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Qualitative Approach (qualitative + approach)
Selected AbstractsQualitative Approaches to the Study of Adverse Events and Near MissesACADEMIC EMERGENCY MEDICINE, Issue 12 2008Mark Hauswald MD First page of article [source] CSR and the environment: business supply chain partnerships in Hong Kong and PRDR, ChinaCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 5 2009Dennis K. K. Cheung Abstract Cross-border relocation of the production lines of Hong Kong companies to the Pearl River Delta Region (PRDR) of China relocates the pollution source geographically. In contextualizing corporate social responsibility (CSR), more and better collaborations on environmental management between Hong-Kong-based companies and their supply chains within Hong Kong and the PRDR are needed. Using a qualitative approach, this research identifies and examines nine concerned business supply chain partnership cases. Stakeholders perceived that partnership is a good tool for improving corporate environmental management. However, although it has become more active since 2002, partnership is not yet popular. More time and support are needed to develop it. Businesses should take further steps to benefit themselves and the environment. Based on the first-hand experiences and opinions of interviewees, this paper analyzes and presents recent partnership activities; their drivers and barriers; factors in their successes; and the possible roles of government and business associations in fostering partnership development. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment. [source] Barriers to effective drug addiction treatment for women involved in street-level prostitution: a qualitative investigationCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2007Frances M. Smith Objectives,To examine barriers to effective drug addiction treatment for women involved in street-level prostitution. Methods,A qualitative approach was selected to enable a detailed exploration, in an informal and unthreatening manner, of the barriers to drug addiction treatment from the women's perspective. Nine in-depth interviews were conducted with women who were involved in street-level prostitution. Transcripts of one-to-one interviews were analysed for recurrent themes using Interpretative Phenomenological Analysis. Results,Barriers to effective addiction treatment are present at psychological, interpersonal, and wider societal levels. Themes identified included: an impoverished sense of self-worth, a lack of trust and consistency in treatment, and the absence of a comprehensive treatment package. Conclusion,Current services could be improved by the provision of a structured treatment programme designed to target the specific physical and psychological requirements of this population. Also, efforts to correct the fictitious, negative portrayals of women involved in prostitution are required, if treatment efficacy is to be improved. Copyright © 2007 John Wiley & Sons, Ltd. [source] Journey into and through an early detection of psychosis service: the subjective experience of persons at risk of developing psychosisEARLY INTERVENTION IN PSYCHIATRY, Issue 1 2009Kate V. Hardy Abstract Aim: This study aimed to explore how persons who have been assessed as being at risk of developing psychosis make sense of and understand their experiences, using a qualitative approach. Methods: The sample comprised six female and four male participants (n = 10), ranging in age from 16 to 30 years, with a mean age of 21.8 years. All the participants had entered into a National Health Service Early Detection service in the North of England, which provides interventions for persons assessed as being at a high risk of developing psychosis. Individual semistructured interviews were conducted to study how persons at risk of developing psychosis construct their understanding and perception of their experiences. Results: The analyses identified three central themes: (i) ,perception of needs', which highlighted how participants recognized the need to enter services and how they identified what they required from the service; (ii) participants' subjective journey; and (iii) participants' orientation to the future. Conclusions: The journey described by participants assessed as being at risk of developing psychosis provides further insight into how persons make sense of their experiences from a qualitative ,insider' perspective. The findings are discussed in relation to the existing literature relating to the early detection and intervention of psychosis and clinical implications are identified. [source] Boundary element simulation of DC stray currents in oil industry due to cathodic protection interferenceEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 5 2007I. A. Metwally Abstract This paper presents a 3D theoretical simulation and analysis of DC stray current corrosion (SCC) in oil fields that could contribute to oil leak and finally oil deferment of electric submersible pump (ESP) systems. Application of the boundary element analysis system (BEASY) allowed cathodic protection (CP) interference to be assessed in terms of the normal current density, which is directly proportional to the corrosion rate, rather than using the qualitative approach of measuring the potential shift of the soil. Different real structures consisting of pipelines and/or well casings with different arrangements and interference conditions are simulated. The results reveal that the application of impressed current cathodic protection (ICCP) systems creates DC SCC on other nearby unprotected structures. This is an inherent potential problem with the application of such systems which dominates with