Developing connections for engagement in stroke rehabilitation

2021 ◽  
pp. 1-18
Author(s):  
Nicola M. Kayes ◽  
Christine Cummins ◽  
Kathryn M. McPherson ◽  
Linda Worrall ◽  
Felicity A. S. Bright
Keyword(s):  
Stroke Rehabilitation ◽  
Neurological Impairment ◽  
Structured Interviews ◽  
Group Discussions ◽  
Regulatory Processes ◽  
Collaborative Processes ◽  
Theoretical Sampling ◽  
Primary Focus ◽  
Design And Methods ◽  
Analytical Tools

Abstract Background and Aims: Engagement is increasingly recognised as important for maximising rehabilitation outcome following stroke. However, engagement can be challenging when neurological impairment impacts a persons’ ability to activate the regulatory processes necessary for engagement and in the context of a changed self. We explored engagement in stroke rehabilitation from the perspective of people with stroke with a primary focus on identifying key processes that appeared important to engagement in stroke rehabilitation. Design and Methods: This study drew on Interpretive Description methodology. Maximum variation and theoretical sampling were used to capture diversity in the sample and access a depth and breadth of perspectives. Data collection included semi-structured interviews with people with stroke (n = 19). Data were analysed through a collaborative and iterative process drawing on range of analytical tools including coding, memoing, diagramming and group discussions. Findings: Our findings highlight that engagement is a complex, nuanced, responsive, flexible and inherently two-way process. Developing connections appeared central to engagement with connections taking various forms. The most fundamental was the therapeutic connection between the person with stroke and their practitioner as it provided the foundation on which to build other connections. Connection was made possible through five collaborative processes: Knowing, Entrusting, Adapting, Investing and Reciprocating. Conclusions: Engagement is a social and relational process enabled through an inherently person-centred approach and active and ongoing reflexivity – highlighting the importance of a humanising approach to care where aspects of self, care and emotion are evident, for both the person with stroke and their practitioner.

scholarly journals Exploring the potential for introducing home monitoring of blood pressure during pregnancy into maternity care: current views and experiences of staff—a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e037874
Author(s):  
Lisa Hinton ◽  
James Hodgkinson ◽  
Katherine L Tucker ◽  
Linda Rozmovits ◽  
Lucy Chappell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Home Monitoring ◽  
Structured Interviews ◽  
Group Discussions ◽  
Self Monitoring ◽  
Team Members ◽  
Registration Number ◽  
In Pregnancy

ObjectiveOne in 20 women are affected by pre-eclampsia, a major cause of maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis is made from monitoring blood pressure (BP) and urine and symptoms at antenatal visits after 20 weeks of pregnancy. There are no randomised data from contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in pregnancy. We explored the perspectives of maternity staff to understand the context and health system challenges to introducing and implementing SMBP in maternity care, ahead of undertaking a trial.DesignExploratory study using a qualitative approach.SettingEight hospitals, English National Health Service.ParticipantsObstetricians, community and hospital midwives, pharmacists, trainee doctors (n=147).MethodsSemi-structured interviews with site research team members and clinicians, interviews and focus group discussions. Rapid content and thematic analysis undertaken.ResultsThe main themes to emerge around SMBP include (1) different BP changes in pregnancy, (2) reliability and accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty and evidence, (6) concerns over action/inaction and patient safety.ConclusionsThe potential impact of SMBP on maternity services is profound although nuanced. While introducing SMBP does not reduce the responsibility clinicians have for women’s health, it may enhance the responsibilities and agency of pregnant women, and introduces a new set of relationships into maternity care. This is a new space for reconfiguration of roles, mutual expectations and the relationships between and responsibilities of healthcare providers and women.Trial registration numberNCT03334149.

scholarly journals The Role of Religious Fundamentalism in the Intersection of National and Religious Identities

