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Thematic Analysis (thematic + analysis)
Selected AbstractsDeveloping a parenting skills-and-support intervention for mothers with eating disorders and pre-school children part 1: qualitative investigation of issues to includeEUROPEAN EATING DISORDERS REVIEW, Issue 5 2007Rachel Bryant-Waugh Abstract Objective This study aimed to (i) identify themes and issues that might usefully be addressed in a skills-and-support intervention for mothers with eating disorders who have children less than 5 years of age, and (ii) determine the most appropriate format for such an intervention. Method Focus groups and individual interviews were conducted with seven mothers with eating disorders and pre-school children, and four local health professionals working with mothers of pre-school children. Results Thematic analysis of interview transcripts revealed 10 themes: ,Passing on Traits', ,Food Preparation and Provision', ,Interactions Around Food and Mealtimes', ,Mother's Intake', ,Self Care', ,Self Identity and Parental Expectations', ,Impact on General Parent,Child Relationship', ,Need for Control', ,The Group Experience' and ,Practicalities and Format'. Discussion Findings highlight a number of difficulties and concerns experienced by mothers with eating disorders who have pre-school age children. An intervention incorporating the identified themes could provide important support to this patient group and potential benefit to their offspring. © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Systematic review of the perceptions and experiences of accessing health services by adult victims of domestic violenceHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2008Louise Robinson RGN RHV BSc (Hons) MSc Abstract This systematic review synthesises evidence on the perceptions and experiences of adult victims of domestic violence when accessing healthcare services. The review was concerned with disclosure of domestic violence by adult victims when accessing health services, the responses of healthcare professionals to these victims, victims' perceived barriers to support, and the appropriateness of support and referrals. These aims required the review to focus on studies using in-depth qualitative methods to explore victims' perceptions and experiences. A comprehensive systematic search of 12 databases was carried out in June/July 2005. Application of the review protocol and inclusion criteria resulted in 10 studies (conducted in the UK, USA and Australia) being considered eligible for the review. Data were extracted from these studies and a quality assessment completed. Thematic analysis was carried out to enable the identification of recurrent themes within the included studies. Findings indicate that victims of domestic violence experience difficulties when accessing healthcare services. Victims perceive that these difficulties can be attributed to inappropriate responses by healthcare professionals, discomfort with the healthcare environment, perceived barriers to disclosing domestic violence, and a lack of confidence in the outcomes of disclosure to a health professional. The methodological quality of included studies was variable, but no papers were rejected based on quality issues. These results can contribute to and inform a comprehensive assessment of the experiences of adult victims of domestic violence when accessing healthcare services. The health service is in a unique position to contribute towards the assessment and identification of domestic violence and to provide access to appropriate support. The messages of this study are important for policy-makers and practitioners. [source] The UCLan community engagement and service user support (Comensus) project: valuing authenticity, making space for emergenceHEALTH EXPECTATIONS, Issue 4 2007Soo Downe BA (Hons) RM MSc PhD Abstract Objective, To develop and evaluate service user, carer and community involvement in health and social care education. Background, Despite the high policy profile of involvement issues, there appear to be no published accounts of schemes that have used a systematic whole-faculty approach to community engagement in health and social care higher education. Focus of this paper, The set up and early development of a faculty-wide community engagement project. Setting and participants, Staff from the faculty of health in one University, local service users and carers and community group project workers and local National Health Service (NHS) and public sector staff. Design, Participatory action research including document review, field notes, questionnaires and interviews. Analysis, Thematic analysis. The emerging themes were tested by seeking disconfirming data, and through verification with stake-holders. Results, Prior to the study, there were examples of community engagement in the participating faculty, but they occurred in specific departments, and scored low on the ,ladder of involvement'. Some previous attempts at engagement were perceived to have failed, resulting in resistance from staff and the community. Despite this, an advisory group was successfully formed, and project framing and development evolved with all stake-holders over the subsequent year. The four themes identified in this phase were: building accessibility; being ,proper' service users/carers;moving from suspicion to trust: mutually respectful partnerships as a basis for sustainable change; and responses to challenge and emergence. Conclusions, Successful and sustainable engagement requires authenticity. Many problems and solutions arising from authentic engagement are emergent, and potentially challenging to organizations. [source] ,I think PCA is great, but . . .',Surgical nurses' perceptions of patient-controlled analgesiaINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2007Sue King RGON MA(Appl) This qualitative study investigated surgical nurses' perceptions of patient-controlled analgesia as a strategy for managing acute pain in a tertiary care hospital. Patient-controlled analgesia is commonly used and nurses play an essential role in caring for patients prescribed it. The study was divided into two parts. First, audiotaped semistructured interviews were conducted with 10 nurses. The interviews were followed by a postal questionnaire to 336 nurses with 171 returned. Thematic analysis was the chosen methodology. The audiotaped transcripts and questionnaires surfaced five themes, with the dominant one being ,I think PCA is great, but . . .'