decreasing soil conductivity, and/or increasing the anode current density and its proximity to the protected structures. On the contrary, SCC can be reduced by using multi-groundbed anodes. Copyright © 2006 John Wiley & Sons, Ltd. [source] Automatic diagnosis of diabetes using adaptive neuro-fuzzy inference systemsEXPERT SYSTEMS, Issue 4 2010Elif Derya Übeyli Abstract: A new approach based on an adaptive neuro-fuzzy inference system (ANFIS) is presented for diagnosis of diabetes diseases. The Pima Indians diabetes data set contains records of patients with known diagnosis. The ANFIS classifiers learn how to differentiate a new case in the domain by being given a training set of such records. The ANFIS classifier is used to detect diabetes diseases when eight features defining diabetes indications are used as inputs. The proposed ANFIS model combines neural network adaptive capabilities and the fuzzy logic qualitative approach. The conclusions concerning the impacts of features on the diagnosis of diabetes disease are obtained through analysis of the ANFIS. The performance of the ANFIS model is evaluated in terms of training performances and classification accuracies and the results confirm that the proposed ANFIS model has potential in detecting diabetes diseases. [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] Understanding service context: development of a service pro forma to describe and measure elderly peoples' community and intermediate care servicesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2009Susan A. Nancarrow PhD Abstract The purpose of this paper was to develop a pro forma which classifies the components of service delivery and organization which may impact on the outcomes of elderly peoples' community and intermediate care services. The resulting analytic template provides a basis for comparison between services and may help guide service commissioning and development. A qualitative approach was used in which key evaluations and reports were selected on the basis that they described elderly peoples' community and intermediate care services. These were analysed systematically using a qualitative (template) approach to draw out the key themes used to describe services. Themes were then structured hierarchically into an analytic template. Seventeen key documents were analysed. The initial coding framework classified 334 themes describing intermediate care services. These items were then clustered into 78 categories, which were reduced to 17 subcategories, then six overall groupings to describe the services, namely; (1) context; (2) reason for the service; (3) service-users; (4) access to the service; (5) service structure; and (6) the organization of care. The resulting analytic template has been developed into a ,service pro forma' which can be used as a basis to describe and compare a range of services. We propose that all service evaluations should describe, in detail, their context in a comparable way, so that other services can learn from and/or apply the findings from these studies. [source] Smoking after the age of 65 years: a qualitative exploration of older current and former smokers' views on smoking, stopping smoking, and smoking cessation resources and servicesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2006Susan Kerr BA MSc PhD RN HV Abstract The aim of this study was to explore older current/former smokers' views on smoking, stopping smoking, and smoking cessation resources and services. Despite the fact that older smokers have been identified as a priority group, there is currently a dearth of age-related smoking cessation research to guide practice. The study adopted a qualitative approach and used the health belief model as a conceptual framework. Twenty current and former smokers aged , 65 years were recruited through general practices and a forum for older adults in the West of Scotland. Data were collected using a semistructured interview schedule. The audio-taped interviews were transcribed and then analysed using content analysis procedures. Current smokers reported many positive associations with smoking, which often prevented a smoking cessation attempt. The majority were aware that smoking had damaged their health; however, some were not convinced of the association. A common view was that ,the damage was done', and therefore, there was little point in attempting to stop smoking. When suggesting a cessation attempt, while some health professionals provided good levels of support, others were reported as providing very little. Some of the participants reported that they had never been advised to stop smoking. Knowledge of local smoking cessation services was generally poor. Finally, concern was voiced regarding the perceived health risks of using nicotine replacement therapy. The main reasons why the former smokers had stopped smoking were health-related. Many had received little help and support from health professionals when attempting to stop smoking. Most of the former smokers believed that stopping smoking in later life had been beneficial to their health. In conclusion, members of the primary care team have a key role to play in encouraging older people to stop smoking. In order to function effectively, it is essential that they take account of older smokers' health beliefs and that issues, such as knowledge of smoking cessation resources, are addressed. [source] Dental hygienists' work environment: motivating, facilitating, but also tryingINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2010A Candell To cite this article: Int J Dent Hygiene,8, 2010; 204,212 DOI: 10.1111/j.1601-5037.2009.00420.x Candell A, Engström M. Dental hygienists' work environment: motivating, facilitating, but