2019 ◽  
Vol 13 ◽  
Author(s):  
Susilo Wibisono ◽  
Winnifred Louis ◽  
Jolanda Jetten
Keyword(s):  
National Identity ◽  
Religious Identity ◽  
National Identities ◽  
Religious Fundamentalism ◽  
Religious Movements ◽  
Structured Interviews ◽  
Group Discussions ◽  
Religious Identification ◽  
National Identification ◽  
The Way

Indonesia has seen recent expansions of fundamentalist movements mobilising members in support a change to the current constitution. Against this background, two studies were conducted. In Study 1, we explored the intersection of religious and national identity among Indonesian Muslims quantitatively, and in Study 2, we qualitatively examined religious and national identification among members of moderate and fundamentalist religious organisations. Specifically, Study 1 (N= 178) assessed whether the association of religious and national identity was moderated by religious fundamentalism. Results showed that strength of religious identification was positively associated with strength of national identification for both those high and low in fundamentalism. Using structured interviews and focus group discussions, Study 2 (N =35) examined the way that self-alignment with religious and national groups develops among activists of religious movements in Indonesia. We found that while more fundamentalist activists attached greater importance to their religious identity than to any other identity (e.g., national and ethnic), more moderate activists represented their religious and national identities as more integrated and compatible. We conclude that for Indonesian Muslims higher in religious fundamentalism, religious and national identities appear to be less integrated and this is consequential for the way in which collective agendas are pursued.

scholarly journals Lack of school requirements and clinician recommendations for human papillomavirus vaccination

2018 ◽  
Author(s):  
Linda M. Niccolai ◽  
Anna L. North ◽  
Alison Footman ◽  
Caitlin E. Hansen
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
School Entry ◽  
Structured Interviews ◽  
Human Papillomavirus Vaccination ◽  
Strong Recommendation ◽  
Entry Requirements ◽  
Design And Methods ◽  
Purposive Sample

Background: A strong recommendation from a clinician is one of the best predictors of human papillomavirus (HPV) vaccination among adolescents, yet many clinicians do not provide effective recommendations. The objective of this study was to understand how the lack of school entry requirements for HPV vaccination influences clinicians’ recommendations. Design and Methods: Semi-structured interviews with a purposive sample of 32 clinicians were conducted in 2015 in Connecticut USA. Data were analysed using an iterative thematic approach in 2016-2017. Results: Many clinicians described presenting HPV vaccination as optional or non-urgent because it is not required for school entry. This was noted to be different from how other required vaccines were discussed. Even strong recommendations were often qualified by statements about the lack of requirements. Furthermore, lack of requirements was often raised initially by clinicians and not by parents. Many clinicians agreed that requirements would simplify the recommendation, but that parents may not agree with requirements. Personal opinions about school entry requirements were mixed. Conclusions: The current lack of school entry requirements for HPV vaccination is an important influence on clinicians’ recommendations that are often framed as optional or non-urgent. Efforts are needed to strengthen the quality of clinicians’ recommendations in a way that remains strong and focused on disease prevention yet uncoupled from the lack of requirements that may encourage delays. Additionally, greater support for requirements among clinicians may be needed to successfully enact requirements in the future.

scholarly journals Implementing English-medium instruction

2021 ◽  
Vol 44 (2) ◽  
pp. 129-153
Author(s):  
Kari Sahan
Keyword(s):  
Teaching And Learning ◽  
Teaching Practice ◽  
State University ◽  
Structured Interviews ◽  
Language Preference ◽  
Group Discussions ◽  
Engineering Programs ◽  
English Medium Instruction ◽  
University Department

