of ethnic cleansing. [source] Tricks of Festival: Children, Enculturation, and American HalloweenETHOS, Issue 2 2005CINDY DELL CLARK The American children's ritual, Halloween, involves an emergent, active and complex process rather than unidirectional socialization of children by adults. Inversions of meaning are prominent in Halloween through: 1) adult support for inverted, anti-normative themes, and 2) a turnabout by which children gain ascendance through costumed trick-or-treating. Based on interviews with six and seven year old children and their parents, as well as participant observation at Halloween events, Halloween's inversions had different interpretations for adults compared to children. For example the degree and quality of fear associated with Halloween varied between elders and children. Following the traumatic events of September 11, 2001, adult-rendered meanings of Halloween were shown to be unfixed and subject to modification. These findings raise critical questions about simplistic notions of socialization and cultural reduplication. [source] AFRICAN, RUSSIAN, AND UKRAINIAN REFUGEE RESETTLEMENT IN PORTLAND, OREGONGEOGRAPHICAL REVIEW, Issue 2 2005SUSAN E. HUME ABSTRACT. The residential patterns, adaptation experiences, and impacts of immigrants on North American cities have been well documented in the geographical literature. In this article, we build on prior work by testing the theories of Gaim Kibreab, who identified three factors that shape the experiences of recent refugees: attitudes of the receiving society; current policy environments; and employment opportunities in local communities. We analyze some of the ways in which these factors operate as interrelated systems for two comparative groups of foreign-born migrants in Portland, Oregon: sub-Saharan Africans; and Russians and Ukrainians. Using a mixed-methods approach, we triangulate data from a blend of in-depth interviews, participant observation in the community and at refugee and immigrant social service agencies, census and other statistical records, and cartographic analyses to report on the findings of our work. Data suggest that the residential, economic, and social spaces of new refugees are constructed as a complex multiplicity of networks and relationships that link time and place [source] Organizational power and culture shift at Ducati motorcyclesGLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE, Issue 1 2007Maktoba Omar In this research into corporate culture at Ducati Motorcycles, Spa., the qualitative approach was used based on Johnson's theory of corporate culture, relying on structured and unstructured interviews followed up by participant observation. Corporate culture was used as a strategic tool in changing the Ducati corporate mindset. The results show that the recognition and alteration of corporate culture played a large role in the successful implementation of a new corporate strategy. The Ducati strategic initiative focused on repositioning Ducati from a traditional Italian motorcycle manufacturer to a global marketing company. © 2007 Wiley Periodicals, Inc. [source] Autonomy and modernisation: the management of change in an English primary care trustHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2004Ruth McDonald BA MSc PhD Abstract Recent New Labour policy for the ,modernisation' of Government places a good deal of emphasis on decentralisation. This emphasis is particularly marked in relation to the organisation of primary care. However, like hospitals and other National Health Service institutions, primary care trusts (PCTs) are subject to a substantial raft of centrally established performance targets and indicators, including those which contribute to the public award of between zero and three performance ,stars'. This raises questions about the extent to which employees can exercise autonomy in the context of rigid top-down directives. This paper presents findings from a study using participant observation and interviews to examine the impact of a training course aimed ostensibly at increasing employee autonomy in an English PCT. The suggestion is that attempts to make employees more autonomous can be seen as a strategy for increasing central control based upon the internalisation by the employees of centrally promulgated values. The attraction of such strategies is that they may be potentially more effective and less costly than alternative strategies of direct control. However, the study suggests that the outcome of attempts by such methods as programmes to increase employee autonomy may be very different from those intended. [source] When doctors disagree: a qualitative study of doctors' and parents' views on the risks of childhood food allergyHEALTH EXPECTATIONS, Issue 3 2008Wendy Hu MBBS Dip Paed MHA PhD FRACGP Abstract Objective, To examine the views of doctors which underpin clinical practice variation concerning an uncertain health risk, and the views of parents who had sought advice from these doctors, using the example of childhood food allergy. Study design, Qualitative study involving in-depth interviews and participant observation over 16 months. Focus groups and consultation audio-recordings provided corroborative data. Setting, Three specialist allergy clinics located in one metropolitan area. Participants, Eighteen medical specialists and trainees in allergy, and 85 parents (from 69 families) with food allergic children. Results, Doctors expressed a spectrum of views. The most divergent views were characterized by: scientific scepticism rather than precaution in response to uncertainty; emphasis on quantifiable physical evidence rather than parental histories; professional roles as providers of physical diagnosis and treatment rather than of information and