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Semistructured Interviews (semistructured + interview)
Selected AbstractsClinical characteristics of inpatient adolescents with severe obsessive,compulsive disorderDEPRESSION AND ANXIETY, Issue 2 2006Gal Shoval M.D. Abstract Obsessive,compulsive disorder (OCD) is a common disorder in adolescents, usually treated in the outpatient setting. Our aim in this study was to evaluate the clinical characteristics of adolescents with severe OCD that required hospitalization. A total of 342 patients consecutively admitted to a psychiatric adolescent inpatient unit and 87 healthy volunteers were assessed by a semistructured interview for clinical diagnosis, suicide risk factors, aggression, ego defense mechanisms, and intelligence. Patients with OCD (n=40) were compared to other four diagnostic patient groups with psychotic, affective, conduct, and eating disorders, as well as to normal controls. Adolescent inpatients with OCD experienced less separation anxiety than all the other psychiatric groups (P < .01) and were less impulsive than controls (P < .001). They differed in aggressive/impulsive traits and hospital-related behaviors from other diagnostic groups. Adolescent inpatients with OCD consist of a unique subgroup in the inpatient unit in terms of their clinical characteristics and risk factors for suicide. These characteristics should be taken into account when developing a treatment plan for these difficult-to-treat inpatients. Depression and Anxiety 23:62,70, 2006. © 2006 Wiley-Liss, Inc. [source] Side-effects and treatment with clozapine: A comparison between the views of consumers and their cliniciansINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2008Kay Hodge ABSTRACT:, This study sought to clarify the prevalence of various side-effects experienced by consumers taking clozapine (n = 27) and to elucidate the impact of clozapine on their quality of life. Responses of consumers were contrasted with those of clinicians to highlight any discrepancies between the two groups, thus providing a focus for the improvement of clinical practice. Consumers completed a demographic questionnaire, the Liverpool University Neuroleptic Side-Effect Rating Scale. They next took part in a semistructured interview, which explored their attitudes to clozapine treatment. File searches provided historical data for antipsychotic use before the prescription of clozapine. Clinicians completed the same instruments and submitted them by mail. Most clinicians overestimated the prevalence and severity of clozapine side-effects. Consumers reported drooling mouth as the most prevalent and severe side-effect, whereas clinicians estimated that difficulty staying awake was the most prevalent side-effect, and the most severe side-effect was sleeping too much. Clinicians and consumers agreed that clozapine lifts mood. Only 19% of consumers were unhappy about blood tests, whereas 52% of clinicians estimated that consumers were unhappy about blood tests. This study suggests that despite significant side-effects and regular blood tests, most stable consumers taking clozapine were happier and more satisfied with their treatment than many of their clinicians believed they were. The study also highlights the need for clinicians to ask consumers about the different side-effects they may be experiencing, so they can provide clinical support to improve their quality of life. [source] Victims of Domestic Violence: A Proposal for a Community Diagnosis Based on One of Two Domains of NANDA Taxonomy IIINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003Patricia Serpa de Souza Batista PURPOSE To explore and identify diagnostic components to amplify NANDA nursing diagnoses by modifying the root violence. Whereas violence is nondebatable as a diagnostic concept in nursing, other alternatives have not been identified in the two existing diagnoses. METHODS Using the case study method, this qualitative study sought to identify commonalties in a population of women who were "donnas da casa" (homemakers) in a small rural community of approximately 100 families, typical of the Brazilian northeast. The sample of 7 women was identified through a larger study that had been based on health needs of the community. Data were obtained through observation during a home visit and a semistructured interview based on NANDA Taxonomy II. Observations were focused on hygiene, manner of dress, home environment, and physical and emotional state. Data were analyzed by content and clustered into major categories. From these a profile of the women and another of the partners emerged. FINDINGS Subjects ranged in age from 33 to 43 years, and number of children between 3 and 7. One of the 7 women was literate; 5 were underweight; all were slovenly attired. They appeared sad and older than their age. The majority seemed relieved to unburden themselves to the interviewers as they went through a gamut of emotions such as sadness, anguish, and irritability expressed through crying, restlessness, changes in body language, and tone of voice. The shortage of beds was supplemented by hammocks and mats or cardboard. The women spoke of being confined to their home and of male partners who drank on weekends, thus leaving them with little money for necessities of life. There were accounts of beatings when the partner returned home after drinking, overt nonacceptance of children from previous marriages, and general destruction of the family environment. New children were regarded as just another mouth to feed. DISCUSSION The profiles pointed to the necessity of identifying a new nursing diagnosis that would be linked, only tangentially, by the root violence to the two diagnoses in NANDA Taxonomies I and II. This insight led us to consider that a new method of listing NANDA diagnoses, by root only, is imperative in the evolution of Taxonomy II. Proposed descriptors, Victims of (Axis 3) and Domestic (Axis 6) would be identified by Axes, thereby facilitating the process of classifying in the Domains and Classes. The two existing NANDA diagnoses, risk for other-directed violence and risk for self-directed violence, are proposed for