also trying Abstract:, The aim of the present study was to describe dental hygienists' experiences of their physical and psychosocial work environment. The study was descriptive in design and used a qualitative approach. Eleven dental hygienists participated in the study and data were collected during spring 2008 using semi-structured interviews. The material was analysed using qualitative content analysis. The results showed that the dental hygienists experienced their work environment as motivating and facilitating, but at the same time as trying. The three categories revealed a theme: Being controlled in a modern environment characterized by good relationships. Motivating factors were the good relationship with co-workers, managers and patients, seeing the results of your work, having your own responsibility and making your own decisions. The new, pleasant and modern clinics, good cooperation between co-workers and varying duties were described as facilitating factors. The trying factors, as described by the dental hygienists, were above all being controlled by time limits or by some elements of the work, such as teamwork. The dental hygienists also felt stress because appointments were too-short. To conclude, the participants described their work environment as trying in several ways, despite the modern clinics and good relationships. [source] The workplace and nurses with a mental illnessINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 6 2009Terry Joyce ABSTRACT A qualitative approach was used to explore workplace experiences of nurses who have a mental illness. Interview transcripts from 29 nurses in New South Wales, Australia were subjected to discourse analysis. One significant finding was a theme depicting the need for support and trust. This superordinate theme encompassed four subelements: declaring mental illnesses, collegial support, managerial support, and enhancing support. Most of the participants portrayed their workplace as an unsupportive and negative environment. A number of colleagues were depicted as having little regard for the codes for professional nursing practice. This paper shows how nurses in the study dealt with the workplace support associated with mental illness. [source] Powerlessness, marginalized identity, and silencing of health concerns: Voiced realities of women living with a mental health diagnosisINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2009Susan Van Den Tillaart ABSTRACT Using a feminist qualitative approach, this study substantiated many earlier research findings that document how women with a mental health diagnosis experience unequal access to comprehensive health care compared to the general population. Accounts of this disparity are documented in the literature, yet the literature has failed to record or attend to the voices of those living with mental health challenges. In this paper, women living with a mental health diagnosis describe their experiences as they interface with the health-care system. The participating women's stories clearly relate the organizational and interpersonal challenges commonly faced when they seek health-care services. The stories include experiences of marginalized identity, powerlessness, and silencing of voiced health concerns. The women tell of encountered gaps in access to health care and incomplete health assessment, screening, and treatment. It becomes clear that personal and societal stigmatization related to the mental health diagnosis plays a significant role in these isolating and unsatisfactory experiences. Lastly, the women offer beginning ideas for change by suggesting starting points to eliminate the institutional and interpersonal obstacles or barriers to their wellness. The concerns raised demand attention, reconsideration, and change by those in the health-care system responsible for policy and practice. [source] Clients' perceptions of client,nurse relationships in local authority psychiatric services: A qualitative studyINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2004Ulrica Hörberg ABSTRACT:,The Mental Health Care reform in Sweden aimed, among other things, to improve the possibilities for persons with mental illnesses to experience companionship and participation in society. The aim of the study was to describe how persons suffering from mental illness perceive their relationships with nursing staff in local authority psychiatric services. Data were collected through semi-structured recorded interviews with 17 strategically chosen clients. A qualitative approach inspired by phenomenography was used to analyse the data. The analysis resulted in four main categories and 13 subcategories. The main categories were: security, companionship, confirmation and development. [source] Relationships in nurse prescribing in district nursing practice in England: A preliminary investigationINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2005Rick Fisher RGN DNT BA(Hons) MScArticle first published online: 25 APR 200 Nurse prescribing is a significant change in the working lives of district nurses in the United Kingdom. It has been achieved as the result of a 13-year sociopolitical struggle, eventually culminating in an Act of Parliament, which enabled selected nurses to prescribe from a limited formulary. This research attempts to discover the nature of its impact on the relationships between prescribers, nurses, doctors, pharmacists, patients and carers. Using a qualitative approach, guided interviews were carried out with nurses, doctors, pharmacists, patients and carers. Initial findings indicate that far from producing an independent prescribing workforce, some prescribers are reverting to their preprescribing behaviour. For