advocacy; libertarian rather than communitarian perspectives on responsibility for risk; and values about allergy as a disease and normal childhood. Parents held a similar, but less divergent range of views. The majority of parents preferred more moderate doctors' views, with 43% (30 of 69) of families expressing their dissatisfaction by seeking another specialist opinion. Many were confused by variation in doctors' opinions, preferring relationships with doctors that recognized their concerns, addressed their information needs, and confirmed that they were managing their child's allergy appropriately. Conclusions, In uncertain clinical situations, parents do not expect absolute certainty from doctors; inflexible certainty may not allow parental preferences to be acknowledged or accommodated, and is associated with the seeking of second opinions. [source] Design for usability on supply chain management systems implementationHUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 5 2009Chao-Hsien Lin Supply chain management (SCM) systems implementation has become a fashion due to advances in information technology and pressures of market competition. Unfortunately, successful implementation was rare. In this article, the concept of usability was extended in an explorative case study to crystallize design for usability (DFU) principles in a large-scale SCM systems implementation project at a leading semiconductor manufacturing company in Taiwan. Proposed was a holistic usability framework to guide the analysis of DFU as well as the compilation of an evidence database composed of design documentation, post hoc evaluation, semistructured interviews, and participant observation. This research revealed a set of usability needs and coping strategies found throughout a series of systems design and redesign processes at the case company. As a result, an emergent usability framework in the form of ICOM (Input, Control, Output, and Mechanism) dimensions was proposed to guide the implementation of SCM systems. © 2009 Wiley Periodicals, Inc. [source] Educating Art in a Globalizing World.INTERNATIONAL JOURNAL OF ART & DESIGN EDUCATION, Issue 1 2006The University of Ideas: A Sociological Case-study In 1999, the Italian Arte Povera artist Michelangelo Pistoletto and other artists laid the foundations of The University of Ideas (UNIDEE), an exceptional international artist-in-residence programme with a strong ideological foundation. As a sociologist of culture I had the opportunity to do research in the huge organization for a month by doing participant observation, in-depth interviews and discourse analysis. In this article the educational programme of UNIDEE is interpreted in sociological terms. First of all it will be contextualized in the artistic work of Michelangelo Pistoletto through his concept of the mirror and his a-modern idea of ,The Minus Artist'. In the second part Pistoletto's artistic, political and economic movement Cittadellarte, in which UNIDEE is based, will be described. Finally UNIDEE will be analysed as a model for art education on the border of modernity attempting to redefine the position of art and of the artist in a globalizing world. [source] ,Download': ,Postcards Home' Contemporary Art and New Technology in the Primary SchoolINTERNATIONAL JOURNAL OF ART & DESIGN EDUCATION, Issue 1 2005Steve Herne ,Postcards Home' using photography, scanning, digital image manipulation, text and colour printing was the third ,Download' project devised by the education department of the Whitechapel Art Gallery, London, England. It was led by artist Laurie Long with teachers and pupils from Pooles Park primary school in Islington, an inner city borough in North London. Based on the production of a postcard featuring an image of personal significance, the children were involved in exploring and constructing their own and others' identities whilst developing their technology skills in creative ways. The project raises interesting questions about the applicability of contemporary art practices to the primary classroom. The research is based on participant observation and includes the voices of the artist and teachers involved. [source] Understanding postorganic fresh fruit and vegetable consumers at participatory farmers' markets in Ireland: reflexivity, trust and social movementsINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 5 2006Oliver Moore Abstract This paper examines how trusting relations between consumers and vendors of organic fresh fruits and vegetables (FFVs) in a particular type of farmers' market (FM) in Ireland are established and maintained, and what the implications of this are. First, the food system is outlined, and then its attendant problems. These problems have led to various solutions, two of which are organic food and FMs. Then, the growth in these two areas is outlined, as is the accompanying growth in the academic literature on these two areas, some of which overlaps. Various pressures, including in particular the increasing distance food travels and disconnected stallholders and products at the FM, are suggested. In light of this, a need to apply an understanding of the reflexive consumer, trust and social movements is suggested. It is found that the consumers interviewed act reflexively by choosing to go to these FMs. They prioritize the trusting relationships built up through repeated personal contact at these FMs over and above organic certification. Along with and as part of this, they prioritize local, fresh, seasonal ,chemical-free' FFVs over and above imported certified organic produce. Various aspects of collective identity formation, including modes of behaviour, objects and stories, and language, are involved in this process. These elements, to some extent, act as a buffer