scholarly journals University of Adelaide Higher Degree by Research Program Supported by an Australian Government Research Training Program Scholarship

2019 ◽  
Vol 34 (s1) ◽  
pp. s27-s27
Author(s):  
Leighton Filmer

Introduction:Collaboration between Foreign Medical Teams (FMT) and Host Health Personnel (HHP) is a core standard for healthcare in a medical response to disaster,1 but descriptions of its application from recipient nation HHP are rare. This paper details the findings from a qualitative study on the experience of collaboration between International Foreign Teams (IMT) and HHP in Gorkha, Nepal since the 2015 earthquake.Aim:To present findings from a study that explored the experience of collaboration by Nepal health workers working with IMT since the 2015 earthquake.Methods:A qualitative study design using semi-structured interviews regarding the experiences and perspectives on collaboration of 12 Nepali health workers was used. The interviews were transcribed, translated, and collated using Nvivo software by QSR international, and themes regarding collaboration were identified.Results:Data collection is not yet complete. However, preliminary results from early analysis indicate that collaborative practice is not uniformly applied by IMT. HHP Satisfaction with IMT appears highly dependent on collaboration. Emerging themes are that rigid organizational procedures, language and cultural barriers, and intimidating leadership inhibit collaboration. Objectives were assumed to align immediately post-disaster, with evidence of objectives increasingly diverging over time. IMT leadership that was experienced, responsive to suggestions, and regularly involved HHP in planning, implementing, and reviewing activities were highly appreciated.Discussion:Emerging themes indicate the time-critical nature of many disasters, along with cultural/institutional/administrative barriers, make the building of collaborative relationships difficult despite being foundational for successful missions. Participants in IMT must proactively involve HHP in the objectives setting, planning, implementation, and reviewing of activities. Successful IMT participation is not only clinically competent but actively seeks collaborative relationships with HHP throughout the mission.

2020 ◽  
Author(s):  
zahra boroumandfar ◽  
masoud kianpour ◽  
maryam afshari

Abstract Background: According to recent studies, the number of women drug users is dramatically increasing. However, the information on the issue of drug rehab in women is not sufficient, and there are numerous traditional, organizational, political and cultural barriers to the provision of relevant information in this regard in Iran. This study, thus, aimed to explain the factors influencing the decision of these women to stop drug use. Methods: This qualitative study was conducted in two rehab camps of Isfahan (in Iran) on July to October 2017. Thirty participants (women drug users) were selected through purposive and theoretical sampling until data saturation was reached. Data collection was conducted through semi-structured interviews. The transcribed interviews were analyzed using conventional content analysis. Results: Based on the analysis of the obtained results, the women's experience of the ups and downs of stopping drug use yielded two themes and nine sub-themes. The themes were “the need for emancipation (the deviated path, being abused, compulsive drug use, acquaintance with God, a supportive family)” and “Sinking factors (non-assisting mates, pro-addictive family, unawareness of assisting official organization and non-government organization, woman’s lack of authority, ineffective opportunities)”. Conclusions: It was concluded that addiction rehab strategies can lead to a brighter life for women drug users only when they are coupled with open-hearted assistance of the families and women specific rehab centers are established to help them meet their specific needs. Keywords: Drug Use, Lived Experience, Substance-related disorders, Women's Health, qualitative study


Author(s):  
Gertrude S. Avortri ◽  
Lebitsi M. Modiba

Background: Many policy makers at country level in both medium and low to middle-income countries still have great difficulty deciding which quality intervention would have the greatest impact on the health outcomes delivered by their health systems. Aim: To investigate women’s perceptions about the factors that hinders or facilitates the provision of quality childbirth services in Ghana’s health care services to guide improvement efforts. Setting: The study was conducted in the greater Accra region of Ghana in two primary level hospitals (district hospitals). Methods: A qualitative study design, which is exploratory, descriptive and contextual in nature, was used. Semi-structured interviews were used to examine the perspectives of 15 women on the factors that influence the quality of childbirth services and how services could be improved in Ghana. Data were analysed through data reduction, data display and generation of themes. Results: The findings in this study revealed two major themes, firstly, barriers to quality childbirth with five subthemes: high workload, shortage of health workers, non-availability of some services, as well as poor coordination, unacceptable staff behaviour and lack of cooperation from some clients, were identified by the participants as the major causes of poor quality. Secondly, ways to improve care reported, were encouraging health workers to be patient with clients, promoting open communication, friendliness and attentiveness. The need to reorganise service provision to make it more client centred, was also highlighted. Conclusion: The study findings highlight the importance of paying attention to factors such as service organisation and coordination, high workload, inadequate number of staff, as well as limitations in infrastructure and logistics for quality services delivery. Equally important are institutionalisation of systems to continuously assess and improve staff competence and attitudes and the creation of an environment that can foster good interpersonal relationship between health care providers and patients.