. The paper outlines and explores these themes and addresses the implications arising from the research for both clinical practice and education. [source] Doctors' assistants' views of case management to improve chronic heart failure care in general practice: a qualitative studyJOURNAL OF ADVANCED NURSING, Issue 4 2009Rebecca Olbort Abstract Title.,Doctors' assistants' views of case management to improve chronic heart failure care in general practice: a qualitative study. Aim., This paper is a report of a study to explore the views, concerns and experiences of doctors' assistants of case management for patients with chronic heart failure, while experiencing the new role of being a case manager within the Heidelberg Integrated Case Management trial. Background., Case management is being investigated as part of a randomised controlled trial aiming to improve care for patients with chronic systolic heart failure. In a complex, multifaceted intervention, trained doctors' assistants (equivalent to a nursing role) adopted new tasks using standardised case management involving telephone monitoring, home visits and diagnostic screening. Method., In April 2007, 3 months after implementation of the intervention programme, 27 doctors' assistants participated in four focus group interviews discussing their views on, and experiences of, case management. Thematic analysis of the data was undertaken. Findings., Participants believed that the most positive factors in case management were about interaction with patients, including opportunities for identifying disease and psychosocial problems. However, barriers included lack of time allocated to perform case management in addition to their normal role and poor cooperation within the practice team. According to the doctors' assistants, the routine implementation of case management was acceptable, feasible and effective in improving the management of patients with chronic systolic heart failure. Conclusion., Case management enhanced the role of doctors' assistants, leading to increased awareness of the perspective of patients with chronic disease. In the wider international primary care practice nursing context, the orchestrated delegation of tasks using specific case management may be a promising strategy for improving the quality of care of chronically ill patients and enabling patient self-management. [source] Assessing the impact of nurse and allied health professional consultants: developing an activity diaryJOURNAL OF CLINICAL NURSING, Issue 17-18 2010Ann Humphreys Aims., To construct and test an activity diary designed to measure the impact and explore the activities of nurse and allied health professional consultants in relation to each speciality and function of the role. Background., This was part of a funded feasibility study to assess the contribution of nurse and allied health professional consultants. Design., This was an exploratory study. Method., Thematic analysis of guided discussions with five nurse consultants and one physiotherapy consultant identified activities which were used to construct an activity diary. The activities were grouped under the four pillars or functions of the consultant role; expert practice, leadership, research and education. Participants recorded their activities in a diary over a one-week period. Conclusion., Results suggest that with some modification, this activity diary could be used to capture the impact, complexity and diversity of activities of the consultant role. Relevance to practice., Advanced practice roles are essential to the healthcare workforce of the future. This tool provides a method for measuring the contribution and complexity of the consultant role. [source] The impact of an ICU liaison nurse: a case study of ward nurses' perceptionsJOURNAL OF CLINICAL NURSING, Issue 6 2005Wendy Chaboyer MN Aims and objectives., To provide a description of ward nurses perceptions of the intensive care unit liaison nurse role. Background., Critical care outreach services have become commonplace over recent years. In Australia, the intensive care unit liaison nurse, developed at a local level by healthcare providers, has emerged as a way of improving the continuity of care offered to this patient group. As a relatively new development in critical care services, evaluation of this role has been limited, particularly in relation to the perceptions of ward nurses who receive patients on discharge from intensive care unit. Design., Case study of one Australian hospital that utilizes an intensive care unit liaison nurse. Methods., Ten ward nurses were purposefully selected for their representativeness of the population and for their experience with the intensive care unit liaison nurse role. Each of these nurses participated in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. Findings., Three major themes emerged from the interviews, highlighting role behaviours, contextual demands and outcomes associated with the intensive care unit liaison nurse role. The role behaviours of the liaison nurse included the professional characteristics of the individual and the primacy of clinical liaison