Abstract As part of the trend toward internationalization of higher education, governments and universities have introduced policies to encourage the expansion of English-medium instruction (EMI). However, top-down policies do not necessarily translate to teaching and learning practices. This article provides a case study examining the implementation of undergraduate EMI engineering programs at a state university in Turkey to explore the gaps that exist between national- and institutional-level EMI policies and classroom-level practices. Data were collected through policy documents, classroom observations, semi-structured interviews with teachers, and focus group discussions with students. The findings suggest that the implementation of EMI varies across classrooms, even within the same university department. Despite policies that envision one-language-at-a-time instruction, the EMI lecturers in this study varied in terms of language preference and teaching practice in their EMI lectures. Implications are discussed with respect to policy planning, teacher training, and the expansion of EMI across university contexts.

scholarly journals A qualitative evaluation of the value of an online peer support community for people with depression: Depression Connect (Preprint)

2020 ◽  
Author(s):  
Dorien Smit ◽  
Janna Vrijsen ◽  
Bart Groeneweg ◽  
Amber Dings ◽  
Janneke Peelen ◽  
...  
Keyword(s):  
Peer Support ◽  
Sense Of Belonging ◽  
Qualitative Evaluation ◽  
Negative Aspect ◽  
Structured Interviews ◽  
User Experiences ◽  
User Perspective ◽  
Theoretical Sampling ◽  
Consumer Perspective ◽  
Relevant Outcome

BACKGROUND Despite their popularity, the efficacy of online peer support communities for individuals with depression remains unclear. Little is known about the working mechanisms of online communities in general and for depression specifically. The evidence for the efficacy of online peer support for depression is confounded by methodological issues and ambiguity of relevant outcome measures. OBJECTIVE This study aimed to evaluate the usefulness of an online peer support community for depression from a user perspective. By employing qualitative modes of inquiry, the aim was to generate hypotheses on the mechanisms of change and outcomes of online peer support usage in depression. METHODS Fifteen semi-structured interviews were conducted with users of the online peer support community Depression Connect [DC], in which experiences and outcomes of forum use in coping with depression were examined. To explore diverse perspectives of community usage, theoretical sampling was performed, and negative cases were included. RESULTS A complex set of factors seemed to influence the subjective usefulness of the online peer support community DC from a consumer perspective. The data revealed 4 distinctive user experiences: A sense of belonging, emotional growth, self-efficacy, and empowerment. Furthermore, losing oneself was the central negative aspect of forum use. The deployment and development of 3 differentiated user roles (e.g., reading, posting, responding) seemed to individually and interactively affect user experiences. Finally, the online peer support community seemed to serve as a digital realm to practice and reflect on coping with depression and was mainly used as a supplement to offline support for depression. CONCLUSIONS The DC online peer support community allowed individuals familiar with depression to learn how to cope (better) with depression and practice these newly gained insights/skills. It may serve as a supplement to formal care for depression.

scholarly journals Mapping the Internal and External Environments in Empowering Semanggi Batik Craftsmen in Surabaya

2020 ◽  
Vol 8 (1) ◽  
pp. 16-22
Author(s):  
Susi Hardjati ◽  
Ananta Prathama ◽  
Kalvin Edo Wahyudi
Keyword(s):  
Swot Analysis ◽  
Economic Value ◽  
Online Marketing ◽  
City Government ◽  
Government Support ◽  
Structured Interviews ◽  
Group Discussions ◽  
Production Scale ◽  
Document Collection ◽  
The City

Batik Semanggi is one of the typical batiks in Surabaya which has economic value for the community. However, the competitiveness of the clover batik business is relatively low. This study aims to identify the internal environmental conditions (strengths-weaknesses) and external (opportunities-threats) of the clover batik craftsmen as the basis for formulating a strategy to increase competitiveness. The study used a qualitative approach with data collection techniques focus group discussions (FGD), semi-structured interviews, observation and document collection. Informants were determined using a purposive method. The data analysis uses interactive models and SWOT analysis. The results showed several strengths that can encourage the floating of clover batik, namely the ability to make a capable batik, iconic distinctive motifs and organic batik technology. The opportunities that arise, namely export opportunities, support of the city government, support of other elements of society, and online marketing opportunities. While weaknesses include the number of craftsmen, low online marketing capabilities, motives not yet registered as intellectual property rights, limited production, and marketing volumes, traditional tools, and low capital. The threat that arises namely, the emergence of other motifs as a competitor batik, and batik printing production that offers cheaper prices with a larger production scale. The map of strengths and weaknesses and threats above are very useful as a material for formulating strategies in empowering clover batik craftsmen.

