scholarly journals Structural distress: experiences of moral distress related to structural stigma during the COVID-19 pandemic

2021 ◽  
Author(s):  
Javeed Sukhera ◽  
Chetana Kulkarni ◽  
Taryn Taylor
Keyword(s):  
Health Equity ◽  
Teaching And Learning ◽  
Moral Distress ◽  
Health Workers ◽  
Well Being ◽  
Future Research ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Resident Physicians ◽  
The Impact

Abstract Introduction The COVID-19 pandemic has taken a significant toll on the health of structurally vulnerable patient populations as well as healthcare workers. The concepts of structural stigma and moral distress are important and interrelated, yet rarely explored or researched in medical education. Structural stigma refers to how discrimination towards certain groups is enacted through policy and practice. Moral distress describes the tension and conflict that health workers experience when they are unable to fulfil their duties due to circumstances outside of their control. In this study, the authors explored how resident physicians perceive moral distress in relation to structural stigma. An improved understanding of such experiences may provide insights into how to prepare future physicians to improve health equity. Methods Utilizing constructivist grounded theory methodology, 22 participants from across Canada including 17 resident physicians from diverse specialties and 5 faculty members were recruited for semi-structured interviews from April–June 2020. Data were analyzed using constant comparative analysis. Results Results describe a distinctive form of moral distress called structural distress, which centers upon the experience of powerlessness leading resident physicians to go above and beyond the call of duty, potentially worsening their psychological well-being. Faculty play a buffering role in mitigating the impact of structural distress by role modeling vulnerability and involving residents in policy decisions. Conclusion These findings provide unique insights into teaching and learning about the care of structurally vulnerable populations and faculty’s role related to resident advocacy and decision-making. The concept of structural distress may provide the foundation for future research into the intersection between resident well-being and training related to health equity.

scholarly journals Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Austad ◽  
Michel Juarez ◽  
Hannah Shryer ◽  
Patricia L. Hibberd ◽  
Mari-Lynn Drainoni ◽  
...  
Keyword(s):  
Health Workers ◽  
Positive Impact ◽  
Qualitative Evaluation ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Future Research ◽  
Care Seeking ◽  
Structured Interviews ◽  
The Impact

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.

scholarly journals ‘When you are a data collector you must expect anything’. Barriers, boundaries and breakthroughs: insights from the South African data-collection experience

2019 ◽  
Vol 27 (2) ◽  
pp. 54-62
Author(s):  
Kathryn Roberts ◽  
Sarah Gordon ◽  
Lorraine Sherr ◽  
Jackie Stewart ◽  
Sarah Skeen ◽  
...  
Keyword(s):  
Data Collection ◽  
Data Gathering ◽  
Well Being ◽  
Research Process ◽  
Future Research ◽  
Structured Interviews ◽  
Middle Income ◽  
Data Collector ◽  
The Individual ◽  
The Impact

The impact of the research process on the researcher is an emerging topic of interest. Data collection in most low- and middle-income countries (LMICs) is often the responsibility of community members who are identified and trained specifically for data collection. When research involves data on mental health and social well-being, data collectors may have specific competency needs and the task of data gathering may impact data collectors. This study aims to explore the experiences and needs of data collectors within South Africa using qualitative methods to examine the impact of data collection on data collectors. Nineteen data collectors, involved in face-to-face data collection, completed semi-structured interviews exploring their insights, attitudes and experiences. Thematic analysis revealed barriers and challenges associated with research, complexities regarding boundaries within the participant-data collector relationship and the benefits of being involved with research for the individual and the community. Numerous challenges and opportunities are outlined. Findings expose the beneficial and often overlooked contribution of data collectors and warrants key considerations in the planning and implementation of future research to ensure adequate support and standardization of practice.

scholarly journals Which mechanisms explain motivation of primary health workers? Insights from realist evaluation of a maternal and child health programme in Nigeria

2019 ◽  
Author(s):  
Bassey E. EBENSO ◽  
Chinyere Mbachu ◽  
Enyi Etiaba ◽  
Reinhard Huss ◽  
Ana Manzano ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Healthcare Delivery ◽  
Well Being ◽  
Realist Evaluation ◽  
Future Research ◽  
Worker Motivation ◽  
The Impact ◽  
And Child Health