against the pressures of distance and disconnection. Along with this, the essential meaning of the word organic is, in this particular context, reconstructed to include various socio-environmental values missing from some certified organic produce. The word postorganic is suggested. The main methodologies used are semistructured in-depth interviews and participant observation. [source] An ethnographic study of three mental health triage programsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2004Margaret Grigg ABSTRACT:,,Triage processes are commonly used to manage the interface between demand for, and supply of, health services. This dimension of service provision is particularly pertinent for mental health services in Australia, where demand outweighs services available. This paper draws on the experiences of using participant observation to explore mental health triage processes. Findings highlight the complexities of the researcher role and benefits of using an ethnographic approach to explore mental health triage patterns. Insider participant observation brings many challenges but also, in this study, enabled the researcher to uncover some roles and processes underpinning triage decisions in mental health services. [source] Conveying caring: Nurse attributes to avert violence in the EDINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2009Dr Lauretta Luck RN BA MA(Psy) PhD Violence towards nurses in Emergency Department's is a world wide problem that some contend is increasing in severity and frequency, despite the many strategies implemented to prevent violent events. This paper presents the findings of an instrumental case study in a busy rural Emergency Department. Twenty Registered Nurses participated in the study and data from 16 unstructured interviews, 13 semi-structured field interviews, and 290 h of participant observation were thematically analysed. In addition, 16 violent events were observed, recorded via a structured observation tool and analysed using frequency counts. Thematically there were five attributes rural emergency nurses were observed to use to avert, reduce and prevent violence. The five attributes were being safe, being available, being respectful, being supportive and being responsive. We argue that these attributes were embodied in the emergency nurses routine practice and their conceptualization of caring. [source] Uncovering the evidence of non-expert nephrology nursing practiceINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2006Ann Bonner BAppSc(Nurs) MA PhD RN MRCNA Expertise in nursing has been widely studied although there have been no previous studies into what constitutes expertise in nephrology (renal) nursing. This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, provides evidence of the characteristics and practices of non-expert nephrology nurses. Using the grounded theory method, the study took place in one renal unit in New South Wales, Australia, and involved six non-expert and 11 expert nurses. Sampling was purposive then theoretical. Simultaneous data collection and analysis using participant observation, review of nursing documentation and semistructured interviews was undertaken. The study revealed a three-stage skills-acquisitive process that was identified as non-expert, experienced non-expert and expert stages. Non-expert nurses showed superficial nephrology nursing knowledge and limited experience; they were acquiring basic nephrology nursing skills and possessed a narrow focus of practice. [source] The influence of HIV/AIDS on the practice of primary care nurses in Jordan: Rhetoric and realityINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2005Hani Nawafleh PhD(Cand) The role of nurses in raising community awareness about HIV/AIDS is well-reported. However, little is known about the practice of Jordanian nurses and the role they play in the prevention and control of HIV/AIDS. This interpretive ethnographic study sought to illuminate the role of primary care nurses and examine the influence of HIV/AIDS on their practice. The study was undertaken in Jordan in three rural and three urban primary health-care centres. Data collection included participant observation, key informant interviews and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants. The findings indicate that the rhetoric offered by all levels of administration and endorsed in policy is not reflective of the reality of practice. Poor resources and educational preparation, a limited nursing skill mix and access to professional development, lack of nursing leadership and role models, cultural beliefs and geographic isolation are factors that reduced the capacity of the primary care nurses to raise awareness and, therefore, influence the prevention and control of HIV/AIDS. [source] Establishing contact and gaining trust: an exploratory study of care avoidanceJOURNAL OF ADVANCED NURSING, Issue 2 2010Gert Schout schout g., de jong g. & zeelen j. (2010) Establishing contact and gaining trust: an exploratory study of care avoidance. Journal of Advanced Nursing 66(2), 324,333. Abstract Title.,Establishing contact and gaining trust: an exploratory study of care avoidance. Aim., This paper is a report of a study conducted to explore the competencies , especially deep-rooted personal qualities , of care providers who succeed in making contact and gaining trust with clients who are inclined to avoid the care they need. Background., Demands, thresholds and fragmentation of services hinder the accessibility of health care, such that some severe mentally ill people do not receive the treatment they need or avoid healthcare services. Methods of establishing contact and gaining trust in mental health care include practical assistance, realistic expectations, establishing