classification in Class 3, Violence, in Domain 11 of Taxonomy II. Safety/Protection could, by virtue of their modification power, find anchor in another domain such as Domain 6, Self-Perception. CONCLUSIONS Although Safety/Protection seems the most logical domain for classification by root, the axes, dimensions of human responses, could pull the diagnosis in another direction, thereby dictating other nursing interventions and nursing outcomes [source] ANTECEDENTS AND CONSEQUENCES OF NEGATIVE MARITAL STRESSORSJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 2 2002Annmarie Cano Many couples seeking therapy report the occurrence of severe, negative marital stressors (e.g., infidelity, threats of marital dissolution). In addition, existing research has demonstrated that these marital stressors precipitate Major Depressive Episodes and psychological symptoms. This longitudinal study examines the antecedents and consequencs of negative marital stressors to help clinicians and researchers develop interventions that might prevent these stressors and their outcomes. Forty-one women completed a semistructured interview and measures of marital discord and depressive symptoms within one month after experiencing a marital stressor (baseline) and at a 16-month follow-up. The results indicate taht baseline marital discord contributes to the occurrence of additional marital stressors during the follow-up period. Although baseline depressive symptoms do not predict additional marital stressors, depressive symtoms along with marital discord predict future depressive symptoms. Finally, baseline marital discord and additional marital stressors contribute to future dissolution. Clinical and research implications are discussed. [source] Findings Across Subgroups Regarding the Level of Response to Alcohol as a Risk Factor for Alcohol Use Disorders: A College Population of Women and LatinosALCOHOLISM, Issue 10 2004Marc A. Schuckit Background: The rates of alcohol dependence, a genetically influenced disorder, are increased among Latino men in the United States and are lower among women across ethnic groups. These analyses explored whether the differential rate of alcohol use disorders (AUDs) might reflect one genetically influenced phenotype related to alcoholism risk: the low level of response (LR) to alcohol. Methods: A questionnaire was mailed to students at two universities to identify drinking but not alcohol-dependent 18- to 29-year-old men and women who had a parent with alcohol dependence. Subjects were subsequently screened with a validated semistructured interview to corroborate the personal and family histories, and they participated in a challenge with alcohol 0.75 ml/kg for women and 0.90 ml/kg for men. LRs to alcohol were determined and compared between genders and between Latino versus Caucasian/Anglo subjects. Results: The data revealed no consistent significant differences between genders regarding either subjective feelings of intoxication or alcohol-induced changes in body sway. A similar lack of differential between groups was observed when Latino and Caucasian/Anglo subjects were compared. However, there was at least a statistical trend for interactions when gender, ethnicity, and time were considered together; there was some evidence for a higher LR in Latina women. Perhaps reflecting the different weights and doses of alcohol used, men demonstrated higher breath alcohol concentrations, but no differences in these values were noted between Latino and Anglo populations. Conclusions: The results indicate that the LR to alcohol is not likely to explain differences in rates of AUDs between genders or these two ethnic groups overall. The possibility that a higher LR might be seen for the subgroup with the lowest AUD rate,Latina women,will require replication in larger samples of well matched groups before definitive conclusions can be drawn. [source] Suggestive Linkage on Chromosome 1 for a Quantitative Alcohol-Related PhenotypeALCOHOLISM, Issue 10 2002Danielle M. Dick Background Alcohol dependence is a clinically and etiologically heterogeneous disorder. Accordingly, a variety of subtypes of alcohol-dependent individuals have been proposed, and multiple operational definitions of alcohol use, abuse, and dependence have been used in linkage analyses directed toward detecting genes involved in alcohol use and problems. Here, we develop quantitative phenotypes that characterize drinking patterns among both alcoholic and nonalcoholic subjects, and use these phenotypes in subsequent linkage analyses. Methods More than 9000 individuals from alcoholic and control families were administered a semistructured interview and personality questionnaire as part of the initial stage of the Collaborative Study on the Genetics of Alcoholism (COGA). A principal component analysis was conducted on items that captured many of the dimensions of drinking and related behaviors, including aspects of alcohol use, antisocial behavior and affective disturbance when drinking, and personality. Factor scores were computed for all individuals. Nonparametric linkage analyses were conducted on these factor scores, in the initial COGA sample consisting of 987 individuals from 105 extended families, and in a replication sample consisting of 1295 individuals from 157 extended families. Results Three factors were identified, accounting for 68% of the total variance. The most promising regions of linkage appeared for factor 2, on which higher scores indicate a later age of onset of regular drinking and higher harm avoidance. Chromosome 1 yielded consistent evidence of linkage in both samples, with a maximum lod score of 3.3 when the samples were combined for analysis. Consistent suggestion of linkage also was found to chromosome 15. Conclusions Developing novel phenotypes that more accurately model the effect of influential genes may help efforts to detect genes involved in complex disorders. Applying principal component analysis in the COGA sample provided support for some regions of linkage previously reported in COGA, and identified other new, promising regions of linkage. [source] The Derryhirk Inn incident: The psychological