Abstract Background: Well-trained, adequately skilled and motivated primary healthcare (PHC) workers are essential for attaining universal health coverage and the Sustainable Development Goal 3 of ensuring healthy lives and promoting well-being for all. While there is abundant literature on drivers of workforce motivation, published knowledge on the mechanisms of how motivation works within different contexts is limited, particularly from low- and middle-income countries. This paper contributes to health workforce literature by reporting on how motivation works among PHC workers in a maternal and child health (MCH) programme in Nigeria. Methods: We adopted a realist evaluation design including scoping review of literature, document review of policies and MCH programme handbook, and in-depth interviews of PHC workers (n=25), facility managers (n=16), policymakers (n=12) and programme managers (n=10) to assess the impact of the MCH programme in Anambra State, Nigeria. A realist process of theory development, testing, verification and consolidation was used to understand how and under what circumstances the MCH programme impacted on workers’ motivation and which mechanisms helped explain how motivation works. The developed programme theory drew upon Herzberg’s two-factor and Adam’s equity theories to unpack the influences of contextual conditions on worker motivation. Results: A complex and dynamic interaction between the MCH programme and organizational, societal and policy contexts triggered five mechanisms which explain PHC worker motivation: i) feeling supported, ii) feeling valued and committed to work, iii) morale and confidence to perform tasks, iv) companionship and v) feeling comfortable with work environment. Some mechanisms were mutually reinforcing while others operated in parallel. Further analysis showed that the conditions that enabled worker motivation to occur were organisational values of fairness, recognition of health workers’ contributions and a culture of task-sharing and teamwork. Conclusions: Policy designs and management strategies for improving performance of health workers, particularly in resource-constrained settings should create working environments that foster feelings of being valued and supported while enabling workers to apply their knowledge and skills to improve healthcare delivery. Future research can test the explanatory framework generated by this study and explore differences in motivational mechanisms among different cadres of PHC workers to inform cadre-related motivational interventions.

scholarly journals “I got into a very dark place”: addressing the needs of young people leaving care during the Covid-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Berni Kelly ◽  
Colm Walsh ◽  
John Pinkerton ◽  
Alicia Toal
Keyword(s):  
Northern Ireland ◽  
Young People ◽  
Design Methodology ◽  
Well Being ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Content Type ◽  
Care Leavers ◽  
The Impact ◽  
Detrimental Impact

Purpose This paper aims to report on the findings of a qualitative study that explored the views and experiences of young people leaving care during the first phase of the Covid-19 pandemic in Northern Ireland. Design/methodology/approach A qualitative approach was adopted involving semi-structured interviews with 24 care leavers 18–25 years old from across the region. Interviews were conducted remotely online or by telephone and explored young people’s lived experiences during the pandemic including their views on the formal support services and how best to provide ongoing for support care leavers during the pandemic. Findings Study findings highlight how known adversities for care leavers are exacerbated during the pandemic, having a detrimental impact, particularly on their emotional well-being. The response of the state as a corporate parent in mitigating the impact of the pandemic was found to be inadequate; with a need for much clearer communication, transparent and prompt decision-making and targeted specialist mental health services. The account given by the young people also highlighted the importance of participation and relationship-based practice to build on the young people’s resilience in the context of high levels of social isolation and limited access to informal support systems. Originality/value This research, based on the views of care experienced young people themselves, is the first study in Northern Ireland to report on the impact of the Covid 19 pandemic on care leaving. As such it makes a contribution to this emerging international field of study and, given the persistence of the pandemic, provides empirical findings and a social justice perspective of ongoing relevance to policy and practice with young people leaving care.

scholarly journals An Exploration of Well-being in Former Covert and Undercover Police Officers

2020 ◽  
Author(s):  
Liam Scott Curran
Keyword(s):  
Police Officers ◽  
Social Impact ◽  
Well Being ◽  
Future Research ◽  
Structured Interviews ◽  
Case Study Design ◽  
The Social ◽  
The Impact ◽  
Political Groups

Abstract Little is known about the stressors of working in covert and undercover policing roles and the impact these can have on the health and psychological well-being of police officers. Extant literature focuses upon the social impact of undercover and covert policing in a democratic society, especially in relation to policing political groups. Presented here are the results of an exploratory study into the lives of former police officers who have engaged in various forms of covert/undercover policing. Utilising semi-structured interviews, in a five-participant case-study design, this research investigates the impact that covert and undercover policing has on the well-being of former officers who have undertaken this role, and how they utilised coping strategies. Data were thematically analysed using Braun and Clarke’s framework (Braun and Clarke 2006). Findings were consistent in that fear of violence was a large factor that impacted the well-being and personal relationships of undercover officers. The paper concludes by outlining pertinent suggestions for future research and considers the implications for covert policing.