these prescribers, there is a suggestion that old hierarchies are being reinforced, which might be detrimental to nurse prescribing. [source] Facilitating best practice in aged care: exploring influential factors through critical incident techniqueINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2009Nadine Janes GNC(C) Aim., The focus of this study is on the perspective of facilitators of evidence-based aged care in long-term care (LTC) homes about the factors that influence the outcome of their efforts to encourage nursing staff use of best practice knowledge. Design., Critical incident technique was used to examine facilitators' experiences. Methods., Thirty-four participants submitted critical incident stories about their facilitation experiences through face-to-face interviews, telephone interviews, and/or a web-based written questionnaire. The resultant 123 stories were analysed using an inductive qualitative approach. Results., Factors at individual and contextual levels impacted the success of facilitators' work. The approaches and traits of facilitators as well as the emotionality and intellectual capacity of nursing staff were the individual factors of influence. On a contextual level, the inherent leadership, culture, and workload demands within LTC homes, as well as externally imposed standards were influential. Conclusions., Primary factors influencing the facilitation of best aged care in LTC homes appear to be largely relational in nature and intimately connected to the emotionality of those who work within these settings. Enhancing the interactional patterns amongst staff and leaders as well as promoting a positive emotional climate may be particularly effective in promoting better aged care nursing practice. [source] Tourist modernisation and social legitimation in SpainINTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 5 2010Alejandro Mantecón Abstract Spain's modernisation has been based, to a large extent, on the so-called ,residential tourism'. Its two-fold nature,as a production model and a type of lifestyle migration,has complex repercussions. The aim of this paper is to delve, with a qualitative approach, into the key factors that explain the current social legitimation of this process by the Spanish society. The research suggests that the process is legitimated by its definition as an essentially tourism phenomenon. The label ,tourism' acts as some sort of ,funnel' that would not allow to go through it the problems associated with lifestyle migration or urbanisation. Copyright © 2010 John Wiley & Sons, Ltd. [source] Turkish women's perceptions of antenatal educationINTERNATIONAL NURSING REVIEW, Issue 3 2010P. Serçeku Serçeku, P. & Mete S. (2010) Turkish women's perceptions of antenatal education. International Nursing Review57, 395,401 Background:, Antenatal education is considered essential for expectant women. Although there are a number of studies on the effects of antenatal education, there are few studies featuring substantial evidence in this area. For this reason, the benefits have not been clearly defined. Aim:, To describe women's perceptions of the effectiveness of antenatal education on pregnancy, childbirth and the post-partum period, and also to describe their impressions on the type of education received. Methods:, A qualitative approach was used. The study featured 15 primipara women who had attended antenatal education. Data were gathered through semi-structured interviews and analysed using the content analysis method. Findings:, The results of this study showed that education provided a basis of knowledge about pregnancy, childbirth and the post-partum period. It was found that education could have positive effects on pregnancy, childbirth, breastfeeding, motherhood and infant care, and that it could at the same time have a positive or negative effect on fear of childbirth. Although different advantages were found to be perceived in both individual and group education, it was discovered that the study participants were much more satisfied with attending group sessions. Key conclusions and implications for practice:, Antenatal education should be planned in such a way that its content and methodology do not increase fear. When the lower costs incurred and the higher satisfaction level attained are considered, group education appears to be the type of antenatal education that should be preferred. [source] Perceptions of a service redesign by adults living with type 2 diabetesJOURNAL OF ADVANCED NURSING, Issue 7 2009Joan R.S. McDowell Abstract Title.,Perceptions of a service redesign by adults living with type 2 diabetes. Aim., This article is a report of a study conducted to explore the perceptions of adults with type 2 diabetes towards the service redesign. Background., Diabetes is reaching epidemic proportions and the management of this chronic illness is changing in response to this challenge. In the United Kingdom, there is ongoing restructuring of healthcare services for people with chronic illnesses to ensure that their general health and clinical needs are met predominantly in primary care. Method., An explorative qualitative approach was used. Eight focus groups were conducted with 35 people with type 2 diabetes in one urban location between 2003 and 2004. Five focus groups were conducted with people who had recently experienced the restructured service and three groups with people who had up to 2 years' experience of the new service. Concurrent data collection and thematic analysis were conducted by three researchers and credibility and verification sought by feedback to participants. Findings., Five main themes were identified: impact of living with diabetes; understanding diabetes; drivers