long-term goals, empathy and a client-centred and flexible approach. Method., A public mental healthcare practice in The Netherlands with outstanding performance was studied from 2002,2007 using participant observation, interviews with experienced care providers and interviews with clients with a long history of avoiding care facilities, conflicts and troubled relationships with care providers. Findings., A number of personal qualities are vital for establishing contact and gaining trust with these clients: altruism, a degree of compassion, loyalty, involvement, tenacity, a critical attitude to the mainstream, flexibility, optimism, diplomacy, patience, creativity, and a certain degree of immunity to stress. Conclusion., Care providers who establish contact and win trust employ ,non-judgemental appreciation'. They start from the acceptance of what is and try to connect with the client and their world. These professionals use their initial actions to identify and praise qualities and achievements of clients. This style of work is supported by a set of deep-rooted personal qualities we can summarize as ,empathy'. [source] Time to precept: supportive and limiting conditions for precepting nurses.JOURNAL OF ADVANCED NURSING, Issue 2 2010Elisabeth Carlson carlson e., pilhammar e. & wann-hansson c. (2010) Time to precept: supportive and limiting conditions for precepting nurses. Journal of Advanced Nursing66(2), 432,441. Abstract Title.,Time to precept: supportive and limiting conditions for precepting nurses. Aim., This paper is a report of a study describing conditions for precepting in a Swedish clinical context from the perspective of precepting nurses. Background., Clinical practice is a complex part of nursing education, and registered nurses who are acting as preceptors for nursing students face a number of challenges that need to be addressed during the precepting process. Method., An ethnographic approach guided by symbolic interactionism was used. Data were collected by participant observation and focus group interviews over a ten-month period in 2006,2007. Participants were selected by purposive sampling of 13 staff nurses who were preceptors during the field work period. In addition, 16 staff nurses, experienced in precepting, were purposively selected for four focus groups. Findings., Precepting was found to be a complex function for nurses, influenced by conditions that could be both supportive and limiting in nature. Three themes described these conditions: organization, comprising clinical responsibilities and routines; collaboration, focusing on professional relations and interactions; and the personal perspective, comprising preceptors' experiences, need for feed back and notions of benefits. Time as a limiting condition reappeared through all categories. Conclusion., It is important to raise the issue of time and its impact on the precepting process. Precepting needs to be further discussed in terms of an integrated nursing competence prioritized by all stakeholders involved in clinical practice. Therefore; efforts should be made to plan nurses' clinical work so that allocated time for precepting can be facilitated. [source] Researchers' experience of co-operative inquiry in acute mental health careJOURNAL OF ADVANCED NURSING, Issue 2 2005Jan Kåre Hummelvoll BA DrPH RPN RNT Aim., The aim of this article is to reflect upon our experiences of using co-operative inquiry in an acute mental health care setting, with a focus on the methodology used in a 4-year intervention programme developed in Norway between 1999 and 2003. Background., Action research plays a crucial role in assisting nurses to integrate theory and research with nursing practice. The central characteristic of this approach is the grounding of research in practice in collaboration with clinical practitioners. Methods., The research was a co-operative inquiry based on a hermeneutic-phenomenological approach. The research methods used were ethnographic, including participant observation and face-to-face interviews, questionnaires, focus group interviews, and our process notes. Findings., The different methods used in the co-operative inquiry design of the Project Teaching Ward (PTW) had both benefits and drawbacks. In particular, the focus group method proved useful due to its ability to stimulate participants' research interest, and thus motivating them to be actively involved in the development of knowledge. The particular knowledge development process used has been described as a local knowledge dialogue. This dialogue must incorporate critical subjectivity on the part of participants in order to ensure that the research has a reflective resistance, which is decisive for its validity and quality. The findings also highlight the importance of the different roles of project leader in lengthy action research collaboration. Conclusions., The PTW has illustrated that co-operative inquiry was well suited for developing knowledge relevant to practice, thus contributing to bridging the gap between practice and theory. In order for this to happen, the research collaboration should be characterized by patience, realism and engagement. [source] Videotaped recording as a method of participant observation in psychiatric nursing researchJOURNAL OF ADVANCED NURSING, Issue 5 2000Eila Latvala RN PhD Videotaped recording as a method of participant observation in psychiatric nursing research This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients. [source] The essentials of Advance Care Planning for end-of-life care for older peopleJOURNAL OF CLINICAL NURSING, Issue 3-4 2010Sarah Yeun-Sim Jeong Aims and objectives., The aim of the study was to investigate the phenomenon of Advance Care Planning and the use of Advance Care Directives in