‘Thinking you're old and frail’: a qualitative study of frailty in older adults

ABSTRACTMany older adults experience what is clinically recognised as frailty but little is known about the perceptions of, and attitudes regarding, being frail. This qualitative study explored adults' perceptions of frailty and their beliefs concerning its progression and consequences. Twenty-nine participants aged 66–98 with varying degrees of frailty, residing either in their homes or institutional settings, participated in semi-structured interviews. Verbatim transcripts were analysed using a Grounded Theory approach. Self-identifying as ‘frail’ was perceived by participants to be strongly related to their own levels of health and engagement in social and physical activity. Being labelled by others as ‘old and frail’ contributed to the development of a frailty identity by encouraging attitudinal and behavioural confirmation of it, including a loss of interest in participating in social and physical activities, poor physical health and increased stigmatisation. Using both individual and social context, different strategies were used to resist self-identification. The study provides insights into older adults' perceptions and attitudes regarding frailty, including the development of a frailty identity and its relationship with activity levels and health. The implications of these findings for future research and practice are discussed.

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Processes and determinants of integration of eGFR in physicians’ drug prescriptions: a qualitative study of semi-structured interviews

Primary Health Care Research & Development ◽

10.1017/s1463423619000847 ◽

2019 ◽

Vol 20 ◽

Author(s):

Louis Lefèvre ◽

Maud Jourdain ◽

Jean-Pascal Fournier

Keyword(s):

Qualitative Study ◽

Adverse Drug Reactions ◽

Healthcare Professionals ◽

Drug Prescriptions ◽

Theory Approach ◽

Snowball Sampling ◽

Drug Reactions ◽

Structured Interviews ◽

Training Professional ◽

Grounded Theory Approach

Abstract Aim: Our objective was to explore the processes and determinants leading physicians to integrate estimated glomerular filtration rate (eGFR) in their drug prescriptions Background: Access to patients’ eGFR would allow primary care pharmacists to optimise their role in the procedure of safe prescribing. Some rare physicians actively integrate eGFR in their prescriptions, in a sporadically and uncoordinated manner. Methods: Qualitative study using semi-directed interviews conducted among 12 French physicians who integrated eGFR in their drug prescriptions, (February 2016–April 2017). These voluntary participants were recruited through different means: Twitter®, forums, direct contact and snowball sampling. Data analysis was based on the grounded theory approach, underpinned by a comprehensive perspective of interactionist orientation. Findings: Residency and training, professional experience – including experiences of adverse drug reactions – and the membership in various communities of professionals were key drivers for the integration of eGFR in prescriptions. The theoretical aim was above all safe prescribing in order to reduce adverse drug reactions, with the control by a dispensing pharmacist and/or other healthcare professionals. Nevertheless, none of the physicians had received any feedback from any healthcare professionals. Despite their disappointment, the physicians remained convinced of the interest of integrating eGFR in their prescriptions and would continue to do so. Characteristics associated with integration of eGFR in drug prescriptions belong partly to Roger’s theory of innovations. If a widespread diffusion of this habit takes place, it will be necessary to evaluate its adoption by both physicians and pharmacists.

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The Virtuous Circle: A Grounded Theory Exploration of the Good Lives Model

Sexual Abuse ◽

10.1177/1079063218780730 ◽

2018 ◽

Vol 31 (8) ◽

pp. 908-929

Author(s):

Miriam Ryan ◽

Mathew McCauley ◽

Davina Walsh

Keyword(s):

Grounded Theory ◽

Constructivist Grounded Theory ◽

Future Research ◽

Theory Approach ◽

Structured Interviews ◽

Community Based ◽

Good Lives Model ◽

Sexual Offenses ◽

Grounded Theory Approach ◽

Good Lives

Sexual offenses evoke strong emotional responses and frequently elicit demands from society that offenders be indefinitely incarcerated or treated until they are deemed safe, which may impact the provision of therapeutic treatment for offenders. However, in recent years, there has been a proposal to move toward a positive, strengths-based treatment approach, namely the Good Lives Model (GLM). The present study used semi-structured interviews and a constructivist grounded theory approach to examine the experience of 13 men who were voluntarily engaging in or had completed a GLM community-based treatment program. A conceptual model emerged which outlines the process the men underwent, the factors they identified as crucial for change, and the perceived gains. The model extends previous work by exploring the process from the clients’ perspective. Implications for future research, prevention, and treatment are discussed.