COVID-19 and self-initiated expatriate health workers: Spanish nurses in Germany

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Juan Miguel Rosa González ◽  
Michelle Barker ◽  
Dhara Shah
Keyword(s):  
Social Networks ◽  
Host Country ◽  
Health Workers ◽  
Instant Messaging ◽  
Well Being ◽  
Relative Effect ◽  
Structured Interviews ◽  
Public Authorities ◽  
Content Type ◽  
The Impact

PurposeGiven that the incidence of coronavirus disease 2019 (COVID-19) varies greatly between countries, it becomes relevant to explore self-initiated expatriate (SIE) health workers' perceptions of home vs host country safety during a global pandemic. Thus, the paper aims to study the effects of COVID-19 on the expatriation experience of Spanish SIE nurses in Germany, focussing on perceptions of home and host country safety as push/pull forces on their intentions to repatriate or stay.Design/methodology/approachSemi-structured interviews (n = 10) were conducted with Spanish SIE nurses in Germany between April/June 2020 followed by instant messaging interactions with the same participants in October/November 2020. Data analysis was assisted by NVivo software.FindingsOverloaded by information from social networks about the impact of COVID-19 in Spain compared with the situation in Germany, Spanish SIE nurses had exacerbated feelings of stress, and some reported having experienced guilt for not being in their home country. Nevertheless, the contrasting impact and management of the crisis and its relative effect on health workers and the larger society in Spain and Germany reinforced the nurses' intention to stay in Germany.Research limitations/implicationsThe research offers insights to organisations and public authorities involved with providing support to SIEs during crises, highlighting the implications of SIEs' social networks and dual allegiance to home and host countries during a global health emergency.Originality/valueThe study contributes to the growing literature on SIEs, whilst adding to the research on expatriates' well-being and safety during crises.

scholarly journals Mapping domain characteristics influencing Analytics initiatives: The example of Supply Chain Analytics

2020 ◽  
Vol 13 (1) ◽  
pp. 56
Author(s):  
Tino Herden
Keyword(s):  
Supply Chain ◽  
Supply Chain Management ◽  
Success Factors ◽  
Research Collaboration ◽  
Future Research ◽  
Structured Interviews ◽  
Chain Management ◽  
Domain Specific ◽  
The Status ◽  
The Impact

Purpose: Analytics research is increasingly divided by the domains Analytics is applied to. Literature offers little understanding whether aspects such as success factors, barriers and management of Analytics must be investigated domain-specific, while the execution of Analytics initiatives is similar across domains and similar issues occur. This article investigates characteristics of the execution of Analytics initiatives that are distinct in domains and can guide future research collaboration and focus. The research was conducted on the example of Logistics and Supply Chain Management and the respective domain-specific Analytics subfield of Supply Chain Analytics. The field of Logistics and Supply Chain Management has been recognized as early adopter of Analytics but has retracted to a midfield position comparing different domains.Design/methodology/approach: This research uses Grounded Theory based on 12 semi-structured Interviews creating a map of domain characteristics based of the paradigm scheme of Strauss and Corbin.Findings: A total of 34 characteristics of Analytics initiatives that distinguish domains in the execution of initiatives were identified, which are mapped and explained. As a blueprint for further research, the domain-specifics of Logistics and Supply Chain Management are presented and discussed.Originality/value: The results of this research stimulates cross domain research on Analytics issues and prompt research on the identified characteristics with broader understanding of the impact on Analytics initiatives. The also describe the status-quo of Analytics. Further, results help managers control the environment of initiatives and design more successful initiatives.

