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Thematic Categories (thematic + category)
Selected AbstractsPerspectives on evidence-based practice from consumers in the US public mental health systemJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2008Sandra J. Tanenbaum PhD Abstract Rationale, aims and objectives, Evidence-based practice (EBP) is a matter of mental health policy in USA. Supporters find it useful in two forms, as generating a list of approved practices and as providing information to practitioners and consumers engaged in shared decision making. Almost nothing has been written about consumer perspectives on EBP. Given that they play an important role in the second form of EBP, this study explores the range and logic of these perspectives and of related views about the role of information in decision making. Methods, Four focus groups (n = 38) were held in two settings in a Midwestern state in 2005. Thirty-nine face-to-face semi-structured interviews were conducted at three settings in 2006. Focus group members and interviewees were seriously mentally ill consumers in the public mental health system. Focus group sessions and interviews were audiotaped and transcribed. Thematic categories and subcategories were analysed. Results, Focus group members and interviewees varied among themselves and between groups in their responses, but three major thematic categories emerged in both groups , consumers have positive and negative attitudes towards evidence; consumers seek and receive information from multiple sources; and consumers have competing and complementary principles for decision making. Interviews revealed that although real shared decision making is rare, consumers want to and may be involved in decisions about their care. Conclusions, EBP per se has mostly by-passed consumers in the public mental health system, but at least some want to be better informed about and more involved in their care. Their misgivings about evidence are reasonable and resonate with the principles of the recovery movement. [source] Genetic testing for cancer predisposition and implications for nursing practice: narrative reviewJOURNAL OF ADVANCED NURSING, Issue 4 2010Elizabeth Kathryn Bancroft bancroft e.k. (2010) Genetic testing for cancer predisposition and implications for nursing practice: narrative review. Journal of Advanced Nursing66(4), 710,737. Abstract Title.,Genetic testing for cancer predisposition and implications for nursing practice:narrative review. Aim., This paper is a report of a review of literature on the psychological and social implications of genetic testing for cancer predisposition and how recent developments in knowledge about genetics may affect clinical practice. Background., Knowledge about the genetics of disease has grown since the completion of the Human Genome Project. Many common genetic changes that predispose to cancer have been found. Identifying genetically ,at risk' individuals is going to become a feature of healthcare and nursing practice over the next decade. The psychological and social effects of this knowledge on patients and their families are important considerations. Data sources., A search of the British Nursing Index, CINAHL, EMBASE and PUBMED databases was conducted between June 2007 and December 2008 without date limits. Grey literature was sought using search engines and through searching relevant websites. Review methods., A narrative review of studies published in English was conducted. The studies were reviewed for relevance and inclusion criteria; their methodological quality was not evaluated. Results., Seventy-eight papers met the inclusion criteria and fell into three thematic categories: social impact, psychological impact and interest in and uptake of genetic testing. To date, research has focussed on high-risk cancer genes. Conclusion., Genetic testing raises social, ethical and psychological concerns. Further research is required to determine how healthcare professionals can support the integration of genetics into clinical practice. Nurses will become increasingly involved in genetic testing and will play a key role in providing information, support and follow-up for individuals identified as being at higher risk. [source] Consumer Experiences with Predatory Lending PracticesJOURNAL OF CONSUMER AFFAIRS, Issue 1 2007RONALD PAUL HILL This investigation examines how consumers perceive and experience predatory lenders. Findings reveal that industry practices are carried out to the detriment of persons typically defined as "vulnerable," such as elderly, impoverished, and African American consumers. Using a series of personal interviews with a geographically diverse set of respondents, data reveal thematic categories that include the friendly veneer, the rules of engagement, and an aggressive response, which capture the nuances of this exchange relationship from the perspective of these unwitting consumers. The closing section provides implications for scholars and regulators seeking workable solutions to limit additional financial exploitation. [source] Perspectives on evidence-based practice from consumers in the US public mental health systemJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2008Sandra J. Tanenbaum PhD Abstract Rationale, aims and objectives, Evidence-based practice (EBP) is a matter of mental health policy in USA. Supporters find it useful in two forms, as generating a list of approved practices and as providing information to practitioners and consumers engaged in shared decision making. Almost