Author(s):  
Johannes Nordsteien Svensøy ◽  
Helene Nilsson ◽  
Rune Rimstad

Abstract Introduction and Objective: Scientific reporting on major incidents, mass-casualty incidents (MCIs), and disasters is challenging and made difficult by the nature of the medical response. Many obstacles might explain why there are few and primarily non-heterogenous published articles available. This study examines the process of scientific reporting through first-hand experiences from authors of published reports. It aims to identify learning points and challenges that are important to address to mitigate and improve scientific reporting after major incidents. Methods: This was a qualitative study design using semi-structured interviews. Participants were selected based on a comprehensive literature search. Ten researchers, who had published reports on major incidents, MCIs, or disasters from 2013-2018 were included, of both genders, from eight countries on three continents. The researchers reported on large fires, terrorist attacks, shootings, complex road accidents, transportation accidents, and earthquakes. Results: The interview was themed around initiation, workload, data collection, guidelines/templates, and motivation factors for reporting. The most challenging aspects of the reporting process proved to be a lack of dedicated time, difficulties concerning data collection, and structuring the report. Most researchers had no prior experience in reporting on major incidents. Guidelines and templates were often chosen based on how easily accessible and user-friendly they were. Conclusion and Relevance: There are few articles presenting first-hand experience from the process of scientific reporting on major incidents, MCIs, and disasters. This study presents motivation factors, challenges during reporting, and factors that affected the researchers’ choice of reporting tools such as guidelines and templates. This study shows that the structural tools available for gathering data and writing scientific reports need to be more widely promoted to improve systematic reporting in Emergency and Disaster Medicine. Through gathering, comparing, and analyzing data, knowledge can be acquired to strengthen and improve responses to future major incidents. This study indicates that transparency and willingness to share information are requisite for forming a successful scientific report.


2020 ◽  
Vol 5 (6) ◽  
pp. e002220
Author(s):  
Stephanie M Topp ◽  
Nicole B Carbone ◽  
Jennifer Tseka ◽  
Linda Kamtsendero ◽  
Godfrey Banda ◽  
...  

BackgroundIn the era of Option B+ and ‘treat all’ policies for HIV, challenges to retention in care are well documented. In Malawi, several large community-facility linkage (CFL) models have emerged to address these challenges, training lay health workers (LHW) to support the national prevention of mother-to-child transmission (PMTCT) programme. This qualitative study sought to examine how PMTCT LHW deployed by Malawi’s three most prevalent CFL models respond to known barriers to access and retention to antiretroviral therapy (ART) and PMTCT.MethodsWe conducted a qualitative study, including 43 semi-structured interviews with PMTCT clients; 30 focus group discussions with Ministry of Health (MOH)-employed lay and professional providers and PMTCT LHWs; a facility CFL survey and 2–4 hours of onsite observation at each of 8 sites and in-depth interviews with 13 programme coordinators and MOH officials. Thematic analysis was used, combining inductive and deductive approaches.ResultsAcross all three models, PMTCT LHWs carried out a number of ‘targeted’ activities that respond directly to a range of known barriers to ART uptake and retention. These include: (i) fulfilling counselling and educational functions that responded to women’s fears and uncertainties; (ii) enhancing women’s social connectedness and participation in their own care and (iii) strengthening service function by helping clinic-based providers carry out duties more efficiently and effectively. Beyond absorbing workload or improving efficiency, however, PMTCT LHWs supported uptake and retention through foundational but often intangible work to strengthen CFL, including via efforts to strengthen facility-side responsiveness, and build community members’ recognition of and trust in services.ConclusionPMTCT LHWs in each of the CFL models examined, addressed social, cultural and health system factors influencing client access to, and engagement with, HIV care and treatment. Findings underscore the importance of person-centred design in the ‘treat-all’ era and the contribution LHWs can make to this, but foreground the challenges of achieving person-centredness in the context of an under-resourced health system. Further work to understand the governance and sustainability of these project-funded CFL models and LHW cadres is now urgently required.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dishant Gupta ◽  
Harsh Sharma ◽  
Manali Gupta