Achieving Financial Inclusion for Persons With Disabilities: Exploring Preparedness and Accessibility of Financial Services for Persons With Disabilities in Malawi

2021 ◽  
pp. 104420732110275
Author(s):  
Alex Nester Jiya ◽  
Maxwell Peprah Opoku ◽  
William Nketsia ◽  
Joslin Alexei Dogbe ◽  
Josephine Nkrumah Adusei
Keyword(s):  
Financial Literacy ◽  
Financial Services ◽  
Commercial Banks ◽  
Empirical Studies ◽  
Well Being ◽  
Living Conditions ◽  
Inclusive Development ◽  
Future Research ◽  
Structured Interviews ◽  
Persons With Disabilities

Deplorable living conditions among persons with disabilities and the need to improve their living conditions cannot be overemphasized. This has triggered international discussion on the need for deliberate social policies to bridge the poverty gap between persons with and without disabilities. In Malawi, expansion of financial services has been identified as an essential tool to accelerate economic and inclusive development. However, empirical studies are yet to explore the preparedness of financial institutions to extend their services to persons with disabilities. In this qualitative study, semi-structured interviews were conducted with managers from commercial banks in Malawi to understand their perspectives on extending financial services to persons with disabilities. Interviews were transcribed verbatim and a descriptive thematic analysis was performed. Although participants reiterated the need to provide persons with disabilities with financial services to improve their well-being, few initiatives have been undertaken to improve their participation. Particularly, participants stated that barriers, such as a lack of financial literacy and adaptive technologies, communication barriers, and high rates of unemployment, explained the reluctance of commercial banks to extend financial services to persons with disabilities. The limitations, recommendations for future research, and implications of the study for policymaking have been highlighted.

scholarly journals “You run out of hope:” An Exploration of Low-Income Parents’ Experiences with Food Insecurity using Photovoice

2021 ◽  
pp. 1-21
Author(s):  
Payge Lindow ◽  
Irene H. Yen ◽  
Mingyu Xiao ◽  
Cindy W. Leung
Keyword(s):  
Food Insecurity ◽  
San Francisco ◽  
Low Income ◽  
Eating Behaviors ◽  
Comparative Method ◽  
Well Being ◽  
Structured Interviews ◽  
Unhealthy Eating ◽  
Low Income Families ◽  
The Impact

ABSTRACT Objective: Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design: Parents submitted photos around their families’ experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analyzed for thematic content using the constant comparative method. Setting: San Francisco Bay Area, California, USA. Subjects: 17 parents (14 mothers and 3 fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. Results: Four themes were identified from the parents’ photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviors. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt, and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. Conclusions: Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.

scholarly journals Connecting Activity Implementation Characteristics to Student Buy-In Toward and Utilization of Formative Assessments Within Undergraduate Biology Courses

2021 ◽  
Author(s):  
Kathleen R. Brazeal ◽  
Tanya L. Brown ◽  
Brian A. Couch
Keyword(s):  
Student Engagement ◽  
Student Perceptions ◽  
Learning Preferences ◽  
Formative Assessments ◽  
Student Experiences ◽  
Future Research ◽  
Structured Interviews ◽  
Undergraduate Biology ◽  
Biology Courses ◽  
The Impact

AbstractWhile formative assessments (FAs) can facilitate learning within undergraduate STEM courses, their impact likely depends on many factors, including how instructors implement them, whether students buy-in to them, and how students utilize them. FAs have many different implementation characteristics, including what kinds of questions are asked, whether questions are asked before or after covering the material in class, how feedback is provided, how students are graded, and other logistical considerations. We conducted 38 semi-structured interviews with students from eight undergraduate biology courses to explore how various implementation characteristics of in-class and out-of-class FAs can influence student perceptions and behaviors. We also interviewed course instructors to provide context for understanding student experiences. Using thematic analysis, we outlined various FA implementation characteristics, characterized the range of FA utilization behaviors reported by students, and identified emergent themes regarding the impact of certain implementation characteristics on student buy-in and utilization. Furthermore, we found that implementation characteristics have combined effects on student engagement and that students will tolerate a degree of “acceptable discomfort” with implementation features that contradict their learning preferences. These results can aid instructor reflection and guide future research on the complex connections between activity implementation and student engagement within STEM disciplines.

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