sequelaeJOURNAL OF TRAUMATIC STRESS, Issue 6 2002Oscar E. Daly Abstract A major incident occurred in a Northern Ireland bar in March 1997. One hundred and fifty customers were held at gunpoint. No one sustained any serious physical injury. Six months after the incident 68 individuals were assessed by means of a semistructured interview. Higher than expected levels of posttraumatic stress disorder (PTSD) were found. The severity of the incident, but not perceived life threat, was associated with the development of PTSD. The results of this preliminary study show that even in the absence of physical injury, significant psychopathology can occur. [source] A national medical education needs' assessment of interns and the development of an intern education and training programmeMEDICAL EDUCATION, Issue 4 2000Frances B Hannon A needs' assessment of interns was undertaken using a self-completion questionnaire and a semistructured interview. The questionnaire explored to what degree graduates had been helped to acquire a range of competencies and professional characteristics. In the interviews graduates discussed their self-perceived learning needs, their educational and training experiences and made suggestions. A 25% random sample of 1996 graduate doctors was selected from the five medical schools in Ireland (n=95). The overall response rate was 88% (n=84). The software package SPSS was utilized to carry out descriptive statistics on the questionnaire data while the interview data were analysed qualitatively. Of the responders, 91% reported that they were not prepared for all the skills needed as an intern. History taking and clinical examination were considered well covered at the undergraduate level but little training was received in a range of professional competencies and personal characteristics. Formal education and training during the intern year was found to be poor. However, some skills and characteristics improved during the year as a result of work experience. In the interviews the graduates explored educational issues. They considered an improved clinical experience throughout the undergraduate years to be at the heart of curriculum development but stressed that, in order to succeed, it would have to be accompanied by leadership within the healthcare system and efforts to improve the learning environment. [source] The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease,MOVEMENT DISORDERS, Issue 11 2009Paolo Barone MD Abstract We performed a multicenter survey using a semistructured interview in 1,072 consecutive patients with Parkinson's disease (PD) enrolled during 12 months in 55 Italian centers to assess the prevalence of nonmotor symptoms (NMSs), their association with cognitive impairment, and the impact on patients' quality of life (QoL). We found that 98.6% of patients with PD reported the presence of NMSs. The most common were as follows: fatigue (58%), anxiety (56%), leg pain (38%), insomnia (37%), urgency and nocturia (35%), drooling of saliva and difficulties in maintaining concentration (31%). The mean number of NMS per patient was 7.8 (range, 0,32). NMS in the psychiatric domain were the most frequent (67%). Frequency of NMS increased along with the disease duration and severity. Patients with cognitive impairment reported more frequently apathy, attention/memory deficit, and psychiatric symptoms. Apathy was the symptom associated with worse PDQ-39 score but also presence of fatigue, attention/memory, and psychiatric symptoms had a negative impact on QoL. These findings further support a key role for NMS in the clinical frame of PD and the need to address them specifically in clinical trials using dedicated scales. © 2009 Movement Disorder Society [source] Female Adoptees' Perceptions of Contact With Their Birth Fathers: Satisfactions and Dissatisfactions With the ProcessAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2009Nola L. Passmore PhD Qualitative data were analyzed to identify factors associated with adoptees' satisfactions or dissatisfactions in their contact experiences with their birth fathers. Participants were 17 women who had been adopted prior to 2 years of age and had subsequently met their birth fathers. All women completed a questionnaire and 7 also took part in a semistructured interview. Four main themes were identified that affected satisfaction with contact: birth fathers' attributes and behavior, adoptees' attributes (e.g., expectations), behavior of others (e.g., birth mother, birth father's family, and adoptive parents), and circumstances of the conception and relinquishment. The implications of these findings for members of the adoption triangle and those providing postadoption services are discussed. [source] Postoperative Orgasmic Function Increases over Time in Patients Undergoing Nerve-Sparing Radical ProstatectomyTHE JOURNAL OF SEXUAL MEDICINE, Issue 1pt1 2010Andrew Salonia MD ABSTRACT Introduction., Postprostatectomy orgasmic function (OF) remains poorly defined. Aims., To assess OF over time in patients who underwent bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP) for organ-confined prostate cancer (PCa). Methods., Baseline data were obtained from 334 consecutive preoperatively sexually active PCa patients at hospital admission; data included a medical and sexual history, IIEF domain scores, and ICIQ-SF. Questionnaire were then completed every 12 months postoperatively, and patients participated in a semistructured interview at the 12-month (191/334 [57.2%] patients), 24-month (95/334 [28.4%] patients), 36-month (42/334 [12.6%] patients), and 48-month (19/334 [5.7%] patients) follow-up (FU). Main Outcome Measures., IIEF-OF domain values throughout the FU. Multivariate linear regression analysis (MVA) of the association between predictors (patient's age, IIEF-erectile function [EF], ICIQ-SF, and the use of postoperative proerectile pharmacological treatments) and the IIEF-OF at 12-month, 24-month, and 36-month FU. Results., Preoperative mean (median) IIEF-OF was 7.6 (10). The anova analysis showed an increase of the IIEF-OF values (P = 0.008; F = 4.009) throughout the FU (namely, IIEF-OF 12-month: 6.1 [6]; 24-month: 7.2 [8]; 36-month: 