Complicated grief knowledge and practice: a qualitative study of general practitioners in Ireland

2021 ◽  
pp. 1-6
Author(s):  
Abiola Muhammed ◽  
Anne Dodd ◽  
Suzanne Guerin ◽  
Susan Delaney ◽  
Philip Dodd
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Current Knowledge ◽  
Complicated Grief ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Relevant Research ◽  
Loved One ◽  
Knowledge And Practice ◽  
Purposive Sample

Objective: Complicated grief is a debilitating condition that individuals may experience after losing a loved one. General practitioners (GPs) are well positioned to provide patients with support for grief-related issues. Traditionally, Irish GPs play an important role in providing patients with emotional support regarding bereavement. However, GPs have commonly reported not being aptly trained to respond to bereavement-related issues. This study explores GPs’ current knowledge of and practice regarding complicated grief. Methods: A qualitative study adopting a phenomenological approach to explore the experiences of GPs on this issue. Semi-structured interviews were carried out with a purposive sample of nine GPs (five men and four women) in Ireland. Potential participants were contacted via email and phone. Interviews were audio-recorded, transcribed and analysed using Braun & Clarke’s (2006) model of thematic analysis. Results: GPs had limited awareness of the concept of complicated grief and were unfamiliar with relevant research. They also reported that their training was either non-existent or outdated. GPs formed their own knowledge of grief-related issues based on their intuition and experiences. For these reasons, there was not one agreed method of how to respond to grief-related issues reported by patients, though participants recognised the need for intervention, onward referral and review. Conclusions: The research highlighted that GPs felt they required training in complicated grief so that they would be better able to identify and respond to complicated grief.

Models for Integrating Medical Acupuncture into Practice: An Exploratory Qualitative Study of Physicians— Experiences

2016 ◽  
Vol 34 (4) ◽  
pp. 280-289 ◽  
Author(s):  
Ellen T Crumley
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Full Time ◽  
Snowball Sampling ◽  
Core Concept ◽  
Structured Interviews ◽  
The Core ◽  
Individual Physician ◽  
Part Time ◽  
Medical Acupuncture

Background Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). Objective To examine how physicians integrate medical acupuncture into their practice. Methods Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of ‘helping’. Quotes were used to illustrate each model and its corresponding themes. Results There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Discussion Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice.

Tiredness of Life in Older persons: A Qualitative Study on Nurses’ Experiences of Being Confronted With This Growing Phenomenon

2019 ◽  
Vol 60 (4) ◽  
pp. 735-744 ◽  
Author(s):  
Liesbeth Van Humbeeck ◽  
Let Dillen ◽  
Ruth Piers ◽  
Nele Van Den Noortgate
Keyword(s):  
Qualitative Study ◽  
Nurse Managers ◽  
Careful Consideration ◽  
Behavioral Approach ◽  
Constructivist Grounded Theory ◽  
Older Individuals ◽  
Structured Interviews ◽  
Nurses Perceptions ◽  
Design And Methods ◽  
Purposive Sample

Abstract Background and Objectives With worldwide aging it is imperative to understand nurses’ perceptions of tiredness of life (ToL) and their ways of dealing with an increasingly common phenomenon. Most research on ToL relates to older individuals’ experiences. This study aimed to gain insight into nurses’ (a) perceptions of, (b) attitude(s) toward, and (c) ways of dealing with ToL in older patients. Research Design and Methods Qualitative study with elements of constructivist grounded theory. Data were collected by means of semi-structured interviews between February 2016 and June 2017 with a purposive sample of 25 nurses working in home care and nursing homes. Results A careful consideration indicative of an oscillation between 3 levels (e.g., behavioral, cognitive, and affective) is present. The confrontation with persons having ToL instigates a cognitive process of searching to understand the state a person is in, which on its turn ensues in an emotional balancing between courage and powerlessness and a behavioral approach of action or dialogue. Discussion and Implications Our findings indicate that nurses aim to provide good care, sensitive to the older person’s needs, but this process is not without ambiguity. This study provides nurse managers with valuable guidance to (a) support nursing staff in dealing with ToL, and (b) advance opportunities for emotionally sensitive care and (individual- and team-based) reflection. Finally, this study offers suggestions for education programs to incorporate ToL in curricula.