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Telemedicine in The Context of Covid-19- A Qualitative Study of Cancer Patients and Clinicians

10.21203/rs.3.rs-149380/v1 ◽

2021 ◽

Author(s):

Dylan Chan Tai Kong ◽

Ashfaq Chauhan ◽

Anaïs Tiffany Ah Leung ◽

Melvin Chin

Keyword(s):

Qualitative Study ◽

Theory Approach ◽

Structured Interviews ◽

Hospital Data ◽

Metropolitan Regions ◽

Theoretical Sampling ◽

Proper Training ◽

Grounded Theory Approach

Abstract Background:Prior to the Covid-19 pandemic, telemedicine was only used to deliver health care to patients living in remote areas of Australia. However, the spread of the Covid-19 virus pushed the widespread uptake of telemedicine across Australia, including in metropolitan regions. This qualitative study will explore the medical oncology (MO) patient and clinician experience of telemedicine in a metropolitan setting as a result of Covid-19.Method:Participants were selected and invited to participate by theoretical sampling from MO clinicians and patients attending MO clinics at Prince of Wales Hospital. Data was collected by in-depth semi-structured interviews. Thematic analysis was performed to analyse the interview data. Transcripts were coded using the grounded theory approach to identify overarching themes.Results:Twelve participants were recruited to the study. Most participants viewed the adoption of telemedicine positively because it was considered as convenient, efficient and could be used in order to reduce the spread of Covid-19. Nonetheless, participants complained about the poor implementation of telemedicine, technical difficulties and lack of proper training. Finally, providers expressed mixed views over the lack of personal interaction and the lack of physical examination from telemedicine. However, both clinicians and patients viewed telemedicine as acceptable to be used in the context of routine follow-ups.Conclusion:Although some operational improvements are necessary, the role of telemedicine in the follow up of MO patients seems likely to continue beyond Covid-19.

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Striving for autonomy in everyday diabetes self-management—qualitative exploration via grounded theory approach

BMJ Open ◽

10.1136/bmjopen-2021-058885 ◽

2021 ◽

Vol 11 (12) ◽

pp. e058885

Author(s):

Viola Sallay ◽

Andrea Klinovszky ◽

Sára Imola Csuka ◽

Norbert Buzás ◽

Orsolya Papp-Zipernovszky

Keyword(s):

Grounded Theory ◽

Family Relationships ◽

Personal Autonomy ◽

The Self ◽

Self Management ◽

Future Research ◽

Theory Approach ◽

Structured Interviews ◽

Everyday Experiences ◽

Grounded Theory Approach

ObjectivesThe rapid worldwide increase in the incidence of diabetes significantly influences the lives of individuals, families and communities. Diabetes self-management requires personal autonomy and the presence of a supportive social environment. These attributes can considerably ameliorate the outcomes of the chronic condition. However, little is known about individual variations in overcoming the illness-related challenges and in the achievement of autonomy in daily activities. This paper seeks to bridge this knowledge gap.DesignThis qualitative study used the grounded theory approach. Semi-structured interviews were conducted, and the data collection and data analysis probed participant experiences of autonomy through the self-management of their daily socio-physical environments.SettingParticipants were recruited from the outpatient ward of a university clinic in Hungary.ParticipantsThe study was conducted with 26 adult patients with type 2 diabetes mellitus (15 females and 11 males aged between 26 and 80 years; M=62.6 years; SD=13.1). The inclusion criteria were: T2D diagnosis at least 1 year before the beginning of the study; prescribed insulin injection therapy; aged over 18 years; native Hungarian speaker and not diagnosed with dementia or any form of cognitive impairment.ResultsThe study established three principal aspects of the active construction of personal autonomy in diabetes self-management: coping strategies vis-à-vis threats posed by the symptoms and the treatment of the disease; autonomous ways of creating protective space and time and relationship processes that support everyday experiences of self-directedness.ConclusionsThe results of this study confirm the validity of the self-determination theory in diabetes self-management. They also imply that pathways towards constructing everyday experiences of self-directedness in participants lead through self-acceptance, supporting family relationships and a doctor–patient relationship characterised by partnership. The tentative empirical model of pathways towards patients’ experience of self-directedness can serve as a framework for future research, patient-centred clinical practice, and education.