as a role descriptor. Contextual demands were environmental characteristics relevant to providing patient, family and staff support. Outcomes of the role were perceived to include environmental preparation and education. Conclusions., This qualitative study has presented an overview of ward nurses perceptions of the intensive care unit liaison nurse role within one Australian hospital, illustrating the educative and empathic support that the liaison nurse role can provide to ward nurses. Relevance to clinical practice., Collaboration with ward nurses in developing specialist roles such as the intensive care unit liaison nurse is essential in ensuring improvements in patient and family care across the continuum. [source] The internet, empowerment, and identity: an exploration of participation by refugee women in a Community Internet Project (CIP) in the United Kingdom (UK)JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 3 2006Asiya Siddiquee Abstract This article considers the relationship between the Internet, empowerment, identity and participation; and focuses on refugee women in the United Kingdom (UK) participating in a Community Internet Project (CIP) to learn Internet skills. Semi-structured interviews and a non-participant observation were conducted with six refugee women and the course tutor participating in the final session of the CIP. Thematic analysis of the interviews supplemented with findings from the observation, revealed outcomes associated with technological engagement and participation. Technological engagement outcomes included intermediate outcomes of maintaining links and re-building networks, and facilitating resettlement and integration; and empowerment and identity outcomes facilitating the maintenance and development of personal identities, and fostering psychological empowerment. Participation outcomes included the development of social identity and community narratives, and collective consciousness-raising. These findings are used to reflect on the theory of the social psychology of participation (Campbell & Jovchelovitch, 2000), by contextualising technological engagement within participatory processes. The article concludes by discussing individual agency within participation; and calls for further research into the utility of digital technologies in community participatory processes. Copyright © 2006 John Wiley & Sons, Ltd. [source] Emotional Experiences and Motivating Factors Associated with Fingerprint AnalysisJOURNAL OF FORENSIC SCIENCES, Issue 2 2010David Charlton Ug. Abstract:, In this study, we investigated the emotional and motivational factors involved in fingerprint analysis in day-to-day routine case work and in significant and harrowing criminal investigations. Thematic analysis was performed on interviews with 13 experienced fingerprint examiners from a variety of law enforcement agencies. The data revealed factors relating to job satisfaction and the use of skill. Individual satisfaction related to catching criminals was observed; this was most notable in solving high profile, serious, or long-running cases. There were positive emotional effects associated with matching fingerprints and apparent fear of making errors. Finally, we found evidence for a need of cognitive closure in fingerprint examiner decision-making. [source] An exploration of factors that influence the regular consumption of water by Irish primary school childrenJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2008C. Johnston Molloy Abstract Background, Inadequate hydration has been linked to many factors that may impact on children's education and health. Teachers play an important role in the education and behaviour of children. Previous research has demonstrated low water intake amongst children and negative teachers' attitudes to water in the classroom. The present study aimed to explore teachers' knowledge about water and the perceived barriers to allowing children access to water during lesson time. Methods, In-depth interviews were conducted with 12 teachers from primary schools in the Midlands of Ireland. Interviews were continued until there was saturation of the data. Thematic analysis of the data was conducted. Results, Participants had a poor knowledge of hydration requirements and the associated health benefits and effect on concentration. Low water intake amongst teachers and pupils, and barriers such as disruption to class and increased need to urinate, were reported. Teachers identified the hydration effect on learning as the education message most likely to influence the decision to allow water in the classroom. Conclusions, The issues, opinions and perceived barriers raised by teachers as part of this qualitative research provide a basis for future health promotion around water. [source] Living with a spouse with chronic obstructive pulmonary disease: the meaning of wives' experiencesJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 4 2009Anne H Boyle PhD Aim., To describe and understand the meaning of the experience of living with a spouse who has chronic obstructive pulmonary disease. Background., Living with a spouse with a chronic illness may have a profound effect on women's lives since society expects families, and especially women, to care for the chronically ill. The family member providing care and support is usually the wife. Design., This study investigated the wife's experience of living with a husband's chronic illness. A hermeneutic phenomenological approach was used to describe and understand the experience of women living with a spouse who has chronic obstructive pulmonary disease to determine the meaning this experience has for their lives. Methods., In-depth interviews were conducted with ten women whose husbands had mild to severe obstructive lung disease. Thematic analysis was based on interpretive