Learnings from implementing telemonitoring – the LITE study

2019 ◽  
Vol 27 (4) ◽  
pp. 346-356 ◽  
Author(s):  
Josephine S.F. Chow ◽  
Veronica Eugenia Gonzalez-Arce ◽  
Andrew Knight ◽  
Nutan Maurya ◽  
Friedbert Kohler
Keyword(s):  
Chronic Disease ◽  
Qualitative Study ◽  
Clinical Outcomes ◽  
Current Literature ◽  
Design Methodology ◽  
Structured Interviews ◽  
Content Type ◽  
Clinician Experiences ◽  
Purposive Sample ◽  
Roll Out

Purpose A recent study on the implementation of telemonitoring has provided an opportunity to explore how telemonitoring could be further developed to enhance better patient, carer and clinician experiences for patients living with chronic disease. The purpose of this paper is to identify the challenges and lessons of the telemonitoring implementation and to identify strategies to inform future implementation. Design/methodology/approach A qualitative study was conducted with a purposive sample using semi-structured interviews to explore their views about the issues identified in the research aims. Interview themes were informed by current literature and the findings from local studies. Interviews were recorded, transcribed verbatim and analyzed thematically. Findings A total of 16 participants were interviewed. Overall the recruitment of 56 percent were from identified potential participants. Five core themes were identified, linking different aspects of the telemonitoring implementation: impact of telemonitoring; implementation and management lessons; program risks; program main changes from beginning; and future strategies and recommendations. Originality/value This study will inform the wider roll out of telemonitoring across the region with the goal of ensuring future interventions achieve better clinical outcomes, patient, carer experience and deliver better value.

scholarly journals General practitioners’ concepts on issuing out-of-pocket prescriptions for hypnotics and sedatives in Germany

2019 ◽  
Vol 36 (6) ◽  
pp. 785-790
Author(s):  
Katharina Schmalstieg-Bahr ◽  
Christiane A Müller ◽  
Eva Hummers
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
General Practitioners ◽  
Statutory Health Insurance ◽  
Medication Use ◽  
Hypnotics And Sedatives ◽  
Structured Interviews ◽  
Medication Costs ◽  
Prescription Form ◽  
To Receive

Abstract Background In Germany, almost 50% of prescriptions for benzodiazepines and drugs as Zolpidem and Zopiclone are as out-of-pocket (OOP) prescriptions—requiring patients to buy the drug at their own expense—although almost 90% of the population has statutory health insurance covering medication costs. Objective To understand why general practitioners (GPs) choose this prescribing method since needed medications are insurance covered, and unnecessary drugs should not be prescribed at all. Methods In this qualitative study, 17 semi-structured interviews with GPs were conducted, audio recorded and transcribed verbatim. Transcripts were analysed with grounded theory to extract a model explaining the described behaviour. Results Knowing the significant medical risks and insecurity about regulations makes GPs wish to avoid hypnotics and sedatives. They achieve this by ‘Creating a barrier’ (central phenomenon) and employing the strategy ‘Using an out-of-pocket prescription’, which not only generates costs for the patient but also reduces the physicians´ legal and financial accountability. The perceived patient type, expected problem duration and diagnosis influence the decision about the prescription form: patients with an alcohol or drug addiction or those with ‘uncomplicated’ insomnia are more likely to receive an OOP prescription. Patients with any psychiatric diagnosis will likely receive a statutory health insurance prescription. Discussion Current regulations do not provide guidance to GPs regarding hypnotics and sedatives. A clear regulatory framework and guidelines could possibly reduce physicians’ defensive attitudes about these drugs and their use of OOP prescriptions. The approach to use OOP prescriptions as a barrier to reduce patients’ medication use lacks evidence regarding effectiveness.

scholarly journals Treatment of female and male inpatient crack users: a qualitative study