scholarly journals Diagnostic SWOT appraisal of the wicker handicraft entrepreneurship development in Kashmir, India

2020 ◽  
Vol 12 (2) ◽  
pp. 193-201
Author(s):  
M. A. Islam ◽  
A.A. Wani ◽  
G.M. Bhat ◽  
A.A. Gatoo ◽  
Murtaza Shah ◽  
...  
Keyword(s):  
Poverty Alleviation ◽  
External Factors ◽  
Structured Interviews ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Internal Factors ◽  
Traditional Art ◽  
Multi Stage ◽  
Employment Generation ◽  
F Statistics

Critical analyses of the perceptions on SWOT (strengths, weaknesses, opportunities and threats) have become a fundamental element of multi-criteria decision making for developing wicker handicraft entrepreneurship. The study examined the effectiveness and prioritization of entrepreneur's perceptions towards SWOT categories and factors and provided insights for developing wicker handicraft entrepreneurship in Pulwama district of Kashmir. Data were collected through structured interviews and focus group discussions of 100 wicker handicraft entrepreneurs of 20 villages selected by multi-stage random sampling. Simple descriptive statistics were used for the data analysis. Results showed that the factors like income generation (19.30%) and employment generation (19.00%) were viewed as most important strengths while labour intensive and less remunerative livelihood (18.80%) and seasonal subsistence (18.70%) were identified as main weaknesses. Further, poverty alleviation (20.70%), preservation of traditional art craft (19.00%) and improvement in public-private relations (17.50%) were adjudged as strong opportunities whereas limited marketing facilities (20.70%), lack of co-operative societies (18.90%) and harassment by officials in withies collection (16.50%) were seen as chief threats. The challenges (weaknesses and threats) (50.40%) for wicker handicraft entrepreneurship outweighed the prospects (strengths and opportunities) (49.60%) while the internal factors (strengths and weaknesses) (54.80%) prevailed over the external factors (opportunities and threats) (54.20%). F statistics (p<0.05) indicated significant differences between the internal factors (strengths and weaknesses) and external factors (opportunities and threats). The results projected the basis to the policymakers to prioritize and address the prominent challenges and reinforce the prospects for conceptualizing, formulating and implementing the strategies for strengthening the wicker handicraft entrepreneurship.

scholarly journals Reinforcement of human resources in implementing healthy indonesian program with family approach

2020 ◽  
Author(s):  
Retno Widiarini ◽  
Djazuly Chalidyanto ◽  
Eva Rusdianah
Keyword(s):  
Human Resources ◽  
Continuous Training ◽  
Group Discussions ◽  
Center Staff ◽  
Family Approach ◽  
Design And Methods ◽  
Document Review ◽  
Feeling Overwhelmed ◽  
Depth Interviews

Background: The Healthy Indonesia Program is a government program implemented with the Family Approach (HIP-FA) through a survey on healthy families. However, the quality of the program depend on the performance of the Human Resources (HR). This study aims to examine various aspects of HR in implementing the program at health centers. Design and methods: Data were collected through in-depth interviews, Focus Group Discussions, and document review on eight informants at the Health Office center. Results: Four themes revealed from the study: being burdened, feeling overwhelmed, feeling incompetent, and confused managing technology. The results showed that the implementation of the HIP-FA survey is an additional burden for health center staff. Conclusions: It is necessary to strengthen the implementation of all programs through continuous training and education, positive affirmation, recalculating employee workload and remunerations.