methods. Data were collected in 1997. Results., The findings are presented as two clusters, living with everyday illness and surviving the illness. Everyday illness includes monitoring, regulating activity, integrating illness effects, and managing technologies. Surviving the illness includes riding the roller coaster, keep on going, garnering support and finding explanations. Conclusions., The spouse's illness had a major influence on these women's lives, and the effects are very complex and interwoven with one another. Relevance to clinical practice., Health professionals can have a major role in assisting women to both live with the everyday illness and to survive its effects. Women were eager to tell their stories. Health professionals can help women deal with the experience by forming support groups and by asking the ,How can I help?' question more often and then actively listening to expressed concerns. Supporting women in their monitoring and regulating role is especially critical. [source] Experiencing psychiatric diagnosis: client perspectives on being named mentally ill,JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2003Y. M. HAYNE rn phd In this article is reported result of a phenomenological study whereby privileged view was gained into the lives of persons who had experienced receiving a diagnosis which named ,severe and enduring mental illness'. Thematic analysis yielded the four essential themes of diagnosis as the experience of ,a knowledge that knows', ,destructive (gift) of difference', ,making visible the invisible' and ,making knowledge knowledgeable'. Each of the themes is discussed under its own heading in this paper as a means for describing the nature of ,experiencing psychiatric diagnosis'. Effort is made to provide glimpse into the ,lifeworld' of being diagnosed mentally ill, and the reader's attention is directed to a particular kind of power that exists in the medical language of diagnoses. Discernment is highlighted as most consequential to an ,action sensitive practice' and a case is made for care-providers in psychiatric-mental health care to be sensitized to how medical terminology is experienced and the need to strive for balance within the ,economy of power' contained in these specialized words. [source] Observing the approaches to weaning of the long-term ventilated patientsNURSING IN CRITICAL CARE, Issue 2 2010Kalliopi Kydonaki Background: The weaning process from mechanical ventilation is a complicated issue for patients with respiratory failure who require long-term respiratory support. Although the application of weaning protocols reduces weaning time, and enhances patient outcome, little is known about the actual approaches that clinicians use for the weaning of these patients. Aim: The purpose of this paper is to explore approaches to weaning of long-term ventilated patients in a Scottish Intensive Care Unit. The findings are part of a larger study on decision-making during the weaning of long-term ventilated patients. Method: Data were collected through participant observation and follow-up interviews with the nursing staff. Twenty-four-hour chart and medical notes review and informal conversation with the bedside nurse were also used to collect information on the weaning process. Findings: Nine patients were recruited to the study. Two patients were extubated and three patients were extubated but then required a tracheostomy. A further four patients had a tracheostomy performed. Thematic analysis of the data showed that weaning was individualized, and physician led, regardless of the existence of the weaning protocol. Six different weaning approaches were identified. Nurses followed a conservative approach to weaning in comparison to doctors who appeared more aggressive. Conclusion: There are many varieties in the approaches clinicians use when weaning long-term ventilated patients, which acts on the continuity of their care. A shift of focus to identify ways of maintaining continuity of care and a combined ,wake and wean' approach needs to be considered. [source] Exploring the quality of dying of patients with chronic obstructive pulmonary disease in the intensive care unit: a mixed methods studyNURSING IN CRITICAL CARE, Issue 2 2009Donna Goodridge Abstract Rationale for the study:, Improving the quality of end-of-life (EOL) care in critical care settings is a high priority. Patients with advanced chronic obstructive pulmonary disease (COPD) are frequently admitted to and die in critical care units. To date, there has been little research examining the quality of EOL care for this unique subpopulation of critical care patients. Aims:, The aims of this study were (a) to examine critical care clinician perspectives on the quality of dying of patients with COPD and (b) to compare nurse ratings of the quality of dying and death between patients with COPD with those who died from other illnesses in critical care settings. Design and sample:, A sequential mixed method design was used. Three focus groups provided data describing the EOL care provided to patients with COPD dying in the intensive care unit (ICU). Nurses caring for patients who died in the ICU completed a previously validated, cross-sectional survey (Quality of Dying and Death) rating the quality of dying for 103 patients. Data analysis:, Thematic analysis was used to analyse the focus group data. Total and item scores for 34 patients who had died in the ICU with COPD were compared with those for 69 patients who died from other causes. Results:, Three primary themes emerged from the qualitative data are as follows: managing difficult symptoms, questioning the appropriateness of care and establishing care priorities. Ratings for the quality of dying were significantly lower for patients with COPD than for those who died from other causes on