7.3 [8]; and 48-month: 7.7 [9.50]). The 12-month MVA showed that while proerectile oral therapy did not affect postoperative OF (P = 0.150; Beta 0.081), IIEF-OF linearly increased with IIEF-EF (P < 0.001; Beta 0.425). Conversely, IIEF-OF linearly decreased with patient's age (P < 0.001; Beta ,0.135) and with ICQ-SF scores (P < 0.001; Beta ,0.438). The 24-month and 36-month analyses showed that IIEF-OF still linearly increased with IIEF-EF (P < 0.001; Beta 0.540, and P < 0.001; Beta 0.536 respectively at the 24- and 36-month FU), whereas pharmacological therapy, rate of urinary continence, and patient's age did not significantly affect postoperative OF. Conclusions., Postoperative OF significantly ameliorates over time in patients undergoing BNSRRP. The higher the postoperative EF score, the higher the OF throughout the FU time frame. Salonia A, Gallina A, Briganti A, Colombo R, Bertini R, Da Pozzo LF, Zanni G, Sacca A, Rocchini L, Guazzoni G, Rigatti P, and Montorsi F. Postoperative Orgasmic Function Increases over Time in Patients Undergoing Nerve-Sparing Radical Prostatectomy. J Sex Med 2010;7:149,155. [source] Measuring men's opinions of prostate needle biopsyANZ JOURNAL OF SURGERY, Issue 8 2005Jessica C. C. Medd Background: Needle biopsy of the prostate is an important, common, invasive procedure. Little is known about men's perceptions of it. The present study was designed to assess men's experience of prostate biopsy, to determine the feasibility of a randomized trial of interventions to alleviate distress during prostate biopsy, and to develop a pragmatic outcome measure for such a trial. Methods: Of 33 consecutive men undergoing prostate biopsy at a Sydney (Australia), tertiary referral urology centre 31 men were selected for study. A cross-sectional, observational was performed. Participants completed both a 24-item questionnaire assessing relevant symptoms, attitudes and emotional responses and a semistructured interview shortly after their prostate biopsy. Each item of the questionnaire was rated on an 11-point scale from 0 (no trouble at all), to 10 (worst they could imagine). Results: The mean score for discomfort was 4.4 with 32% scoring ,7; the mean score for pain was 4.2 with 29% scoring ,7. The other most troubling aspects were: ,waiting for the result' (mean 4.4, 32% ,7) and ,fear of the result' (mean 3.7, 32% ,7). Seventy-one per cent of subjects stated that they would have been willing to participate in a randomized trial of interventions to make prostate biopsies less unpleasant. Thirteen of the 24 items were retained and refined for use as an outcome measure for subsequent trials. Conclusions: Many men experience pain, discomfort and anxiety during prostate needle biopsy and most would be willing to participate in trials of interventions to make it less unpleasant. [source] Medical masters: A pilot study of adaptive ageing in physiciansAUSTRALASIAN JOURNAL ON AGEING, Issue 3 2009Carmelle Peisah Aim:, To describe models of career and lifestyle options for ageing doctors that suggest adaptability to ageing and retirement. Method:, Doctors aged 60 or older from Australia, Canada and the United States (n= 25) deemed to be ageing well by peers were administered a semistructured interview to obtain demographic and qualitative data regarding lifestyle, attitudes to ageing and retirement. Results:, Emergent themes included: (i) insights into the physical and psychological vicissitudes of ageing and the effects of such on practice; (ii) the need for adaptations in working hours and choice of work; (iii) the importance of long-term retirement planning; (iv) the usefulness of a transitional phase to ease into retirement; and (v) the need to cultivate a variety of medical and non-medical pursuits and relationships early in one's career. Conclusion:, These insights might encourage doctors to engage in long-term occupational, familial, social and financial planning and provide potential models of adaptive ageing in doctors for further study. [source] Occupational therapists' perception of their practice: A phenomenological studyAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2009Liv Grethe Kinn Background:,International literature seems consistent in reporting that occupational therapists value their methods. However, little empirical evidence has been generated supporting the basic system of belief for occupational therapy. Few studies have explored the nature of the occupational therapists' experiences and thoughts about their use of occupation as means and ends, and which strategies they use to implement their tools in their current practice. Accordingly, the aim of this study was to explore how occupational therapists understood and presented their practice and interventions. Methods:,A sample of six occupational therapists graduated in different decades, from diverse client populations and health-care settings was selected to participate in a semistructured interview. Results:,Three main themes were developed: ,To make the client's potentials visible', ,reaching a position one values' and ,looking with other eyes'. Whatever their specialities, the participants were unanimous in the way they described their role. Their common focus was ,activities of daily living'. However, they had problems describing their therapeutic tools, and were not able to clearly articulate the ,common sense aspects' of their own methods. The participants were engaged in constructing their professional identities, and stressed the need to construct professional boundaries relevant to their particular work. Conclusion:,The occupational therapists perceived their practice and interventions as distinctly different from other team members, thus, they provided a ,counterpoint'. The participants used various ways of marketing their perspectives. While the novices tended to go along with the team, the experienced therapists tended to assert their own special contribution. [source] Divergent Hybrid Capitalisms in China: Hong Kong and Taiwanese Electronics Clusters in DongguanECONOMIC GEOGRAPHY, Issue 4 2007Chun Yang Abstract: This article explores and compares the changing dynamics and organization of cross-border