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Qualitative Responses (qualitative + response)
Selected AbstractsFactual memories of ICU: recall at two years post-discharge and comparison with delirium status during ICU admission , a multicentre cohort studyJOURNAL OF CLINICAL NURSING, Issue 9 2007Brigit L Roberts RN, IC Cert Aims and objective., To examine the relationship between observed delirium in ICU and patients' recall of factual events up to two years after discharge. Background., People, the environment, and procedures are frequently cited memories of actual events encountered in ICU. These are often perceived as stressors to the patients and the presence of several such stressors has been associated with the development of reduced health-related quality of life or post-traumatic stress syndrome. Design., Prospective cohort study using interview technique. Method., The cohort was assembled from 152 patients who participated in a previously conducted multi-centre study of delirium incidence in Australian ICUs. The interviews involved a mixture of closed- and open-ended questions. Qualitative responses regarding factual memories were analysed using thematic analysis. A five-point Likert scale with answers from ,always' to ,never' was used to ask about current experiences of dream, anxiety, sleep problems, fears, irritability and/or mood swings. Scoring ranged from 6 to 30 with a mid-point value of 18 indicating a threshold value for the diagnosis of post-traumatic stress syndrome. A P -value of <0·05 was considered significant for all analyses. Results., Forty-one (40%) out of 103 potential participants consented to take part in the follow-up interview; 18 patients (44%) had been delirious and 23 patients (56%) non-delirious during the ICU admission. The non-participants (n = 62) formed a control group to ensure a representative sample; 83% (n = 34) reported factual memories either with or without recall of dreaming. Factual memories were significantly less common (66% cf. 96%) in delirious patients (OR 0·09, 95%CI 0·01,0·85, p = 0·035). Five topics emerged from the thematic analysis: ,procedures', ,staff', ,comfort', ,visitors', and ,events'. Based on the current experiences, five patients (12%, four non-delirious and one delirious) scored ,18 indicative of symptoms of post-traumatic stress syndrome; this did not reach statistical significance. Memory of transfer out of ICU was less frequent among the delirious patients (56%, n = 10) than among the non-delirious patients (87%, n = 20) (p = 0·036). Conclusion., Most patients have factual memories of their ICU stay. However, delirious patients had significantly less factual recall than non-delirious patients. Adverse psychological sequelae expressed as post-traumatic stress syndrome was uncommon in our study. Every attempt must be made to ensure that the ICU environment is as hospitable as possible to decrease the stress of critical illness. Post-ICU follow-up should include filling in the ,missing gaps', particularly for delirious patients. Ongoing explanations and a caring environment may assist the patient in making a complete recovery both physically and mentally. Relevance to clinical practice., This study highlights the need for continued patient information, re-assurance and optimized comfort. While health care professionals cannot remove the stressors of the ICU treatments, we must minimize the impact of the stay. It must be remembered that most patients are aware of their surroundings while they are in the ICU and it should, therefore, be part of ICU education to include issues regarding all aspects of patient care in this particularly vulnerable subset of patients to optimize their feelings of security, comfort and self-respect. [source] Evaluation of the Centers for Disease Control and Prevention's Concussion Initiative for High School Coaches: "Heads Up: Concussion in High School Sports"JOURNAL OF SCHOOL HEALTH, Issue 3 2010Kelly Sarmiento MPH BACKGROUND: To reduce the number of sports-related concussions, the Centers for Disease Control and Prevention (CDC), with the support of partners and experts in the field, has developed a tool kit for high school coaches with practical, easy-to-use concussion-related information. This study explores the success of the tool kit in changing knowledge, attitudes, and practices related to the prevention and management of concussions. METHODS: A mail questionnaire was administered to all eligible high school coaches who received the tool kit. Follow-up focus groups were conducted for additional information. Both quantitative data from the surveys and qualitative data from the focus groups were analyzed to support the objectives of the study. RESULTS: Respondents self-reported favorable changes in knowledge, attitudes, and practices toward the prevention and management of concussions. Qualitative responses augmented the quantitative data. CONCLUSION: Barriers to concussion prevention and management are complex; however, these results highlight the role that coaches can play in school settings in establishing a safe environment for their athletes. [source] Paediatric training for family doctors: principals and practiceMEDICAL EDUCATION, Issue 5 2002C Melville Background There is controversy as to how best to train general practitioners for the paediatric challenges they will meet in practice, in particular what should be included in training, what should be left out and how long should it last? Subjects and methods All 615 general practice principals referring to 6 hospitals were surveyed (40% response rate). Setting West Midlands region of England. Study design Postal questionnaire. Statistics Quantitative and qualitative assessment of responses. Quantitative responses were analysed by hospital, decade of qualification, and duration of paediatric training. Qualitative responses were analysed using grounded theory. Results Satisfaction with training was directly related to its duration, with low levels of satisfaction for less than 6 months paediatrics, moderate levels for 6,11 months, and high levels with 12 months or more. The most important item of training was recognition of the sick child. Acute and chronic paediatrics was generally well covered. Psychosocial aspects, public health and immunisation were poorly addressed. Neonatal resuscitation and first day checks were seen as relevant, but neonatal intensive care was not. Conclusions At least 6 months of paediatrics is necessary for GPs in training, but longer paediatric exposure further increases their satisfaction with training. GPs have a biopsychosocial rather than biomedical approach to their child patients, suggesting potential benefits from a greater emphasis on psychosocial and public health aspects at the expense of neonatal intensive care. Recognition of the sick child is essential, and acute and chronic organic illness should be covered in breadth. Possible future models for GP training in paediatrics are discussed. [source] FS07.2 Occupational contact dermatitis and workers' compensationCONTACT DERMATITIS, Issue 3 2004Kathryn Frowen Statistics for occupational contact dermatitis (OCD) in Australia are gathered from workers' compensation (WC) data and research has indicated that occurrence is underestimated by as much as 400%. This study investigated reasons which might influence decisions whether to claim WC or not. A questionnaire was posted to 168 individuals diagnosed with significantly work related OCD at a specialised occupational dermatology clinic, therefore fulfilling valid claim criteria under the WC scheme operating in the state of Victoria. 70 completed responses were analysed. Ages ranged from 18,65 and only 40% had claimed workers' compensation, with those under 45 y less likely to claim. Females were significantly (P < 0.05) less likely to claim, as were respondents who had dermatitis present for less than 6 months. At the time of diagnosis, 37% of respondents were health care workers, 10% hairdressers, 7% food handlers, and 29% worked in hospitals, 24% manufacturing, 10% hairdressing salons, and 7% each vehicle maintenance, food service and trades. 31% no longer worked for the same employer, however 90% of respondents were still employed. Those who did not claim WC lost less time from work than those who claimed, but more non-claimants still had skin problems quite often or constantly than did claimants. 28.6% of non-claimants had all or some of their medical and/or lost time costs paid by their employer, and only 18% of claimants had all of their costs paid by their employer or WC insurer. Although the sample size was small, interesting data was also obtained from the qualitative responses. [source] | ||||||||||