several survey items, including dyspnoea, anxiety and the belief that the patient had been kept alive too long. The qualitative data allowed for in-depth explication of the survey results. Conclusions:, Attention to the management of dyspnoea, anxiety and treatment decision-making are priority concerns when providing EOL care in the ICU to patients with COPD. [source] Thematic analysis of the experience of making a decision to place a family member with Alzheimer's disease in a special care unit,RESEARCH IN NURSING & HEALTH, Issue 6 2001Howard Karl Butcher Abstract The purpose of this study was to provide an in-depth description of the experience of making the decision to place a family member in a special care unit among a diverse sample of family caregivers. To achieve purposive maximum variation of the sample, the sample of 30 family caregivers was chosen from an original study of 256 family caregivers. The sample was randomly stratified according to ethnicity, gender, and relationship to the care receiver. Three independent researchers used Luborsky's method of thematic analysis to analyze the interviews. After mutual consensus, 1565 themes (descriptive statements) were identified and synthesized into 21 topics. The topics were then synthesized into four patterns describing the decision-making experience: moving toward the unavoidable decision, struggling with the decision, seeking reassurance, and remaining connected. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24:470,480, 2001 [source] Mental health impact for adolescents living with prolonged droughtAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2010John G. Dean Abstract Background:,A 2004 study showed adolescents living in rural Australia were aware of the impact of drought on self, family and community, but did not report levels of emotional distress higher than adolescents of similar age and gender in the Australian community. It was proposed that the rural lifestyle had helped adolescents build resilience for managing this environmental adversity. Objective:,To re sample adolescents from the same rural area and determine if this resilience remained after ongoing drought three years later. Design:,A mixed methods approach using focus groups and a self-report questionnaire. Setting:,Government Central Schools within the Riverina region of New South Wales. Participants:,Male and female adolescents (n = 111) aged 11,17 years completed the self-report questionnaires, while some adolescents (n = 61) within this group also participated in focus groups. Main outcome measure:,The Strengths and Difficulties Questionnaire and a Drought and Community Survey for Children comprised the self-report survey. Results:,Adolescents reported significantly higher levels of emotional distress than those in the previous study (t (191) = 2.80, P < 0.01) and 12% of adolescents scored in the clinical caseness range. Thematic analysis showed consistency with the previous study as well as new themes of grief, loss and the impacts of global climate change. Conclusions:,Results indicate a reporting of lesser well-being than was reported by a comparable group of young people four years earlier. A preventative intervention with a focus on family and community is recommended to address the mental health of adolescents enduring a chronic environmental adversity such as drought. [source] Stress and help-seeking for drought-stricken citrus growers in the Riverland of South AustraliaAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2009Alice K. Staniford Abstract Objective:,To explore the psychological impact of a problematic industrial climate for citrus growers, their help-seeking behaviour and perspectives on ways to encourage better use of rural mental health services. Design:,Thematic analysis of in-depth interviews. Setting:,The Riverland of South Australia. Participants:,Sixteen citrus growers (12 male, 4 female) from eight Riverland towns. Main outcome measures:,Citrus growers' perceived factors relating to psychological stress, coping behaviours, impact of stress on well-being, help-seeking behaviours, barriers to help-seeking and ways to encourage better use of rural mental health services. Results:,Work-related stresses grouped under broad themes, including ,Uncontrollable events', ,Financial hardship' and ,Pressure', had negative effects on participants' well-being. Furthermore, it was found that significant difficulties arise because many of the stresses which growers endure are not controllable, and that the alleviation of strain with the help of mental health professionals is uncommon because of barriers preventing help-seeking. Five broad themes of barriers to help-seeking were extracted from the data: ,Self-reliance', ,Social image', ,Lack of knowledge', ,Negative perceptions of health professionals' efficacy' and ,Restrictive lifestyle factors'. A specialised model of occupational health for citrus growers was proposed. Conclusions:,These results highlight the practical need to address the identified issues in delivery and promotion of health services when facilitating help-seeking within this group. The findings also add to our knowledge of occupational health psychology broadly. [source] "Not the Romantic, All Happy, Coochy Coo Experience": A Qualitative Analysis of Interactions on an Irish Parenting Web SiteFAMILY RELATIONS, Issue 1 2010Ellen Brady Support groups in online communities provide an anonymous place to exchange information and advice. Previous research has suggested that these groups offer a safe, nonjudgmental forum for new parents to share experiences and interact anonymously. This study investigated how participants in online parenting groups experience support via the Internet and what types of support they receive. All posts made over a 2-week period on the parenting-related