production by Hong Kong and Taiwanese electronics firms in China, on the basis of more than 40 semistructured interviews with firms from April 2005 to January 2007 in various towns of Dongguan, an emergent "global factory" in south China. Despite initial resemblances, Hong Kong and Taiwanese electronics clusters have adopted different approaches to organize their cross-border production since the late 1990s. Little systemic comparative analysis has been conducted on the causes. The divergent practices can be interpreted as differences in corporate strategies of parent and branch firms, industrial policies in Hong Kong and Taiwan, linkages with global leaders, and home-host interactions in response to the challenges of globalization. To tap into the domestic market of mainland China, Hong Kong companies have tended to become "domestic firms," while Taiwanese companies have become wholly foreign owned and pursued a "pseudo-location" of suppliers of raw materials and components. The article concludes that more comparative studies are needed on divergent hybrid capitalisms that are driven by different sources of foreign direct investment in various host regions, so as to develop empirical insights into appropriate conceptual frameworks. [source] Voices From the System: A Qualitative Study of Foster Children's StoriesFAMILY RELATIONS, Issue 3 2003Jason B. Whiting This project qualitatively analyzed the stories that 23 preadolescent foster children told about their lives. An ecological framework in conjunction with the social constructionist understanding of stories guided the ethnographic semistructured interviews. These stories contained both common and unique features and provided insight into the lives of foster children whose environments involved poverty, drugs, crime, violence, and racism. Research domains included confusion, social ambivalence, anger, loss, and aids to resiliency. This study highlights the importance of these stories for the children who create them and those who will work with them. [source] Not Very Material but Hardly Immaterial: China's Bombed Embassy and Sino-American Relations,FOREIGN POLICY ANALYSIS, Issue 1 2010Gregory J. Moore In 1999 Sino-American relations experienced intense strain as a result of NATO's Kosovo intervention, and in particular by the bombing of the Chinese Embassy in Belgrade by an American B-2 bomber. Why did the bombing of China's embassy in Belgrade in the spring of 1999 touch such a raw nerve among the Chinese people and leadership? With the coming of the tenth anniversary of these events, what still needs to be explained is how Chinese and Americans could draw such divergent conclusions about that which they've never disagreed on,the incontestable fact of the embassy's demolition,and how the fact that what Americans called "a mistake" could almost completely derail Sino-American relations, which President Clinton in his very successful visit to China a year before had called a "strategic partnership." Based on a series of semistructured interviews the author did in Beijing and Washington with 28 Chinese and 30 American experts, this research draws a number of important conclusions in this regard. First, intensifying and even defining the conflict were a number of important perceptual gaps. Second, given the dispute over the intentionality of the embassy bombing, the conflict boiled down not to clashing interests, per se, but rather to issues of trust and beliefs about motives and intentions. Third, poor handling of the embassy bombing by both governments deepened the conflict and the alienation both sides felt. Fourth, underlying the lack of trust and the perceptual gaps between the two sides was "Fundamental Attribution Error." [source] Improving transfer of mental health care for rural and remote consumers in South AustraliaHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2009Judy Taylor BA Dip Soc Wk MSW PhD Abstract In Australia, it is commonplace for tertiary mental health care to be provided in large regional centres or metropolitan cities. Rural and remote consumers must be transferred long distances, and this inevitably results in difficulties with the integration of their care between primary and tertiary settings. Because of the need to address these issues, and improve the transfer process, a research project was commissioned by a national government department to be conducted in South Australia. The aim of the project was to document the experiences of mental health consumers travelling from the country to the city for acute care and to make policy recommendations to improve transitions of care. Six purposively sampled case studies were conducted collecting data through semistructured interviews with consumers, country professional and occupational groups and tertiary providers. Data were analysed to produce themes for consumers, and country and tertiary mental healthcare providers. The study found that consumers saw transfer to the city for mental health care as beneficial in spite of the challenges of being transferred over long distances, while being very unwell, and of being separated from family and friends. Country care providers noted that the disjointed nature of the mental health system caused problems with key aspects of transfer of care including transport and information flow, and achieving integration between the primary and tertiary settings. Improving transfer of care involves overcoming the systemic barriers to integration and moving to a primary care-led model of care. The distance consultation and liaison model provided by the Rural and Remote Mental Health Services, the major tertiary provider of services for country consumers, uses a primary care-led approach and was highly regarded by research participants. Extending the use of this model to other primary mental healthcare providers and tertiary facilities will improve transfer of care. [source] Investigating the nature of formal social support provision for young mothers in a city in the North West of EnglandHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2006Angela McLeod BA (Hons) MPH Abstract Young mothers often require support to remain socially ,included' after becoming pregnant and this, in its turn, could protect their health. In this context, new policy initiatives aimed at tackling social exclusion, such as those implemented under the National Teenage Pregnancy Strategy, could be working to build social support mechanisms. The present paper addresses the issue of whether statutory services do in fact deliver ,social inclusion', through the provision of appropriate social support for young mothers. Data are drawn from semistructured interviews with service providers from a variety of different settings. The questionnaire was structured around an established model of social support, developed by M. Barrera, called the Inventory of Socially Supportive Behaviours. The study took place in a deprived inner city in North West England. Eleven participants were interviewed from seven separate organisations. The findings indicate that there were well-developed referral systems between services, with services adopting a social model of health. Much informational and emotional support was provided. What was less clear is how services are enabling social support to be developed amongst peer groups accessing the services particularly at community level. It is questionable to what extent services are able to foster the development of social support through social activities and support groups, and even whether it is appropriate to expect them to do so. In some sense, services go some way to delivering social inclusion, in that they are providing advice about income, housing and other opportunities. However, services appear to be missing an opportunity to foster social inclusion through the lack of development of supportive networks amongst groups of peers, which may have implications for the health of young mothers. [source] The communication challenges faced in adopting a palliative care approach in advanced dementiaINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2009Amanda Johnson RN DipT(Ng) MHScEd This paper discusses one aspect from the findings of an Australian study aimed at understanding the needs of people with advanced dementia. Specifically, this paper focuses on the communication issues that might potentially inhibit the implementation of a palliative care approach for a person with advanced dementia in a residential aged care facility (RACF). Six focus groups consisting of 34 participants and 24 semistructured interviews were conducted. Participants were drawn from palliative care specialty staff, palliative care volunteers, designated aged or dementia specialist staff from an area health service, general practitioners, RACF staff and family carers. The findings show communication issues identified by the participants were a significant factor impacting on their capacity to adopt a palliative care approach in caring for people with advanced dementia. The findings support the need for education, skill development and networking to occur among the key providers of care in RACFs to ensure the provision of ,best practice' palliative care to residents with advanced dementia and their families. [source] Impoverished Children With Asthma: A Pilot Study of Urban Healthcare AccessJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2004Andrea Wallace ND ISSUES AND PURPOSE Using Andersen's Behavioral Model of Health Care Use, this pilot study was conducted to better understand the experiences of children with asthma as they access an urban healthcare system. DESIGN AND METHODS This descriptive study used a convenience sample of 34 families of pediatric asthma patients who participated in semistructured interviews and closed medical record review. RESULTS Only one patient reported having a written exacerbation management plan. Beliefs regarding medication addiction and side effects were frequently reported as barriers to medication adherence, and children seeking asthma care in primary care settings saw many care providers. PRACTICE IMPLICATIONS Exploring how expanded nursing roles can help address both family and system factors serving as barriers to health care ought to be a key priority for nursing. [source] Caregiver Understanding of Adolescent Development in Residential TreatmentJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 4 2002Susan Kools PhD PROBLEM Caretaker knowledge and understanding of adolescent development and its application to clinical practice with severely emotionally disturbed adolescents in residential treatment. METHODS Twenty child-care workers and registered nurses participated in semistructured interviews analyzed using dimensional analysis, a grounded theory method. FINDINGS Three distinct categories of caregivers were identified based on level of expertise and engagement in developmentally appropriate treatment practices: inexperienced, party-liners, and transcenders. Developmental issues identified included lack of resident preparation for puberty and staff discomfort with adolescent sexuality. CONCLUSIONS Caregiver, institutional, and social barriers to developmentally sensitive practice were identified. Practice recommendations include direct preparation of children and adolescents in residential treatment for pubertal changes and sexual development, and carefkl discernment of age-appropriate and psycho-pathological adolescent behaviors. [source] Nurses' Use of Physical Restraints in Four Turkish HospitalsJOURNAL OF NURSING SCHOLARSHIP, Issue 1 2007Ayten Demir Purpose: (a) Determine the frequency and types of physical restraints used by nurses in intensive care units, emergency departments, and neurosurgery wards; (b) understand nurses' attitudes toward physical restraint; and (c) identify complications in physically restrained patients. Design and Methods: This descriptive, cross-sectional study was carried out on 254 nurses working in intensive care units, emergency departments, and neurosurgery wards in four Turkish hospitals where physical restraints were used. The whole population was studied without any sampling, and data were collected via semistructured interviews from July 20 to September 6, 2005. Findings: Nurses used either wrist, ankle, or whole body restraints at various levels. Those