for organizational change; care in context and individual concerns. Participants identified issues for ongoing development of the service. Conclusion., People with type 2 diabetes appreciate their care management within the primary care setting where there has been investment in staff to deliver this care. Healthcare resources are required to support the development of staff and the necessary infrastructure to undertake management in primary care. Policy makers need to address the balance of resources between primary and secondary care. [source] Resources, Staff Beliefs and Organizational Culture: Factors in the Use of Information and Communication Technology for Adults with Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2008Sarah Parsons Background, Access to, and the use of, information and communication technology (ICT) is increasingly becoming a vital component of mainstream life. First-order (e.g. time and money) and second-order factors (e.g. beliefs of staff members) affect the use of ICT in different contexts. It is timely to investigate what these factors may be in the context of service provision for adults with intellectual disabilities given the role ICT could play in facilitating communication and access to information and opportunities as suggested in Valuing People. Method, Taking a qualitative approach, nine day service sites within one organization were visited over a period of 6 months to observe ICT-related practice and seek the views of staff members working with adults with intellectual disabilities. All day services were equipped with modern ICT equipment including computers, digital cameras, Internet connections and related peripherals. Results, Staff members reported time, training and budget as significant first-order factors. Organizational culture and beliefs about the suitability of technology for older or less able service users were the striking second-order factors mentioned. Despite similar levels of equipment, support and training, ICT use had developed in very different ways across sites. Conclusion, The provision of ICT equipment and training is not sufficient to ensure their use; the beliefs of staff members and organizational culture of sites play a substantial role in how ICT is used with and by service users. Activity theory provides a useful framework for considering how first- and second-order factors are related. Staff members need to be given clear information about the broader purpose of activities in day services, especially in relation to the lifelong learning agenda, in order to see the relevance and usefulness of ICT resources for all service users. [source] Cladistic biogeography and the art of discoveryJOURNAL OF BIOGEOGRAPHY, Issue 4 2002Malte C. Ebach Aims Cladistic biogeography is about discovering geographical congruence. The agreement of several taxon-area cladograms (TACs) rarely yields a perfect result. Areas may overlap, taxa may not be evenly distributed, and thus, ambiguity may be prevalent in the data. Ambiguity is incongruence and may be resolved by reducing paralogy and resolving potential information. Recently, several new approaches in cladistic biogeography [i.e. Brooks parsimony analysis (BPA), Assumption 0] interpret ambiguity as congruence. These methods are problematic, as they are generational. Methods constructed under the generation paradigm are flawed concepts that are immunized from falsifying evidence. A critique of modified BPA reveals that taking an evolutionary stance in biogeography leads to flaws in implementation. Methods Area cladistics is a new development in cladistic biogeography. Area cladistics adopts paralogy-free subtree analysis using Assumption 2, to discover the relative positions of continents through time. Results Geographical congruence is the result of allopatric (geographical) speciation. Vicariance, dispersal and combinations of both, are recognized causes for allopatric speciation. Area cladistics highlights the concept that all these events occur in response to geological changes (e.g. continental drift) either directly, by geographical boundaries, or indirectly, at the level of ocean currents. Samples of chosen examples all respond to the geological process. The examples include Ordovician,Silurian and Lower Devonian trilobites to yield a general areagram which is a representational branching diagram that depicts the relationships of areas. Main conclusion Finding one common biogeographical pattern from several unrelated groups is a qualitative approach to interpret the positions of continental margins through time. Area cladistics is not a substitute for palaeomaps that are derived from palaeomagnetic data, but general areagrams adding to the body of knowledge that yields more precise interpretations of the earth's past. [source] Managing infant feeding practices: the competing needs of bulimic mothers and their childrenJOURNAL OF CLINICAL NURSING, Issue 6 2009Helen Stapleton Aim., This paper seeks to explain how bulimic mothers accommodated infant feeding demands in conjunction with managing their disordered eating practices. Background., Eating disorders are chronic and disabling illnesses primarily affecting women. There are few qualitative studies describing bulimia in the context of motherhood. Design., The study employed an inductive qualitative approach. Methods., A purposive sample of childbearing women (n = 16), who self-defined as living with an eating disorder, were recruited. Data were generated from one-to-one interviews; a thematic analysis identified key issues. Results., Participants were primarily responsible for ensuring child/ren's socialisation processes, including modelling appropriate dietary behaviours and these