discussion boards of an Irish parenting Web site were analyzed using content and thematic analyses. Exploratory, semistructured interviews were also conducted with 2 forum participants to discuss their experience of using the Web site. Themes uncovered from the data gathered included the attempts by posters to dispel the myths surrounding motherhood and the recognition of the superiority of the mother as caregiver. The results revealed that the parenting Web site was seen as a safe, supportive space, in which mothers could develop an enhanced frame of reference in which to better understand the role of parenting. The role of online support groups as a viable solution to the decreasing social networks created by modern society is discussed, along with the implications of the findings for future practice and research. [source] Emotionally Focused Therapy for Couples and Childhood Sexual Abuse SurvivorsJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 3 2008Heather B. MacIntosh This study explored Emotionally Focused Therapy (EFT) for couples with childhood sexual abuse survivors (CSA) and their partners. Half of the couples in this study reported clinically significant increases in mean relationship satisfaction and clinically significant decreases in trauma symptoms, and thematic analyses identified numerous areas where trauma survivors were challenged in fully engaging in the therapy process. In particular, trauma symptoms such as affect dysregulation and hypervigilance were identified to play a role in the challenges that survivors experienced in fully engaging in the EFT process. Results of these thematic analyses yielded clinical recommendations for working with CSA survivors and their partners in EFT for traumatized couples. Recommendations for future study were articulated. [source] Traditional Chinese medicine in cancer care: perspectives and experiences of patients and professionals in ChinaEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2006W. XU md, msc Although traditional Chinese medicine (TCM) is widely used in Chinese cancer centres, it is a brand new area for formal scientific evaluation. As the first step of developing a research programme on clinical evaluation of TCM for cancer patients, we conducted a qualitative study to explore the perspectives and experiences of Chinese cancer patients and TCM professionals. Twenty-eight persons participated in two cancer patient focus groups and one professional focus group. Semi-structured interviews were audiotaped, transcribed and translated. Textual transcripts and field notes underwent inductive thematic analysis. We found that patients' decision to use TCM for cancer is a self-help process with a deep cultural grounding, which is related to the traditional Chinese philosophy of life. Participants perceived TCM to be an effective and harmless therapy. They highly valued the fact that TCM is tailored to patients, and believed it was the basis of an optimal and safe treatment. Participants also highlighted the long-term positive effects, the benefit of group interventions and the low cost as important features of TCM. Subjects believed that conducting clinical research would be crucial for the recognition and dissemination of TCM in Western countries. The findings of this study are expected to contribute to the knowledge base on the current TCM use for cancer in China, and to provide useful information for developing future clinical research in this area in Western countries. [source] Lesbian, gay, bisexual and transgender young people's experiences of distress: resilience, ambivalence and self-destructive behaviourHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2008Jonathan Scourfield BA MA DipSW PhD Abstract The research presented in this paper set out to explore the cultural context of youth suicide and more specifically any connections between sexual identity and self-destructive behaviour, in the light of international evidence about the disproportionate risk of suicidal thoughts and suicide attempts in lesbian, gay, bisexual and transgender (LGBT) young people. The empirical basis for the paper is qualitative research that was carried out in the North West of England and South Wales. Focus groups and interviews were conducted with a total of 69 young people, with a purposive sample to reflect diversity of sexual identity, social class and regional and rural-urban location. The paper presents a thematic analysis of the data specifically relating to the experiences of LGBT young people. A range of strategies that LGBT young people employ in the face of distress are described. These are categorised as resilience, ambivalence and self-destructive behaviour (including self-harm and suicide). The potential implications for health and social care of these strategies include the need for ecological approaches and for sexual cultural competence in practitioners, as well as prioritisation of LGBT risk within suicide prevention policies. [source] Evaluating the impact of a cancer supportive care project in the community: patient and professional configurations of needHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2007Kristian Pollock PhD MA PGCHE Abstract Advances in cancer care and treatment have created a new and somewhat anomalous category of patients with a diagnosis of non-curative disease who still have a considerable period of life remaining. During much of this time they may remain relatively well, without manifest need for clinical care. The responses of patients to this challenging situation are largely unknown. However, it has been assumed that because they confront a difficult experience they will need, or can benefit from, professional intervention. The implementation of pre-emptive support measures is anticipated to improve patients' resilience in coping with their