nurses who worked in surgical intensive care units and emergency departments and had in-service training used more physical restraint than did others. Only a third of nurses decided on physical restraint together with physicians and three-fourths tried alternative methods. Nurses reported edema and cyanosis on wrist and arm regions, pressure ulcers on various regions, and aspiration and breathing difficulties in relation to physical restraint. Moreover, they reported 9 deaths of patients in chest restraints. Reduction in the frequency of caregiving was related to complications. Conclusions: Actions to reduce use of and complications from physical restraints should include attention to nurse staffing and education about use of restraints. [source] The Menopause Experience: A Woman's PerspectiveJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2002Sharon A. George PhD Objective: To understand the complexities of the experience of menopause in American women from diverse ethnic and socioeconomic backgrounds. The specific aims of this phenomenologic study were to (a) examine and interpret the reality of the menopausal transition as experienced by American women and (b) identify common elements and themes that occur as a result of the complexities of this experience. Design: Data for this qualitative study were gathered through semistructured interviews with 15 women who experienced natural menopause. Participants: A multiethnic sample of 15 menopausal American women in Massachusetts was selected from a pool of voluntary participants from the Boston area. Data Analysis: The interviews were analyzed to identify themes pertinent to the personal experience of menopause. Those themes, extracted from the similarities and differences described, represent broad aspects of these women's experiences. Results: Three major themes or phases were identified: expectations and realization, sorting things out, and a new life phase. Although some women expressed similar thoughts in particular categories, no two women had the same experience of menopause. Conclusions: The data support the premise that the experience of menopause in American women is unique to each individual and that the meaning or perspective differs among women. The data revealed the complexities of this human experience by explicating personal meanings related to experiences, expectations, attitudes, and beliefs about menopause. [source] Teaching nature of science within a controversial topic: Integrated versus nonintegratedJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 4 2006Rola Khishfe This study investigated the influence of two different explicit instructional approaches in promoting more informed understandings of nature of science (NOS) among students. Participants, a total of 42 students, comprised two groups in two intact sections of ninth grade. Participants in the two groups were taught environmental science by their regular classroom teacher, with the difference being the context in which NOS was explicitly taught. For the "integrated" group, NOS instruction was related to the science content about global warming. For the "nonintegrated" group, NOS was taught through a set of activities that specifically addressed NOS issues and were dispersed across the content about global warming. The treatment for both groups spanned 6 weeks and addressed a unit about global warming and NOS. An open-ended questionnaire, in conjunction with semistructured interviews, was used to assess students' views before and after instruction. Results showed improvements in participants' views of NOS regardless of whether NOS was integrated within the regular content about global warming. Comparison of differences between the two groups showed "slightly" greater improvement in the informed views of the integrated group participants. On the other hand, there was greater improvement in the transitional views of the nonintegrated group participants. Therefore, the overall results did not provide any conclusive evidence in favor of one approach over the other. Implications on the teaching and learning of NOS are discussed. © 2006 Wiley Periodicals, Inc. J Res Sci Teach 43: 395,418, 2006 [source] Development and evaluation of the conceptual inventory of natural selectionJOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 10 2002Dianne L. Anderson Natural selection as a mechanism of evolution is a central concept in biology; yet, most nonbiology-majors do not thoroughly understand the theory even after instruction. Many alternative conceptions on this topic have been identified, indicating that the job of the instructor is a difficult one. This article presents a new diagnostic test to assess students' understanding of natural selection. The test items are based on actual scientific studies of natural selection, whereas previous tests have employed hypothetical situations that were often misleading or oversimplified. The Conceptual Inventory of Natural Selection (CINS) is a 20-item multiple choice test that employs common alternative conceptions as distractors. An original 12-item version of the test was field-tested with 170 nonmajors in 6 classes and 43 biology majors in 1 class at 3 community colleges. The test scores of one subset of nonmajors (n,=,7) were compared with the students' performances in semistructured interviews. There was a positive correlation between the test scores and the interview scores. The current 20-item version of the CINS was field-tested with 206 students in a nonmajors' general biology course. The face validity, internal validity, reliability, and readability of the CINS are discussed. Results indicate that the CINS will be a valuable tool for instructors. © 2002 Wiley Periodicals, Inc. J Res Sci Teach 39: 952,978, 2002 [source] Describing clinical teachers' characteristics and behaviours using critical incidents and repertory gridsMEDICAL EDUCATION, Issue 7 2006Praminthra Chitsabesan Context, Completion of a rating questionnaire is the method used most frequently to evaluate a teacher's performance. Questionnaires that largely assess ,high-inference' teaching characteristics, such as ,enthusiasm' and ,friendliness', require