2013 ◽  
Vol 35 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Rosemeri Siqueira Pedroso ◽  
Félix Kessler ◽  
Flavio Pechansky
Keyword(s):  
Qualitative Study ◽  
Health Care Services ◽  
Spiritual Support ◽  
Structured Interviews ◽  
Criminal Involvement ◽  
Care Services ◽  
Preventive Actions ◽  
The Relationship ◽  
Purposive Sample ◽  
Crack Users

OBJECTIVE: To map treatment trajectories in a sample of male and female crack users through their narratives about the course of treatment seeking and their attempts to access health care services in Brazil. METHODS: Qualitative study of a purposive sample (five female and nine male hospitalized crack users) using semi-structured interviews. The interviews were transcribed and data explored using content analysis. RESULTS: Respondents reported difficulties getting access to hospitalization, relapse after discharge, and abandonment of treatment. There seems to be a peculiar model of behavior for women and men while dealing with craving for crack: while women got involved with prostitution and consequently became infected with HIV, every men of the sample reported criminal involvement. CONCLUSIONS: The relationship between relapse and a social environment conducive to consumption, associated with belief or disbelief in spiritual support, prostitution, and the legal complications arising from the use of crack, are relevant issues and should be taken into consideration in the development of preventive actions aimed at this specific population.

scholarly journals GPs’ decisions about prescribing anticipatory medicines at the end of life: a qualitative study

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702809
Author(s):  
Ben Bowers ◽  
Kristian Pollock ◽  
Sam Barclay ◽  
Stephen Barclay
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
End Of Life ◽  
Thematic Analysis ◽  
Symptom Management ◽  
Symptom Relief ◽  
Structured Interviews ◽  
Family Experiences ◽  
Decision Making Processes ◽  
Purposive Sample

BackgroundGPs have a central role in decisions about prescribing anticipatory medications (AMs) to help control symptoms at the end of life. Little is known about GPs’ decision-making processes in prescribing AMs and the subsequent use of prescribed drugs.AimTo explore GPs’ decision-making processes in the prescribing and use of AMs for patients at the end of life.MethodA qualitative interpretive descriptive enquiry with a purposive sample of 13 GPs working across one English county. Data was collected in 2017 via semi-structured interviews and analysed inductively using Braun and Clarke’s thematic analysis.ResultsThree themes were constructed from the data: 1) ‘Something we can do’: AMs were a tangible intervention GPs felt they could offer to provide symptom relief for patients approaching death. 2) ‘Getting the timing right’: the prescribing of AMs was recognised as a harbinger of death for patients and families. GPs preferred to prescribe drugs weeks before death was expected, while recognising this meant that many prescribed AMs were never used. 3) ‘Delegating care while retaining accountability’: GPs relied on nurse to assess when to administer drugs and keep them updated about their use.ConclusionGPs view AMs as key to symptom management for dying people. AMs are routinely prescribed even though they are often not used. In order to feel comfortable delegating care, GPs need regular access to nurses and trust in their skills to administer drugs appropriately. Patient and family experiences of AMs, and their preference for involvement in decision-making about their use warrant urgent investigation.

scholarly journals Electronic transmission of prescriptions in primary care: transformation, timing and teamwork

2021 ◽  
Vol 13 (4) ◽  
pp. 340
Author(s):  
Chloë Campbell ◽  
Caroline Morris ◽  
Lynn McBain
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
General Practitioners ◽  
Community Pharmacists ◽  
Unintended Consequences ◽  
Structured Interviews ◽  
Interprofessional Communication ◽  
Potential Benefits ◽  
Handwritten Signature ◽  
Purposive Sample

ABSTRACTINTRODUCTIONDuring the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy.AIMThe purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy.METHODSSemi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants’ perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach.RESULTSFour themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs).DISCUSSIONBoth general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners.

scholarly journals Changing University Students’ Mindset: From Job Seekers to Job Creators

2021 ◽  
Vol 18 ◽  
pp. 433-443
Author(s):  
Hartono Hartono
Keyword(s):  
Data Collection ◽  
Qualitative Study ◽  
College Graduates ◽  
Phenomenological Approach ◽  
Growth Mindset ◽  
University Graduates ◽  
Ministry Of Education ◽  
Job Seekers ◽  
Structured Interviews ◽  
The Government