residential aged care facilities in Australia. The objectives were to: ,,investigate the implementation process of Advance Care Planning and the use of Advance Care Directives; ,,investigate the outcomes of Advance Care Planning and experiences of people involved in Advance Care Planning and Advance Care Directives, including residents, families and nursing staff. Background., Benefits of Advance Care Planning for older residents are considerable given their degenerative health-breakdown and minimal chance of recovery. To date, the use of Advance Care Planning and Advance Care Directives is limited and models of service delivery and processes are needed to enhance best practice with Advance Care Planning and positive outcomes for older Australians. Design., Case study. Methods., The study conducted using multiple sources of evidence to enrich understanding of the phenomenon of Advance Care Planning. The researcher engaged in data collection over six months involving participant observation, field notes, semi-structured interviews and document analysis. The findings contribute to the limited knowledge of options currently available to older adults and their families in their decision-making about end-of-life care options. Permission to conduct the study., Prior to commencement of the data collection, ethics clearances from the University of Newcastle and the regional Area Health Service were achieved. Permission to access the residential aged care facilities to undertake the study was obtained from the relevant residential aged care facility ethics committees or designated authorities. The researcher undertook several strategies to ensure all the ethical principles were considered and adhered to while conducting the project. Results., The research identified the components and factors involved in the Advance Care Planning process and in attaining desired outcomes. The conceptual framework developed elaborates how Advance Care Planning should be implemented and what may constitute successful implementation of Advance Care Planning in residential aged care facilities. The four main elements (input, throughput, output, feedback), and 20 sub-elements were requisites for nurses to initiate and implement the Advance Care Planning. Conclusion., The essential components for end-of-life care are identified in the implementation processes of Advance Care Planning in residential aged care facilities. The study contributes to greater awareness of the processes needed for ,dying well' and highlights the need to explore experiences of ,successful dying' and the way nurses contribute to these events. Relevance to clinical practice., The case study identified four determinative requisites for successful implementation of Advance Care Planning in aged care facilities: the expert nurse, discussion, education and involvement of a multidisciplinary team. Nurses should take these factors into account and use person-centred approach in formalised processes to encourage participation in plans for end-of-life care. [source] Staying or returning: Pre-migration influences on the migration process of German migrants to New ZealandJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 4 2008Petra T. Bürgelt Abstract Changes in migrants' backgrounds and societies sending and receiving migrants might increase adaptation issues and reduce retention. To enhance migrants' well-being/health and their likelihood of staying it is necessary to gain an understanding of psychological and social factors that contribute to resilience and adaptation. This paper presents findings from a qualitative study that investigated the experiences, interpretations and actions of German migrant couples to New Zealand throughout the whole migration process to identify these factors. In depth, episodic interviews were conducted with four couples who decided to stay in New Zealand and four couples who decided to return to Germany. Interview data were complemented with participant observation. This paper provides insights into how the pre-migration experiences, interpretations and actions of German migrants to New Zealand influenced their establishment, their interpretations and actions and consequently adaptation, well-being/health and the decision whether to stay in New Zealand or to return to Germany. The findings illuminate the influence of psychological and social factors on migration experiences, interpretations and actions throughout the migration process. The paper offers some solutions for addressing the identified barriers to successful migration and integration into host societies. Copyright © 2008 John Wiley & Sons, Ltd. [source] Pragmatic post-structuralism (I): participant observation and discourse in evaluating violence interventionJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 4 2001Damian O'Neill Abstract This paper discusses the process and merits of a post-structuralist approach to participant observation and describes the use of this research strategy in evaluating a community based ,stopping violence' programme. While the participant observation research strategy is commonly employed as a ,process evaluation' method (Rossi and Freeman, 1993) it's role within a distinctly post-structuralist programme is a novel application of a well-established research strategy. This has significant implications for how social scientists may approach both participant observation and evaluation in the future. Copyright © 2001 John Wiley & Sons, Ltd. [source] Developing interdisciplinary maternity services policy in Canada.JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2010Evaluation of a consensus workshop Abstract Context, Four maternity/obstetrical care organizations, representing women, midwives, obstetricians and family doctors conducted