illness and approaching death. This study aimed to investigate the impact of the keyworker role in a 3-year cancer supportive community care project to identify and provide for the needs of patients with a diagnosis of non-curative cancer. It was a qualitative study incorporating face-to-face interviews and focus groups with 19 healthcare professionals and 25 patients and carers from an urban East Midlands locality and a thematic analysis of qualitative interview and focus group transcripts. The project was positively evaluated by patients, carers and professionals. However, the findings raised questions about the different configuration of ,need' within the lay and professional perspectives and how this should most appropriately be addressed. In contrast to widespread professional assumptions about patients' need for counselling, many patients preferred to turn to their friends and families for support, and to adopt a stance of emotional and personal self-reliance as a strategy for coping with their predicament. The study highlights the continuing orientation of services around professional, rather than patient, agendas and the momentum towards increasing specialisation of professional roles and the medicalisation of everyday life that flows from this. [source] The role of reflection in the library and information sector: a systematic reviewHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 3 2007Maria J Grant Objectives:,To systematically review published literature on the role of reflection in the library and information science sector. To identify examples of good practice and to investigate the reported contribution, if any, of reflection by library and information workers as part of their professional practice. Methods:,Free text searches (reflective or reflection* or reflexion*) were conducted for English language papers on the Library and Information Science Abstracts (lisa) bibliographic database in two phases; in March 2004 for literature dating from 1969 to 2003 and between 2004 and 2006 in January 2006. Thirteen papers met the inclusion criteria and were coded and analysed using thematic analysis. Results:,Two categories of reflection exist: analytical and non-analytical. These focus on events in the recent and distant past. Non-analytical reflective accounts generally adopt a retrospective tone in reporting on multiple events over a number of decades. In contrast, analytical accounts of reflection focused on single events and attempt to understand the relationship between past experiences and how this might impact on future practice. Conclusion:,From the examples of reflective practice identified, greatest personal and professional benefit is reported when time is given to considering the implications of past events on future practice, that is, analytical reflection. [source] Near misses: Paradoxical realities in everyday clinical practiceINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2008Lianne Jeffs RN PhD (c) This qualitative study was conducted to define and describe what constitutes and contributes to near miss occurrences in the health-care system and what is needed to ensure safer processes of care. Nine health-care organizations (13 sites total) including six academic health sciences centres (acute care, mental health and geriatric) and three community hospitals participated in this study. The final sample consisted of 37 focus groups (86 in the nursing staff only; 62 in the pharmacy staff only; and 99 in the mixed nursing and pharmacy focus groups respectively) and 120 interviews involving 144 health-care consumers. Data were collected using focus groups (health-care professionals) and key informant interviews (health-care consumers). A multi-level content analyses schema (transcription, coding, categorizing, internal consistency, thematic analysis and community validation) was used. Six themes emerged from the multi-level content analyses that combined focus group (health-care professionals) and key informant interview (health-care consumers) data. These themes are discussed under the three original research questions with supporting data derived from codes and categories. Study findings implicate changes for the health-care landscape relative to system, health policy, professional development and quality improvement. [source] Professional socialization: The key to survival as a newly qualified nurseINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2007Higher DiplomaArticle first published online: 29 MAR 200, MSc (Nursing), Mary Mooney RGN The impact and prevalence of professional socialization in nursing has been written about extensively. Despite the many positive developments that have taken place in nursing within the past decade, the role of professional socialization remains heavily weighted and is of particular significance to those nurses who are newly qualified. The account given by newly registered nurses in this study demonstrates that their ability and willingness to become professionally socialized determines their ease of survival at clinical level. Twelve newly qualified Irish nurses, from two separate cohorts, were interviewed to ascertain their perceptions of becoming newly qualified nurses. A grounded theory approach was used and data were analysed using thematic analysis. A category that emerged was linked very strongly with professional socialization. The respondents did not refer to professional socialization per se, but through the coding process this emerged as the linchpin of the discussion. [source] Developing a questionnaire to measure nurses' attitudes towards hospitalized older peopleINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 2 2007Dip N. (C.T) Dip., Ella McLafferty PhD A number of studies have used generic measures to evaluate nurses' attitudes toward hospitalized older