demands often conflicted with their personal needs for food restraint. Pressures to participate in social activities with children were widely experienced as stressful especially when these events focused on food. Participants viewed early and repeated exposure to ,healthy' eating as protective against their children acquiring an eating disorder and in this respect commercial child-care facilities provided alternative environments for children to explore food-related activities. Conclusions., Participants employed a variety of strategies to ensure children's exposure to normalising influences and socialising processes. Concerns about personal competencies with respect to food preparation and storage were articulated by all participants. Relevance to clinical practice., Professionals involved with providing care to mothers and their infants are well placed to support bulimic clients and to foster confidence in their mothering skills. Early and appropriate intervention is key to effecting positive changes in bulimic patterns, with potential benefits to women's future health and well-being and that of their children. [source] Opioid-taking tasks and behaviours in Taiwanese outpatients with cancerJOURNAL OF CLINICAL NURSING, Issue 15 2008Shu-Yuan Liang PhD Candidate Aim., The aim of this study was to describe those tasks and behaviours that contribute to self-efficacy in the context of opioid-taking in Taiwanese outpatients with cancer and to explore those factors that influence a patient's self-efficacy with engaging in these behaviours. Background., Self-management with prescribed opioid regimen has become a necessary component of the cancer pain experience at home. Tailoring prescribed regimens is a complex and continuing effort for cancer pain control. Few studies, however, have explored the specific skills and behaviours required by patients to manage their opioid analgesics effectively. Design., A qualitative approach was used to explore those behaviours that contribute to patients' ability to self-manage medication for their cancer pain. Method., Ten Taiwanese cancer patients aged between 41,75 years attending two oncology outpatient departments, who were prescribed opioid analgesics, were interviewed. All interviews were tape-recorded and were transcribed verbatim. Qualitative content analysis was undertaken to identify categories. Results., Five main categories of behaviours were identified, which reflected patient's perceptions of the actions required for effective opioid-taking. These behavioural domains included communicating about pain and analgesic-taking, taking analgesics according to schedule, obtaining help, tailoring medication regimens and managing treatment-related concerns. In addition, patients described various situations in which performance of these behaviours was more or less difficult. Conclusions., Our results suggest that self-efficacy with opioid-taking includes not only beliefs about the ability to communicate, but also the ability to fulfil more complex tailoring of medication regimens and management of treatment-related concerns. Relevance to clinical practice., Health professionals need to incorporate strategies to assist cancer patients' ability to engage in these behaviours and to manage situational impediments that may influence this ability. More importantly, clinicians need to assist patients to enhance their beliefs in their ability in overcoming various situation impediments for opioid-taking. [source] Good work , how is it recognised by the nurse?JOURNAL OF CLINICAL NURSING, Issue 12 2008Bjørg Christiansen Dr. Polit. Aim., The aim of this paper is to shed light on how nurses describe situations that reflect achievement and provide confirmation that they have done good work. Background., Nurses' recognition of good work does not seem to have been the object of direct investigation, but is indirectly reflected in studies focusing on nurses' perceptions on work environments and the multifaceted nature of nursing. However, acknowledging high-quality performance in professional nurses can facilitate nurses in maintaining and strengthening the goals and values of the profession. This in turn can help nurses shoulder the multifaceted responsibilities they have to patients and next of kin. Design., This paper is part of the Professional Learning in a Changing Society project, Institute of Educational Research, University of Oslo, funded by the Research Council of Norway. The project involves four professional groups. This paper, however, focuses on a group of 10 nurses, nine of whom work in hospitals and one in an outpatient clinic. A qualitative approach was chosen to gain insight into how nurses, as well as the other professional groups in the project, engage in processes of knowledge production and quality assurance work. Methods., Data presented in this paper derive from semi-structured in-depth interviews conducted during spring 2005 and focuses on the recognition of good work. Results., The following themes were identified as essential in confirming that one did good work: securing fundamental needs of patients and next of kin; managing the flow of responsibilities; positive feedback. Conclusions., Good work seems to be related to specific situations and a sense of achievement by the respondents. Relevance to clinical practice., Recognition of good work is not only rewarding and enjoyable; it may also serve as a source of consciousness raising for professional and ethical guidelines in the work place. [source] Hospitalized elders and family caregivers: a typology of family worryJOURNAL OF CLINICAL NURSING, Issue 1 2005Hong Li PhD Objective., This qualitative study explored the kinds of worry that family caregivers