PurposeEsports has been emerging as a multi-billion dollar industry by attracting players, viewers, advertisers and investors across the globe. Even though there are plenty of professional titles present, only a few have been considered mainstream due to lack of formal governance mechanisms, presence of corruption and cheating mechanisms. “Doping” is one such practice where the players try to gain unfair advantage over their competitors, causing major hindrance in esports development. This qualitative study would draw insights from their perceptions about different doping mechanisms and possible recommendations to curb them.Design/methodology/approachThis study has analyzed the semi-structured interviews of selected esports professionals to draw insights from their perceptions about different doping mechanisms and possible recommendations to curb them. This qualitative study would explore the content of their interviews for extracting relevant themes and subthemes.FindingsThe findings of this study have made significant contributions to deeply lacking literature about the esports industry and barriers it faces in order to be considered as a legitimate sport. The study has extracted contemporary and new emerging themes about the rising trends in the industry and their impact on society and the way we see sports as a whole. Moreover, this study dwells upon the rampant drug abuse persisting in this industry and how it offers itself as a barrier to the legitimization of esports as a viable global industry.Originality/valueThis study provides an on-ground reality reports on esports and various malpractices rampant in the industry by conducting interviews with various industry professionals and analyzing them through a thematic analysis method using an inductive approach.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e054145
Author(s):  
Dell D Saulnier ◽  
Dawin Thol ◽  
Ir Por ◽  
Claudia Hanson ◽  
Johan von Schreeb ◽  
...  

ObjectiveHealth system resilience can increase a system’s ability to deal with shocks like floods. Studying health systems that currently exhibit the capacity for resilience when shocked could enhance our understanding about what generates and influences resilience. This study aimed to generate empirical knowledge on health system resilience by exploring how public antenatal and childbirth health services in Cambodia have absorbed, adapted or transformed in response to seasonal and occasional floods.DesignA qualitative study using semi-structured interviews and thematic analysis and informed by the Dimensions of Resilience Governance framework.SettingPublic sector healthcare facilities and health departments in two districts exposed to flooding.ParticipantsTwenty-three public sector health professionals with experience providing or managing antenatal and birth services during recent flooding.ResultsThe theme ‘Collaboration across the system creates adaptability in the response’ reflects how collaboration and social relationships among providers, staff and the community have delineated boundaries for actions and decisions for services during floods. Floods were perceived as having a modest impact on health services. Knowing the boundaries on decision-making and having preparation and response plans let staff prepare and respond in a flexible yet stable way. The theme was derived from ideas of (1) seasonal floods as a minor strain on the system compared with persistent, system-wide organisational stresses the system already experiences, (2) the ability of the health services to adjust and adapt flood plans, (3) a shared purpose and working process during floods, (4) engagement at the local level to fulfil a professional duty to the community, and (5) creating relationships between health system levels and the community to enable flood response.ConclusionThe capacity to absorb and adapt to floods was seen among the public sector services. Strategies that enhance stability and flexibility may foster the capacity for health system resilience.


2020 ◽  
Author(s):  
David Schmidt ◽  
Jill Reyment ◽  
Emma Webster ◽  
Sue Kirby ◽  
David Lyle

Abstract Background: The calls for increased numbers of researchers in rural health are growing. To meet this demand training is needed. If training is to be effective the value placed on research, organizational need for research training and key targets for research skill development within a rural health organisation must be understood. Methods: This qualitative study was underpinned by a critical realist perspective which allowed exploration of the organisational, cultural and structural contexts of research training, and the ability of individuals to act within these contexts. Individual interviews with purposively selected key informants from the organisation’s board, executive and facility management (n=7) and two focus groups with a convenience sample of frontline health workers with interests in research (total n=11) were held. Data were analysed using NVivo software and thematic analysis. Results: The themes emerging from this study were1. Fragmentation of research activity2. A need for supportive structures3. Collaboration for expertiseConclusions: This study has identified an overreliance on individual activity leading to a fragmented approach to research. There is a need for supportive structures, coordination and workplace leadership to overcome a longstanding culture that views research as out of the rural scope of practice. Identifying research training targets, partnering for educational expertise and planning for long-term sustainability are necessary steps toward increasing research activity in the longer term.