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Facilitators and Barriers to Social Participation of Community-dwelling Older Adults in Iran: A Qualitative Study

Salmand ◽

10.32598/sija.16.2.3052.1 ◽

2021 ◽

Vol 16 (2) ◽

pp. 172-187

Author(s):

Raziyeh Amini ◽

◽

Farahnaz Mohammadi Shahboulaghi ◽

Kian Norouzi Tabrizi ◽

Amene Setareh Forouzan ◽

...

Keyword(s):

Older Adults ◽

Qualitative Study ◽

Social Participation ◽

The Elderly ◽

Community Dwelling ◽

Active Aging ◽

Theory Approach ◽

Structured Interviews ◽

Facilitators And Barriers ◽

Community Dwelling Older Adults

Objectives: Social participation in older adults is one of the key pillars of active aging. Social participation is influenced by multiple underlying factors. The present study aims to explore the facilitators and barriers to social participation in community-dwelling older adults in Iran. Methods & Materials: This is a qualitative study using the grounded theory approach. The study population consisted of community-dwelling older adults. Fifteen samples were selected using a purposive sampling method. Data were collected through in-depth semi-structured interviews. Information were collected until data saturation. Each interview lasted for 45-60 minutes. Analysis was done using the method of Corbin and Strauss (2015). Results: Three main categories and 11 sub-categories were found based on data analysis which were: Participatory elderly (with 5 sub-categories), participatory family (with 2 sub-categories), and community capacity for social participation (with 4 sub-categories). Conclusion: Facilitating social participation of community-dwelling older adults in Iran is associated by individual, family and community. Proper planning should be done in these areas. Providing facilitators for the development of social participation in the elderly can facilitate movement towards active aging.

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Mind the Gap

Applied Clinical Informatics ◽

10.4338/aci-2016-06-r-0105 ◽

2016 ◽

Vol 07 (04) ◽

pp. 1069-1087 ◽

Cited By ~ 27

Author(s):

Terry Fairbanks ◽

Erica Savage ◽

Katie Adams ◽

Michael Wittie ◽

Edna Boone ◽

...

Keyword(s):

Future Research ◽

Theory Approach ◽

Health It ◽

Structured Interviews ◽

Clinical Workflow ◽

Stakeholder Perspectives ◽

Critical Areas ◽

Key Stakeholders ◽

Emerging Themes ◽

Grounded Theory Approach

SummaryObjective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs.Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment.Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps.Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs.Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.Citation: Ratwani R et al.: Review to identify usability and safety challenges and practices during EHR implementation.

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Temporary stays with housed family and friends among older adults experiencing homelessness: Qualitative findings from the HOPE HOME study

Qualitative Social Work ◽

10.1177/14733250211012745 ◽

2021 ◽

pp. 147332502110127

Author(s):

Kelly R Knight ◽

Jeremy Weiser ◽

Margaret A Handley ◽

Pamela Olsen ◽

John Weeks ◽

...

Keyword(s):