interdisciplinary policy research under auspices of four key stakeholder groups. These projects teams and key stakeholders subsequently collaborated to develop consensus on strategies for improved maternity services in Ontario. Objectives, The objective of this study is to evaluate a 2-day research synthesis and consensus building conference to answer policy questions in relation to new models of interdisciplinary maternity care organizations in different settings in Ontario. Methods, The evaluation consisted of a scan of individual project activities and findings as were presented to an invited audience of key stakeholders at the consensus conference. This involved: participant observation with key informant consultation; a survey of attendees; pattern processing and sense making of project materials, consensus statements derived at the conference in the light of participant observation and survey material as pertaining to a complex system. The development of a systems framework for maternity care policy in Ontario was based on secondary analysis of the material. Findings, Conference participants were united on the importance of investment in maternity care for Ontario and the impending workforce crisis if adaptation of the workforce did not take place. The conference participants proposed reforming the current system that was seen as too rigid and inflexible in relation to the constraints of legislation, provider scope of practice and remuneration issues. However, not one model of interdisciplinary maternity/obstetrical care was endorsed. Consistency and coherence of models (rather than central standardization) through self-organization based on local needs was strongly endorsed. An understanding of primary maternity care models as subsystems of networked providers in complex health organizations and a wider social system emerged. The patterns identified were incorporated into a complexity framework to assist sense making to inform policy. Discussion, Coherence around core values, holism and synthesis with responsiveness to local needs and key stakeholders were themes that emerged consistent with complex adaptive systems principles. Respecting historical provider relationships and local history provided a background for change recognizing that systems evolve in part from where they have been. The building of functioning relationships was central through education and improved communication with ongoing feedback loops (positive and negative). Information systems and a flexible improved central and local organization of maternity services was endorsed. Education and improved communication through ongoing feedback loops (positive and negative) were central to building functioning relationships. Also, coordinated central organization with a flexible and adaptive local organization of maternity services was endorsed by participants. Conclusions, This evaluation used an approach comprising scoping, pattern processing and sense making. While the projects produced considerable typical research evidence, the key policy questions could not be addressed by this alone, and a process of synthesis and consensus building with stakeholder engagement was applied. An adaptive system with local needs driving a relationship based network of interdisciplinary groupings or teams with both bottom up and central leadership. A complexity framework enhanced sense making for the system approaches and understandings that emerged. [source] Coping over time: the parents of children with autismJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 12 2006D. E. Gray Abstract Background Although coping with autism has been examined in a number of papers, virtually no research exists on how families cope over time. This paper reports the results of a longitudinal study of parents coping with autism over a period of approximately a decade. Methods The research method for the study was based on ethnographic methods that emphasized in-depth interviews and participant observation. The sample for this study consisted of 28 parents (19 mothers and nine fathers) of children with autism. The instrument for the interviews consisted of questions concerning: the child's medical history and referral experience, the child's present symptomatology, the effects of the child's problems on the parent's well-being, the effects of autism on the family's social life, parental coping strategies, illness conceptualization and the parents' expectations for the future. Results and conclusions Coping strategies changed from the time of the initial study, as fewer parents coped through reliance on service providers, family support, social withdrawal and individualism and relatively more parents coped through their religious faith and other emotion-focused strategies. The results tentatively support previous research on coping that indicates that aging is linked to the use of more emotion-focused coping strategies. [source] Arab-American Muslims' Home Interiors in the US: Meanings, Uses and CommunicationJOURNAL OF INTERIOR DESIGN, Issue 1 2006Cherif M. Amor Ph.D. ABSTRACT The role of tradition and the attachment to homeland culture remain prerequisites that guide the development of the interior home environment of Arab-American Muslims in the United States. Space appropriation and the use of artifacts illustrate the rooted sensory need to reaffirm the attachment to the homeland's social and cultural values; additionally, these trends symbolize the enduring values of the group and render the home interior a place apart. This paper explores the role of tradition and its influence in shaping the home interior's physical environment, identifies the meanings associated with the resulting composition, and examines the consequences of adaptation to the host