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Selected AbstractsAn 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] Patients' experiences of hip fractureJOURNAL OF ADVANCED NURSING, Issue 4 2003Graeme Archibald BA MSc RN Background., Hip fracture is a major cause of mortality and morbidity, particularly among older people, but there is little information on how individuals experience this. Aims., This study was conducted to explore the experiences of individuals who had suffered a hip fracture. The aim was not to produce generalizable findings but, rather, to generate a rich description of the experience of incurring and recovering from a hip fracture, to inform nursing practice. Method., Phenomenological methodology was used. A purposeful sample of five older patients was interviewed, following a stay in a community hospital for rehabilitation after surgical repair of a hip fracture. The unstructured interviews were tape-recorded, transcribed verbatim and analysed for significant statements and meanings. Findings., Four major themes emerged: the injury experience, the pain experience, the recovery experience and the disability experience. The injury experience consisted of storytelling, recalling the experience of the injury itself. The pain experience consisted of coping with the pain. The recovery experience involved the operation, beginning the struggle of recovery, and regaining independence. The disability experience consisted of the disability itself, depending on others, and being housebound. Conclusions., Pain management, meeting psychological and physical needs for nursing care, planning for discharge, and ensuring a reasonable quality of life are areas for nursing care development. Consideration of appropriate settings for rehabilitation is needed and there should be further investigation into improving quality of life after discharge. [source] Identifying facilitators and barriers to physical activity for adults with Down syndromeJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 9 2010J. Mahy Abstract Background Adults with Down syndrome are typically sedentary, and many do not participate in the recommended levels of physical activity per week. The aim of this study was to identify the facilitators and barriers to physical activity for this group. Method Semi-structured interviews were conducted to elicit the views of adults with Down syndrome and their support people about what factors facilitate physical activity and what factors are barriers to activity. A sample of 18 participants (3 men, 15 women) was recruited through two agencies providing services for adults with disabilities; six participants were adults with Down syndrome and 12 participants were support people (four were parents of adults with Down syndrome and eight participants were employed by day programmes attended by the adults with Down syndrome). The interviews were recorded, transcribed verbatim and independently coded by two researchers. Results Three themes around facilitators to physical activity were identified: (1) support from others; (2) that the physical activity was fun or had an interesting purpose; and (3) routine and familiarity. Three themes around barriers were also identified: (1) lack of support; (2) not wanting to engage in physical activity; and (3) medical and physiological factors. Conclusions The results suggest that support people play a key role, both as facilitators and barriers, in the participation by adults with Down syndrome in physical activity. Many of the barriers and facilitators of activity for adults with Down syndrome indentified are similar to those reported for adults without impairment. Our findings are also consistent with established theories in the field of health behaviour change. [source] Facing inadequacy and being good enough: psychiatric care providers' narratives about experiencing and coping with troubled conscienceJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2009V. DAHLQVIST rnt phd The aim of this study is to illuminate the meaning of encounters with a troubled conscience among psychiatric therapists. Psychiatric care involves ethical dilemmas which may affect conscience. Conscience relates to keeping or losing a sense of personal integrity when making judgments about one's actions. Ten psychiatric therapists were interviewed in June 2006. The interviews were tape-recorded, transcribed verbatim and interpreted using a phenomenological-hermeneutic method. Two themes Facing inadequacy and Struggling to view oneself as being ,good enough' are presented. In the therapists interviewed, awareness of their use of power, a sense of powerlessness and a sense of blame gave rise to feelings of betrayals and shameful inadequacy. By sharing their inadequacy with co-workers, they managed to endure the sense of their inadequacy which otherwise would have threatened to paralyse them. Finding consolation in sharing wearing feelings, becoming realistic and attesting their worthiness, they reached reconciliation and found confirmation of being good enough. The findings are interpreted in light of Lögstrup's ethics of trust, according to which conscience alerts us to silent but radical ethical demand and the risk of self-deception. [source] Identifying challenges for academic leadership in medical universities in IranMEDICAL EDUCATION, Issue 5 2010Ali Bikmoradi Medical Education 2010: 44: 459,467 Context, The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. Objectives, This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. Methods, A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. Results, The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). Conclusions, This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance. [source] Medical students' first clinical experiences of deathMEDICAL EDUCATION, Issue 4 2010Emily Kelly Medical Education 2010: 44: 421,428 Objectives, Many medical students feel inadequately prepared to address end-of-life issues, including patient death. This study aimed to examine medical students' first experiences of the deaths of patients in their care. Methods, Final-year medical students at the Schulich School of Medicine & Dentistry, University of Western Ontario were invited to share their first experience of the death of a patient in their care. The students could choose to participate through telephone interviews, focus groups or e-mail. All responses were audiotaped, transcribed verbatim and analysed using a grounded theory approach. Results, Twenty-nine students reported experiencing the death of a patient in their care. Of these, 20 chose to participate in an interview, five in a focus group and four through e-mail. The issues that emerged were organised under the overlying themes of ,young', ,old' or ,unexpected' deaths and covered seven major themes: (i) preparation; (ii) the death event; (iii) feelings; (iv) the role of the clinical clerk; (v) differential factors between deaths; (vi) closure, and (vii) relationships. These themes generated a five-stage cyclical model of students' experiences of death, consisting of: (i) preparation; (ii) the event itself; (iii) the crisis; (iv) the resolution, and (v) the lessons learned. ,Preparation' touches on personal experience and pre-clinical instruction. ,The event itself' could be categorised as referring to a ,young' patient, an ,old' patient or a patient in whom death was ,unexpected'. In the ,resolution' phase, coping mechanisms included rationalisation, contemplation and learning. The ,lessons learned' shape medical students' experiences of future patient deaths and their professional identity. Conclusions, A tension between emotional concern and professional detachment was pervasive among medical students undergoing their first experience of the death of a patient in their care. How this tension was negotiated depended on the patient's clinical circumstances, supervisor role-modelling and, most importantly, the support of supervisors and peers, including debriefing opportunities. Faculty members and residents should be made aware of the complexities of a medical student's first experience of patient death and be educated regarding sympathetic debriefing. [source] Patient,physician communication during oncology consultationsPSYCHO-ONCOLOGY, Issue 10 2008Hanna Fagerlind Abstract Objective: The aim of this study was to characterize the content of patient-physician communication in standard oncology care. Methods: The sample consisted of 19 patients with gastrointestinal cancer. The consultations were audio-recorded, transcribed verbatim, and analyzed according to qualitative content analysis. Results: The analysis resulted in seven main categories: Disease and treatment, Healthcare planning, Everyday living, Psychological well-being, Coping with disease, Expressions of concerns and feelings, and Other aspects of communication. The main focus during the consultations was on disease and treatment. Physicians tended to concentrate on response to treatment and types and severity of side effects and how to treat them. More patient-centered subjects of psychosocial character like coping and psychological well-being were discussed only briefly, if at all. Conclusions: This study adds to the information given by the existing communication analysis systems, and hence we suggest a development of the psychosocial content categories of those systems to make them more valid. Copyright © 2008 John Wiley & Sons, Ltd. [source] |