2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 122-122 ◽  
Author(s):  
Jennifer Tjia ◽  
Julia Gallagher ◽  
Paul Han ◽  
Sarah L Cutrona ◽  
Kathleen Mazor

122 Background: Polypharmacy is common, burdensome, and potentially harmful in older adults with advanced cancer. According to the IOM, prescribing and coordination of chronic disease medication for these patients is suboptimal. We conducted a qualitative study with patients, caregivers, nurses, and physicians to better understand these issues. Methods: We used semi-structured interviews to explore participants’ views on medication management, care coordination, and communication for advanced cancer patients enrolled in 3 hospice agencies in New England. Eligible hospice patients were aged ≥ 65 yrs, had a diagnosis of cancer, and prescribed ≥5 medications. Family caregivers participated at the patient’s discretion. We also interviewed nurses and physicians to obtain an interdisciplinary perspective on medication coordination and communication. We used content analysis to identify emerging themes. Eighteen (18) patients (mean age 80 yrs [SD 10], 42% female) and 8 caregivers (mean age 63 yrs [SD 16.6], 88% female) were included, along with 10 nurses and 7 physicians from hospice, outpatient oncology and primary care settings. Results: Emerging themes revealed that patients and families were receptive to comprehensive medication reviews upon transition to hospice that assess the ongoing use of longstanding medications for comorbid illness. Effective framing for discussions included a focus on reducing harmful and non-essential medications; a less effective approach emphasized time to benefit (i.e. whether a medication is indicated for active symptom management vs prevention). Hospice nurses reported physician reluctance to discontinue medications, lack of physician confidence in their medication assessments, and lack of prescribing guidelines as barriers to optimizing prescribing. Conclusions: Patients enrolled in hospice for cancer and their families are willing to reassess the ongoing use of chronic medications for comorbid illness; information about medication harms and their impact on quality of life is considered particularly useful. Barriers to optimal prescribing include physician reluctance to discontinue medications and mistrust between providers.


Sains Insani ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. 15-21
Author(s):  
Zulkefli Aini ◽  
Abdul Ghafar Don ◽  
Ahmad Irdha Mokhtar ◽  
Nur Uswah Ahmad Fauzi

One of the factors that can affect a person's behavior is a communication message. In the context of the da`wah, preachers who involved actively in da`wah communication with the Orang Asli should be able to ensure that the message conveyed can be understood by the target group. In addition, the selection of the correct messages of da`wah based on the foremost priority simplify the process of sharing information between the preachers and the Orang Asli. Accordingly, this article aims to identify specific topics of Islamic faith (akidah) submitted by the Orang Asli in the process of da`wah communication and to identify verbal feedback given by the preachers to the Orang Asli of the topics. This qualitative study using case study design and data was collected through semi-structured interviews. Interviews involving nine preachers were active in da`wah activity to the Orang Asli community in Selangor. Data were analyzed thematically according to the specified objectives. The study found that the topics frequently raised by the Orang Asli is concerned about belief in Allah, belief in Malaikat, and belief in Qada' and Qadar. The topics may be found within the framework of worldview in their beliefs and practice of ancient traditions. Therefore, the preachers gave verbal feedback on these topics is based on a clear and precise sample corresponding to the level of their thinking. The emphasis on these topics is very important to strengthen and purify the faith of the community.Keywords: Communication; Message; Preacher; Indigenous community Abstrak: Elemen mesej dalam komunikasi merupakan salah satu faktor yang dapat memberi kesan terhadap perubahan tingkah laku seseorang. Dalam konteks dakwah, pendakwah yang terlibat dalam proses komunikasi dakwah dengan Orang Asli seharusnya berkebolehan memastikan kandungan mesej yang disampaikan boleh difahami oleh sasaran dakwahnya. Di samping itu, pemilihan mesej dakwah yang betul mengikut keutamaan memudahkan proses perkongsian maklumat antara pendakwah dengan Orang Asli. Sehubungan dengan itu, artikel ini bertujuan untuk mengenalpasti topik-topik tertentu dalam mesej akidah yang dikemukakan oleh masyarakat Orang Asli kepada pendakwah dan mengenalpasti maklum balas lisan yang diberikan oleh pendakwah kepada Orang Asli terhadap topik tersebut. Kajian kualitatif ini menggunakan reka bentuk kajian kes dengan pengumpulan data melalui temu bual separa struktur. Temu bual melibatkan sembilan orang pendakwah yang aktif dalam aktiviti dakwah masyarakat Orang Asli di Selangor. Data kajian dianalisis secara tematik mengikut objektif yang ditentukan. Kajian ini mendapati bahawa topik-topik yang sering dikemukan oleh Orang Asli kepada pendakwah dalam penyampaian mesej akidah ialah berkenaan tentang keimanan kepada Allah SWT, keimanan kepada malaikat, dan keimanan kepada qada’ dan qadar. Topik-topik berkenaan didapati berada dalam kerangka worldview kepercayaan dan amalan tradisi mereka. Sehubungan dengan itu, pendakwah memberikan maklum balas lisan terhadap topik-topik tersebut adalah berdasarkan keterangan yang jelas dan contoh yang tepat bersesuaian dengan tahap pemikiran mereka. Penekanan terhadap topik-topik tersebut merupakan perkara yang penting dalam rangka mengukuhkan dan memurnikan akidah masyarakat Orang Asli.Kata kunci: Komunikasi; Mesej; Pendakwah; Komuniti Orang Asli