experience when their older relatives are hospitalized. Background., Little is known about what kinds of worries family caregivers may have in association with the hospitalizations of older relatives. An understanding of the different patterns of family worry may help health care teams intervene more effectively to meet family caregiver's needs by reducing their anxiety. Design., A qualitative descriptive design with Loftland and Loftland (1984) approach for the study of a phenomenon occurring in a social setting was used. Method., A purposeful sample of 10 participants was obtained that included six family caregivers and four nurses. Participants were recruited from two hospitals in the northwest US. Intensive interviews and participant observations were used for data collection, and Loftland and Loftland's (1984) qualitative approach was used for data analysis. Results., Family worry was defined as family caregivers' felt difficulty in fulfilling their roles because of worry. Four categories of family worry were identified as a result of this study: (i) worry about the patient's condition; (ii) worry about the patient's care received from the health care team; (iii) worry about future care for the patient provided by the family caregiver; and (iv) worry about finances. Conclusions., The findings of this pilot study provide nurses with the initial knowledge of the typology of family worry associated with elderly relatives' hospitalizations. Relevance to clinical practice., The findings of this study may sensitize the nurses to more precisely evaluate family caregivers' worry about their hospitalized elders and provide more effective nursing interventions to improve outcomes of both patients and their family caregivers. [source] Defining the nature of participation in rural Australian communities: A qualitative approachJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2002Sheridan J. Coakes Within the literature, theories and analyses of social involvement or participation have focussed primarily on the political and formal role of participation within the community or neighborhood. This study illustrates, through qualitative inquiry, that within small rural communities, individuals find it difficult to separate formal and informal participation, when both have an equally important role to play in community life. Fifty-five structured interviews were conducted with women across six rural shires in the southwest region of Western Australia. Qualitative analysis revealed that approximately 50% of women, when asked about their involvement in their community, referred initially to their informal participation within the community, rather than their participation in formal community groups or associations. These results are discussed in relation to life in small rural towns. © 2002 Wiley Periodicals, Inc. [source] Small Business in the Face of Crisis: Identifying Barriers to Recovery from a Natural Disaster,JOURNAL OF CONTINGENCIES AND CRISIS MANAGEMENT, Issue 1 2006Rodney C. Runyan The crisis management literature has not dealt in depth with small business response to disasters. This study takes a qualitative approach to consider how small businesses respond to and recover from a large disaster, by interviewing stakeholders in five different communities in the Gulf Coast of the United States. Events that are considered to be crises in nature are usually characterized by high consequence, low probability, ambiguity, and decision making time pressure. Hurricane Katrina and its aftermath caused small business owners in the U.S. Gulf region to experience each of these. Findings include lack of planning by small business; vulnerability to cash flow interruption; lack of access to capital for recovery; problems caused by federal assistance; and serious infrastructure problems impeding recovery. [source] GPs' perceptions of multiple-medicine use in older patientsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2010Janne Moen PhD Abstract Rationale, aim and objective, Multiple-medicine use (polypharmacy) is a growing problem for older patients, prescribers and health policy makers. The general practitioner (GP) is most often the main professional care provider; hence, improvements of treatment can only be carried out in concordance with GPs. The aim of this study was, therefore, to explore GPs' perspectives of treating older users of multiple medicines, using a qualitative approach. Method, Six focus groups, with four private GPs and 27 county-employed GPs, were analysed by using the framework method. Results, In contrast to definitions in most epidemiologic studies, the GPs gave a spontaneous definition of polypharmacy as ,the administration of more medicines than are clinically indicated'. They had problems stating both a cut-off number and which medicines should be included. Clinical practice guidelines were thought of as ,medicine generators', having an ambiguous effect on the GPs, who both trust them and find them difficult to apply. There was a perceived lack of communication between GPs and hospital specialists concerning their patients' medicines, which was further perceived to reduce treatment quality. The influence of patient pressure was acknowledged by the GPs as a factor contributing to the development of multiple-medicine use. Conclusions, The GPs felt insecure although surrounded by clinical practice guidelines. There is a need for policy makers to appreciate this paradox, as the problem is likely to grow in size and proportion. GPs must be empowered to handle the increasing proportion of older users of multiple medicines with individual agendas, receiving care from multiple specialists. [source] An evaluation of a domiciliary respite service