nothing has been written about consumer perspectives on EBP. Given that they play an important role in the second form of EBP, this study explores the range and logic of these perspectives and of related views about the role of information in decision making. Methods, Four focus groups (n = 38) were held in two settings in a Midwestern state in 2005. Thirty-nine face-to-face semi-structured interviews were conducted at three settings in 2006. Focus group members and interviewees were seriously mentally ill consumers in the public mental health system. Focus group sessions and interviews were audiotaped and transcribed. Thematic categories and subcategories were analysed. Results, Focus group members and interviewees varied among themselves and between groups in their responses, but three major thematic categories emerged in both groups , consumers have positive and negative attitudes towards evidence; consumers seek and receive information from multiple sources; and consumers have competing and complementary principles for decision making. Interviews revealed that although real shared decision making is rare, consumers want to and may be involved in decisions about their care. Conclusions, EBP per se has mostly by-passed consumers in the public mental health system, but at least some want to be better informed about and more involved in their care. Their misgivings about evidence are reasonable and resonate with the principles of the recovery movement. [source] Prosthodontic decision-making: what unprompted information do dentists seek before prescribing treatment?JOURNAL OF ORAL REHABILITATION, Issue 1 2010R. OMAR Summary, This study explored the nature of the unprompted information that clinicians seek before making a treatment decision and whether this decision corresponded with the clinical parameters of the case. Interns, general practitioners (GP) and prosthodontists (n = 70, mean age 33 years, range 23,68) were presented with a written vignette of partial edentulism that included two spaces and were invited to ask any questions for the purpose of making a treatment recommendation. A list of 48 potential question/answer items was available to the interviewer, of which 38 were asked. These were then allotted to four thematic categories. Mean number of questions asked did not differ significantly amongst groups, although prosthodontists asked significantly more questions in the ,clinical and radiographic information' category than GPs (P = 0·0001) and interns (P = 0·003). The relationship between a prescribed treatment and questions asked was tested by dichotomizing all recommendations into ,possible' or ,not possible' based on the authors' knowledge of the actual case history. There were no significant differences amongst the groups in the frequency of prescribing ,possible' treatment (Pearson chi-square 0·083 and 0·108 for upper and lower spaces, respectively), but those who prescribed ,possible' treatment asked significantly more questions in the ,clinical and radiographic information' category, specifically about bone adequacy in the edentulous areas: upper jaw (P = 0·0001) and lower jaw (P = 0·003). It may be concluded that prosthodontists generally opted for more ,possible' treatments, as well as seeking items of information that seemed to improve the chance of making recommendations that conformed to the actual case characteristics. [source] Teledermatology in the U.K.: lessons in service innovationBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2007T.L. Finch Summary Background, Teledermatology has the potential to revolutionize the delivery of dermatology services by facilitating access to specialist services at a distance. In the U.K. over the previous decade there have been numerous attempts at introducing and using teledermatology; however, the development of teledermatology as routine service provision remains limited. Objectives, To identify factors that promote successful use of teledermatology as a part of routine service provision. Methods, A longitudinal qualitative study of teledermatology, drawing on data from in-depth semistructured interviews; observations of systems in practice; and public meetings. Data were analysed collectively by the research team using established qualitative analytical techniques to identify key thematic categories. The sample consisted of teledermatology services within the U.K. (n = 12) studied over 8 years (1997,2005). Individual participants (n = 68 interviews) were consultant dermatologists, researchers, teledermatology nurses, administrators, patient advocates, general practitioners and technologists. Results, The analysis compared services that did or did not become part of routine healthcare practice to identify features that supported the normalization of teledermatology. Requirements for using and integrating teledermatology into practice included: political support; perceived benefit and relative commitment that outweighs effort; pragmatic approaches to proving efficacy and safety; perception of risk as being ,manageable' on the basis of professional judgement; high levels of flexibility in practice (in terms of individuals, technology and organization); and reconceptualizing professional roles. Conclusions, Successful implementation of teledermatology as a routine service requires greater understanding of and attention to the interplay between social and technical aspects of teledermatology, and how this is accommodated both by healthcare professionals and the organizations in which they work. [source] | ||||||||||