environment. This qualitative investigation used a grounded theory of two Arab-American Muslim immigrant settlements in Chicago, Illinois and Dearborn, Michigan. The sample consisted of 20 household heads living in two-parent families. The heterogeneity of the Arab-Muslim immigrants necessitated the use of purposeful sampling. Focus groups, interviews, and participant observation constituted the different forms of data collection. Data were analyzed using open coding (Strauss & Corbin, 1990). Findings indicated and confirmed that cultural forces remain a pivotal role in influencing the design of the home interior. More importantly, it was found that despite the attachment to traditional values, a growing indifference to homeland ideals can be sensed as the household undergoes generational, social, and cultural metamorphosis. [source] Creating a High-Trust Organization: An Exploration into Organizational Policies that Stimulate Interpersonal Trust BuildingJOURNAL OF MANAGEMENT STUDIES, Issue 5 2008Frédérique Six abstract We examine empirically how an organization that deliberately enhances interpersonal trust to become a significant organizational phenomenon, is different from a similar organization without explicit trust enhancement policies. The point of departure is relational signalling theory, which says that trust is a function of consistently giving off signals that indicate credible concern, to potential trustors. A matched pair of two consulting organizations, with different trust policies but otherwise similar characteristics, were studied intensively, using survey research, participant observation and half-open interviewing, focused on the generation of trust and the handling of trouble when trust was threatened or destroyed. A higher stage of trust can be reached by an inter-related set of policies: promoting a relationship-oriented culture, facilitation of unambiguous signalling, consistent induction training, creating opportunities for meeting informally, and the day-to-day management of competencies. Such policies are in principle independent of recognized contextual contingencies. [source] Indicators Nurses Employ in Deciding to Test for HyperbilirubinemiaJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 6 2001Anita J. Gagnon RN Objective: To identify the indicators nurses employ in deciding to test healthy full-term newborns for total serum bilirubin in the absence of a written protocol. Design: Secondary analysis of data available on 130 mother-newborn pairs and informal interviews of 30 postpartum unit nurses. Setting: Two university teaching hospitals. Participants: All tested newborns and a 33% random sample of remaining newborns from a control group data set created during a previous study and a convenience sample of postpartum nurses from all shifts. Measurement: Outcome data were obtained from a review of records. Background data were obtained from a review of records and questionnaires. Nurse data were obtained through a modified form of participant observation. Results: Ninety-one percent of newborns tested for bilirubin were tested unnecessarily. In logistic regression analyses, variables predictive of nurse-driven total serum bilirubin testing were presence of jaundice, odds ratio (OR) = 31.95 (95% confidence interval, 6.71, 152.03), and feeding frequency, OR = 0.28 (0.11, 0.72). Identifying both presence and location of jaundice simultaneously did not significantly predict testing, OR = 1.82 (0.66, 5.04). Fifty-three percent of nurses who were interviewed identified both the presence of jaundice and feeding as indicators to consider for testing. Conclusion: Newborns are overtested for bilirubin. Indicators used by nurses in deciding to test a healthy newborn for total serum bilirubin are the presence of jaundice and feeding frequency. Nurses who assess feeding frequency are less likely to order bilirubin testing. [source] Value choices and considerations when limiting intensive care treatment: a qualitative studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2009K. HALVORSEN Background: To shed light on the values and considerations that affect the decision-making processes and the decisions to limit intensive care treatment. Method: Qualitative methodology with participant observation and in-depth interviews, with an emphasis on eliciting the underlying rationale of the clinicians' actions and choices when limiting treatment. Results: Informants perceived over-treatment in intensive care medicine as a dilemma. One explanation was that the decision-making base was somewhat uncertain, complex and difficult. The informants claimed that those responsible for taking decisions from the admitting ward prolonged futile treatment because they may bear guilt or responsibility for something that had gone wrong during the course of treatment. The assessments of the patient's situation made by physicians from the admitting ward were often more organ-oriented and the expectations were less realistic than those of clinicians in the intensive care unit who frequently had a more balanced and overall perspective. Aspects such as the personality and the speciality of those involved, the culture of the unit and the degree of interdisciplinary cooperation were important issues in the decision-making processes. Conclusion: Under-communicated considerations jeopardise the principle of equal treatment. If intensive care patients are to be ensured equal treatment, strategies for interdisciplinary, transparent and appropriate decision-making processes must be developed in which open and hidden values are rendered visible, power structures disclosed, employees respected and the various perspectives of the treatment given their legitimate place. [source] | ||||||||||||||||||||||||||||||||||||||||