2020 ◽  
pp. 17-26
Author(s):  
Arista Apriani ◽  
M Mufdlilah ◽  
Menik Sri Daryanti

ABSTRAK GDM dapat berpotensi menimbulkan komplikasi serius yang dapat mengakibatkan risiko kesehatan jangka pendek dan jangka panjang bagi ibu dan bayinya. diagnosis GDM menimbulkan efek emosional yang negatif. Persepsi ibu hamil tentang GDM dapat memengaruhi perubahan gaya hidup. Garis pertama penatalaksanaan DMG yaitu dengan perubahan gaya hidup. Tujuan menggali secara mendalam kebutuhan ibu dengan diagnosis diabetes melitus gestasional. Metode penelitian kualitatif dengan pendekatan  fenomenologi. Lokasi di Kabupaten Karanganyar yaitu Puskesmas Jaten I, Puskesmas Matesih dan RSUD Kabupaten Karanganyar, pada bulan Oktober 2019 - Januari 2020. Sampel secara criterion sampling Pengumpulan data dengan semistructure interview dengan one on one interview. Uji Keabsahan Data dengan Credibility pada penelitian ini menggunakan strategi validitas triangulasi, Tranferability, Dependability, Confirmability. Analisis data dengan Interpretative Phenomenological Analysis (IPA). Hasil penelitian kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga dalam hal mengontrol pola makan, mengatarkan periksa ke tenaga kesehatan, dan mengingatkan untuk aktifitas olah raga. Dukungan sosial, yaitu cara mengontrol gula darah. Dukungan tenaga kesehatan, yaitu saran dan motivasi untuk mengontrol gula darah. Informasi mendapat saran atau perawatan DMG dalam kehamilan adalah dari tenaga kesehatan yaitu bidan, dokter, serta selain tenaga kesehatan dari teman dan internet. Kesimpulannya kebutuhan ibu hamil dengan DMG teridentifikasi empat tema, yaitu dukungan keluarga, dukungan sosial, dukungan tenaga kesehatan dan informasi.   Kata kunci: diabetes melitus gestasional, kehamilan, kebutuhan.   ABSTRACT GDM can overcome serious problems that can overcome short-term and long-term health problems for mother and baby. a diagnosis of GDM has a negative emotional effect. Pregnant women 's perception of GDM can affect lifestyle changes. The first line of management of DMG is lifestyle changes. Diagnosis of gestational diabetes mellitus. Qualitative research methods by studying phenomenology. Locations in Karanganyar Regency are Jaten I Health Center, Matesih Health Center and Karanganyar District Public Hospital, in October 2019 - January 2020. Sample sampling criteria Data collection by semi-structured interviews with one-on-one interviews. Data Validity Test with Credibility in this study using the triangulation validity strategy, Transparency, Dependability, Confirmability. Data analysis with Interpretative Phenomenological Analysis (IPA). The results of the study of the needs of pregnant women with DMG identified four themes, namely supporting the family in terms of controlling diet, sending check to health workers, and reminding for sports activities. Social support, which is a way to control blood sugar. Support of Health Workers, namely advice and motivation to control blood sugar. The information obtained from DMG advice or treatment in the assessment is from health workers, namely midwives, doctors, and also health workers from friends and the internet. In conclusion, the needs of pregnant women with DMG identified four themes, namely family support, social support, support of health workers and information.  


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