The government continues to encourage the growth of entrepreneurship in Indonesia. Currently, university graduates are generally more interested in becoming workers or employees than in creating jobs. Indonesia still needs around 4.75 million entrepreneurs. Data from the Ministry of Education and Culture shows that in general, college graduates are more interested in becoming job seekers than job creators. Therefore, universities have the responsibility to change the students’ mindset from wanting to become job seekers to job creators. This research is a qualitative study using the phenomenological approach. Data collection was carried out by means of semi structured interviews by selecting 20 students from private universities in Jakarta. The results of this study indicate that students’ mindset from job seekers to job creators cannot change without improvement of entrepreneurship education at universities. The students’ mindset must be changed from a fixed mindset to a growth mindset. Curricula and learning methods that are too theoretical must be transformed into learning that emphasizes practical elements and entrepreneurial mental development

Self-help organisations: A qualitative study of successful collaboration with general practice

2003 ◽  
Vol 9 (3) ◽  
pp. 75 ◽  
Author(s):  
Frances M Boyle ◽  
T. Natasha Posner ◽  
Christopher B Del Mar ◽  
Jill McLean ◽  
Robert A Bush
Keyword(s):  
Health Care ◽  
General Practice ◽  
Qualitative Study ◽  
General Practitioners ◽  
Health Care System ◽  
Cross Section ◽  
Structured Interviews ◽  
Self Help ◽  
Successful Collaboration ◽  
Two Sectors

Thousands of self-help organisations (SHOs) exist in Australia but little is known about how they relate to the mainstream health care system. This qualitative study, based in south-east Queensland, aimed to identify examples of collaboration between general practitioners (GPs) and SHOs in order to examine the attributes of successful partnerships. Representatives of six SHOs, identified by key informants as having good collaborative links with GPs, and seven GPs with whom they collaborated, completed semi-structured interviews. The interviews focused on evidence of collaboration and perceptions of benefits and barriers experienced. Maximum variation sampling enabled a cross-section of SHOs in terms of size, funding, and health issue. Although GPs readily identified SHO benefits, they referred patients to them only rarely. SHO credibility, evidence of tangible benefits for patients, ease of contacting the SHO, and correspondence between the SHO?s focus and the GP?s personal and professional interests appear to contribute to the success of partnerships. We conclude that mutually beneficial partnerships between GPs and SHOs exist but are under-utilised. A more coordinated effort is needed to strengthen links between the two sectors.

scholarly journals Families of victims of homicide: qualitative study of their experiences with mental health inquiries

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Lillian Ng ◽  
Alan F. Merry ◽  
Ron Paterson ◽  
Sally N. Merry
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Qualitative Study ◽  
Healthcare Providers ◽  
Mental Healthcare ◽  
Interpretive Description ◽  
Structured Interviews ◽  
Mental Health Patient ◽  
Loved One ◽  
Inquiry Process

Background Investigations may be undertaken into mental healthcare related homicides to ascertain if lessons can be learned to prevent the chance of recurrence. Families of victims are variably involved in serious incident reviews. Their perspectives on the inquiry process have rarely been studied. Aims To explore the experiences of investigative processes from the perspectives of family members of homicide victims killed by a mental health patient to better inform the process of conducting inquiries. Method The study design was informed by interpretive description methodology. Semi-structured interviews were conducted with five families whose loved one had been killed by a mental health patient and where there had been a subsequent inquiry process in New Zealand. Data were analysed using an inductive approach. Results Families in this study felt excluded, marginalised and disempowered by mental health inquires. The data highlight these families’ perspectives, particularly on the importance of a clear process of inquiry, and of actions by healthcare providers that indicate restorative intent. Conclusions Families in this study were united in reporting that they felt excluded from mental health inquiries. We suggest that the inclusion of families’ perspectives should be a key consideration in the conduct of mental health inquiries. There may be benefit from inquiries that communicate a clear process of investigation that reflects restorative intent, acknowledges victims, provides appropriate apologies and gives families opportunities to contribute.

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