the observer to make a judgement about the teacher but do not describe what the teacher actually did and so have limited use in providing feedback. Measures of ,low-inference' teaching behaviours (i.e. those that are concrete and observable), such as frequency, amount or types of verbal interaction, do not demonstrate how these are linked to good teaching. Objectives, To describe high-inference teacher characteristics and define the associated low-inference behaviours. Methods, A purposive sample of consultants, postgraduate and undergraduate students, nurse lecture practitioners and patients were selected for semistructured interviews using repertory grids and critical incidents to elicit preferred characteristics and behaviours of clinical teachers. Interviews were audiotaped, transcribed and then content-analysed using a framework to pair teachers' characteristics and their behaviours. Results, We identified a variety of preferred high-inference characteristics and their associated observable and recordable low-inference behaviours. Discussion, We carried out a study that included all participants in clinical teaching and found that participants differed in their preferred characteristics and behaviours. It is important for future research to look at behaviours interdependently, rather than alone, and to take into account the evidence that participants tend to infer characteristics rather than think in terms of behaviours. This information will be used to inform the development of a formative tool for evaluating clinical teaching. [source] Training the ideal hospital doctor: the specialist registrars' perspectiveMEDICAL EDUCATION, Issue 10 2001N Khera Background When training for junior doctors is being planned, little discussion is focused on what outcomes hospitals are trying to achieve with regard to education/training, i.e. on what makes the ideal hospital doctor. Instead, the primary focus is on the requirements of the syllabi of the Royal Colleges (credentialing) and the requirements of service delivery (job description). Current literature has no qualitative studies of any longitude in which middle-grade doctors are asked about their vision of the ideal hospital doctor, what they feel can be done to help realize this vision, and how they feel about their own training. Methods This study examined data principally collected through a series of semistructured interviews conducted with eight specialist registrars (SpRs), four each from the North Trent and South Thames rotations over a period of 18 months. Additional information was taken from focus groups, interviews with programme directors, and questionnaires. Findings A model was created of the SpRs' perceptions of the key attributes of an ideal hospital doctor and of how these may be achieved in training. Eight broad areas were identified: clinical knowledge and skills; key clinically related generic/non-clinical skills; self-directed learning and medical education; implementing change management; applying strategic and organizational skills in career planning; consultation skills; research; and key personal attributes. Conclusions SpRs are articulate in expressing their own expectations of their training and have considerable insight into the components of good training. Further improvement could be made and will require significant commitment from both trainees and trainers. [source] Research Article: Participation of patients with chronic illness in nursing care: An Iranian perspectiveNURSING & HEALTH SCIENCES, Issue 3 2010Mohsen Soleimani rn, phd (Cand.) Abstract The increasing number of chronically ill people has served as an impetus for the promotion of patient participation in nursing care. However, little is known about patient participation in Iran. The aim of this study was to identify the factors that are relevant to patient participation and the nature of that participation, as experienced by chronically ill patients and registered nurses in Iran. Grounded theory was used as the method. Twenty-two participants were recruited by using purposeful and theoretical sampling. The data were generated by semistructured interviews and participant observations. Constant comparison was used for the data analysis. This study indicated that participation is an interactive process between nurses, patients, and family members in the caregiving context. Participation occurred when the caring agents worked together. The core category of "convergence of the caring agents" emerged. The subcategories emerged as the levels of participation and included "adhering", "involving", "sharing", and "true participation". The factors related to the caring agents and caregiving context could be considered as predictors of the level of participation when caring for these patients. [source] Reconciliation in Londonderry: The Challenges and Constraints Experienced by Protestant ClergyPEACE & CHANGE, Issue 4 2006Neil Southern Northern Ireland is a place that is more peaceful due principally to the cessation (although imperfect) of republican and loyalist paramilitary violence in 1994. While the violent excesses of ethnic dispute in Northern Ireland no longer saturate media reports, there remains much fear, distrust, and insecurity between Protestant and Catholic communities. This article conducts a microexamination of church-led attempts at cross-community reconciliation by Protestant clergy in the city of Londonderry. These attempts are often hampered because of factors that affect both the clergy and the wider Protestant community within which the clergy discharge their pastoral duties. The constraints in their ecumenical activity and interfaith contacts that Protestant clergy experience highlight other factors that hinder the evolution of a more peaceful society. It also causes one to reflect carefully upon the effectiveness of ecumenism and interfaith dialogue as a model for advancing society towards peace and reconciliation. The findings of this paper are based upon a qualitative methodology that involved eight semistructured interviews with clergy of the Church of Ireland, Presbyterian, and Methodist traditions. [source] | ||||||||||||||||||||||||||||||||||