for younger people with dementiaJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2002Kader Parahoo RMN BA(Hons) PhD Abstract Rationale, aims and objectives There is a lack of respite services designed specifically for younger people with dementia. There is also a dearth of studies on the evaluation of domiciliary respite services for carers of people with dementia in general. This paper reports on the evaluation of a domiciliary respite service for carers of younger people with dementia, in one area in Northern Ireland, provided by a local branch of the Alzheimer's Society. Methods Using a qualitative approach, eight carers and their families were interviewed in their own homes about their views and expectations of the service, the benefits and problems they experienced, and other issues of relevance to them. Results Overall, they reported great satisfaction with the service. The way they used, and benefited from, the service differed for individuals. Most of them, however, gained respite in the form of help with bathing and dressing the person with dementia. Carers reported that they did not engage in social or recreational activities during the period of respite. Instead they used the respite time to catch up with household chores and shopping. Discussion and conclusions The benefits and concerns can only be understood from the perspectives of carers and in the context of their needs, values, beliefs and traditions. The insight gained can be used to inform future provision of services for this population. [source] A study of the criteria used by healthcare professionals, managers and patients to represent and evaluate quality careJOURNAL OF NURSING MANAGEMENT, Issue 2 2001M. Attree msc, bnurs Aim,To explore the perceptions of and criteria used by healthcare professionals, managers, patients and relatives to represent and evaluate their concept of quality care. Methods A qualitative approach using grounded theory was adopted in thisexploratory descriptive study. Data collected by semi-structured interviews from a purposive sample of nurses, doctors, managers (n = 36), patients (n = 34) and relatives (n = 7) from one acute medical ward, were subjected to content, question and thematic analysis, using an inductive categorizing scheme. Findings Three categories of criteria relating to Care Resources, Processes and Outcomes were identified by healthcare professionals, managers, patients and relatives. Resource criteria included Human Resources: staff numbers, ratio to patients, skill mix; as well as Environmental/Physical and Financial Resources. Process criteria included Care Functions, Practices and Standards as well as Interpersonal Processes. Outcome criteria were either patient-focused: feeling comfort, happy, informed and satisfied; or health-related: maintenance or progress with health problems and goals. Conclusions The criteria used by healthcare stakeholders in this study were notunusual; virtually all were supported by the literature, a proportion of which was evidence-based. The criteria identified in this study are however consensual, agreed upon by healthcare professionals, managers, patients and relatives as representing their view of quality care. These consensual criteria could be used as unifying constructs for the development and testing of more comprehensive, reliable and valid methods of evaluating quality care which represent its multiple dimensions and perspectives. [source] The experiences and perceived changes of Chinese ex-mental patients attending a holistic psychiatric rehabilitation programme: a qualitative studyJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2008A. L. LUK The paper reports a study on the subjective experiences and perceived personal changes of Chinese ex-mental patients attending a psychiatric holistic rehabilitation programme. The programme adopted a self-help group approach in which holistic aspects of physical, psycho-social and spiritual needs are emphasized. There are different rehabilitation programmes for chronic mental patients. However, spiritual element is not consciously included in most of these programmes. Furthermore, few studies document the changes of participants attending psychiatric rehabilitation adopting self-help and holistic care principles. A qualitative approach using an in-depth interview was adopted. A total of 20 members from the programme, which was about one-sixth of all the regular group members were recruited. All interviews were audiotaped and transcribed. Data were coded, categorized and developed to different themes using content analysis. Totally, there were 52 themes developed from the data. However, only 13 themes on experiences in the group and nine themes on the perceived personal changes were reported. By attending the programme, participants had positive feelings and gained many positive learning opportunities when interacting with peers. Interacting with group counsellors was also very beneficial to them. Though there were only some improvements physically, there were clear perceived positive changes in the psychological, social and spiritual dimensions. These findings are consistent with those found in the quantitative measures reported previously. The subjective experiences of the participants were positive and they perceived positive personal changes after joining the group. The findings support the effectiveness of the long-term nature of self-help group. Furthermore, the holistic programme helps members rediscover meaning and purpose of life and the religious practices in the group can be regarded to be a protective factor to stress not only to those believers but also to the non-believers. [source] | ||||||||||||||||||||||||||||||||||||||||||||||