people. Those measures do not consider the context in which nurses meet older people and the influence that this may have on nurses' attitudes. The aims and objectives of the study were to develop a questionnaire from focus group data to evaluate nurses' attitudes towards hospitalized older people. To evaluate the psychometric properties of the questionnaire the design included a qualitative and quantitative phase. The method used for the qualitative phase was focus group interviews with the intention of identifying the phenomena that may indicate nurses' attitudes towards older people. The quantitative phase included the development and psychometric testing of an attitudinal questionnaire. Samples for the qualitative phase included Registered Nurses from the care of older people setting; Registered Nurses from the acute setting; nursing students and nurse teachers. The sample for the quantitative phase included nursing students (numbering 355). Ten themes were identified through thematic analysis. Eighty items were extrapolated from the qualitative analysis and used to formulate a questionnaire which was then distributed to the nursing students. On analysis, the reliability was 0.78. Further analysis using Principal Components Analysis (P.C.A.) with orthogonal rotation indicated that 45 items loaded on to eight factors. Results of the quantitative analysis indicated that there was a strong correlation between the thematic analysis and the P.C.A. The results would suggest that there may be important and relevant domains that are worthy of further study into nurses' attitudes towards older people. If the domains identified are useful for identifying negative attitudes towards older people, then strategies can be implemented to try and reduce negative attitudes in clinical practice. [source] An exploration of work-related stress in Northern Ireland community pharmacy: a qualitative studyINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 5 2009Laura McCann Abstract Objectives The aim of this study was, through qualitative methodology, to explore the factors which contribute to job-related stress in community pharmacy in Northern Ireland. Methods All community pharmacists in Northern Ireland were invited to participate in one-to-one semi-structured interviews. Interview schedules explored pharmacists' attitudes to job-related stress and the situations that may contribute to stress. All interviews took place at participants' work sites between December 2007 and April 2008, were audio-taped, transcribed verbatim, read independently by the authors and analysed using thematic analysis. Key findings Seventeen pharmacists participated in the interviews. The main themes that emerged in relation to job-related stress were workplace issues, issues regarding professional expansion, recognition and responsibility, and a demanding public. Although there was general support for development in community pharmacy, this was tempered by concerns as to how expectations would be met and how all services would be delivered. Conclusions The themes that emerged from this work reflect what was reported from a survey conducted in 2007 and reinforce the tension between developments in practice and the ability to deliver. Developments in professional practice can be positive; however, commissioners and policy-makers need to consider whether community pharmacists have the infrastructure in terms of environment, personnel and multi-professional support to deliver what is required of them. [source] Palliative care patients' experiences of healthcare treatmentINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 3 2010Cynthia Kennett Kennett C, Payne M. Palliative care patients' experiences of healthcare treatment Int J Soc Welfare 2010: 19: 262,271 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article reports on a thematic analysis of the opinions of 34 palliative care patients about medical and healthcare treatment expressed in comments, narratives and discussions during a series of facilitated group discussions undertaken as part of training events for medical students. Palliative care patients often have long healthcare careers, which enables them to compare different professionals and services, thus offering a more powerful and complex analysis of patient experience than that obtainable from analysis of complaints or satisfaction surveys, and permits some understanding to be obtained of the attitudes that condition evaluations of services. The patients balanced negative views with positive experiences. They appreciated open, listening, equal and friendly relationships with professionals in which careful explanation fostered their confidence in the overall service. They criticised inflexible services that did not consider their broad needs, and in which relationships with professionals were characterised by busy-ness and professional distance. [source] Parents' Concerns About Issues Related to Their Children's Genetic ConditionsJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2008Agatha M. Gallo PURPOSE.,The purpose of this analysis was to examine parents' (N = 142) concerns about issues (i.e., privacy of information, insurance, healthcare costs, employment, school) related to their children's genetic conditions. DESIGN AND METHODS.,Using a series of matrices, thematic analysis was conducted focusing on parents' concerns. RESULTS.,Parents were less concerned with privacy and more concerned with insurance, healthcare costs, employment, and school issues. PRACTICE IMPLICATIONS.,Nurses and other healthcare professionals need to give parents the opportunity to discuss their concerns and to assist parents with strategies and resources to meet the needs of their children and families. [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] | |||||||||||||||||||||||||||||||||||||