Older Adults ◽

Theory Approach ◽

Friendship Networks ◽

Structured Interviews ◽

Interpersonal Conflicts ◽

Home Study ◽

Interpersonal Barriers ◽

Negative Impacts ◽

Grounded Theory Approach ◽

Policy Solutions

Background The proportion of adults age 50 and older experiencing homelessness is growing. People at risk for homelessness may stay with family and friends during homelessness episodes. Moving in with housed family and friends is a strategy used to exit homelessness. Little is known about these stays with family and friends. This study examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with family or friends. Methods We purposively sampled 46 participants from the HOPE HOME study, a cohort of 350 community-recruited adults experiencing homelessness age ≥50 in Oakland, CA. Inclusion criteria included having stayed with housed family/friends for ≥1 nights in the prior 6 months. We sampled 19 family/friends who had hosted participants experiencing homelessness. We conducted separate, semi-structured interviews, summarized, memoed and coded data consistent using a grounded theory approach. Results Older adults experiencing homelessness reported primarily temporary stays. Motivations for stays on the part of participants included a need for environmental, physical, and emotional respite from homelessness. Both individuals experiencing homelessness and hosts cited the mutual benefits of stays. Barriers to stays included feelings of shame, concerns about burdening the hosts, and interpersonal conflicts between older adults experiencing homelessness and host participants. Conclusions There are potential opportunities and concerns surrounding temporary stays between older adults experiencing homelessness and their family or friends. Policy solutions should support the potential mutual benefits of temporary stays, while addressing interpersonal barriers to strengthen kinship and friendship networks and mediate the negative impacts of homelessness.

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Real cost of flex-offices: discourse and reality

Journal of Corporate Real Estate ◽

10.1108/jcre-02-2020-0006 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Ingrid Nappi ◽

Hajar Eddial

Keyword(s):

Real Estate ◽

Future Research ◽

Theory Approach ◽

Structured Interviews ◽

Content Type ◽

Real Cost ◽

The Press ◽

Real Estate Management ◽

The Cost ◽

Grounded Theory Approach

Purpose This paper aims to draw on the field of real estate management to explore the cost of flex-offices as well as the corporate discourse toward it and to identify the possible gap between real estate directors' discourse and the real cost of flex-offices. Design/methodology/approach This paper follows the grounded theory approach. Three studies were conducted: 16 semi-structured interviews with real estate actors, categorization of internal corporate documents and a thorough content analysis of the press discourse. Findings There is a positive vision as well as a very optimistic outlook on the flex-office on the part of real estate actors and the press. This research shows that reality does not reflect the discourse as 12 hidden costs identified are not currently factored into costs when setting up a flex-office, which can distort the discourse and efficiency. It will be interesting to measure those hidden costs in future research so as to have an objective discourse and a better cost estimate when deploying this kind of workspace. Originality/value Contradict the widespread discourse about flex-offices by highlighting the hidden costs that should be taken into consideration to allow managers to make accurate estimates. Although these hidden costs may seem ancillary at first sight, they might have an impact on efficiency.

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Perceptions and Emotional State of Mothers of Children with and without Microcephaly after the Zika Virus Epidemic in Rural Caribbean Colombia

Behavioral Sciences ◽

10.3390/bs10100147 ◽

2020 ◽

Vol 10 (10) ◽

pp. 147

Author(s):

Kelly Romero-Acosta ◽

Elena Marbán-Castro ◽

Katy Arroyo-Alvis ◽

Germán Arrieta ◽

Salim Mattar

Keyword(s):

Mental Health ◽

Zika Virus ◽

Maternal Mental Health ◽

Mixed Methods Study ◽

Future Research ◽

Theory Approach ◽

Sources Of Information ◽

Structured Interviews ◽

Zikv Infection ◽

Grounded Theory Approach

Zika virus (ZIKV) infection during pregnancy can cause neurological manifestations such as microcephaly. The aim of this study was to explore perceptions of ZIKV and mental health in women exposed to ZIKV during pregnancy in Colombia. This was a mixed-methods study based on structured interviews and psychological tests. Structured interviews were transcribed and analysed with Atlas Ti software. A grounded theory approach was applied. Quantitative analysis was performed with Statistical Package for Social Science, SPSS, V. 20. The study was approved by the Ethics Committee of the Universidad de Córdoba, Montería. Seventeen women participated in the study; nine of them were mothers of children with microcephaly. Maternal age ranged from 16 to 41 years old. The main themes discussed during interviews were: feelings, support, sources of information, and consequences on children’s health. Women with children affected by microcephaly showed worse mental health compared to women with normocephalic children. Maternal mental health worsened after 24 months from giving birth. Perceptions regarding disease severity and lack of knowledge were considered to affect maternal mental health. Social support and spirituality were key determinants for caregivers. Future research is needed to further study coping mechanisms and mental health outcomes over time by affected populations.

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