scholarly journals Operationalising Community Resilience to Climate Change in Developing Countries: A Grounded Delphi Method (GDM) Approach

2021 ◽  
Author(s):  
Alima Ogah ◽  
Tracey Crosbie ◽  
Theresia Komang Ralebitso-Senior
Keyword(s):  
Climate Change ◽  
Developing Countries ◽  
Delphi Method ◽  
Community Resilience ◽  
Structured Interviews ◽  
Adaptation To Climate Change ◽  
Economic Discourse ◽  
Delphi Approach ◽  
The Face ◽  
Analytical Tools

Abstract Background Climate change and its impact have taken centre stage in contemporary political economic discourse. Climate change is posing complex problems that far outweighs the solutions suggested by the conventional analytical tools used for guiding responses to major environmental challenges. This is particularly the case in developing countries like Nigeria. Unsurprisingly the concept of community resilience towards climate change has received a great deal of attention from researchers and policy makers. However, community resilience is a contested concept, which leads to disagreement about the methods of achieving it. The nature of community resilience makes the measurement of the efficiency of the policies designed to increase community resilience problematic, particularly in developing countries where limited funds must be prioritised. Methods The research presented uses a Grounded Delphi Method (GDM) to identify how experts in Nigeria define community resilience and reach a consensus on its measurement in Nigeria’s context and other developing nations. The data collection involved three rounds of Delphi with a panel of 21 experts, the first round employed semi-structured interviews, following the exploratory Delphi approach, and subsequent rounds employed online surveys. Findings: The findings indicate that there is a process of stages that communities need to go through to become resilient to climate change. These begin with coping with climate change, followed by adaptation to climate change with the final stage being transformation in the face of climate change. Twenty indicators are identified categorised under eight elements that are suitable for measuring community resilience at the different stages of this process. It is interesting to note that the experts in Nigeria who participated in the study excluded notions of transformation in their conceptualisation of community resilience illustrating a potential gap in their perceptions of the requirements for how communities can become fully resilient. Conclusion This research provides a method of prioritising specific, measurable indicators to inform policies designed to reduce the impacts of climate change by supporting community resilience in the context of developing countries with limited funding.

Language and Representation: Framing of HIV/AIDS Discourse in Gikuyu “Mukingo” Songs and Common-Talk by Public Transport Operators in Nyeri Town

2019 ◽  
Vol 1 (2) ◽  
pp. 78-94
Author(s):  
Mary Kamunyu; Phylis Bartoo
Keyword(s):  
Critical Discourse Analysis ◽  
Public Transport ◽  
Hiv And Aids ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Group Discussions ◽  
Social Phenomena ◽  
African Languages ◽  
Collection Data ◽  
Hiv Aids

This paper aims to uncover representations and framings of the HIV/AIDS phenomenon. The paper asks: What are the representations and framings of the HIV/AIDS phenomenon in HIV/AIDS discourse in Gikuyu AIDS "Mukingo" songs and common-talk by public transport operators in Nyeri town? Although HIV and AIDS are biomedical and social phenomena that affect Kenyan society to the core, HIV/AIDS discourse has not been investigated adequately, especially with regard to how its discourse is represented in the African languages. The language and topics of research on HIV/AIDS, based on Western perceptions of reality, continue to exclude and marginalize the Third World’s own perceptions of reality and what counts as knowledge in the fight against HIV/AIDS. The paper is hinged within the frameworks of Critical Discourse Analysis (CDA) and Systemic Functional Linguistics Theory (SFL) as the theoretical orientations to the study of HIV/AIDS discourse. To get the needed data, the paper used purposive, and snowball sampling was used due to the mobile nature of public transport operators. Structured interviews and Focus Group Discussions (FGD) was also used for data collection. Data analysis was done using a traditional thematic analysis. Unpacking the social constructions of HIV/AIDS in this paper sheds light on the ways in which laypeople construct “common sense assumptions”, of the epidemic in the public realm.

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