scholarly journals Knowing me, knowing you: a qualitative study of the effects on patients of doctors’ self-illness disclosures

2019 ◽  
Vol 11 (4) ◽  
pp. 327
Author(s):  
Laura Bolger ◽  
Katherine Helen Hall ◽  
Martyn Williamson
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
General Practitioners ◽  
Current Literature ◽  
Thematic Analysis ◽  
Patient Relationship ◽  
Structured Interviews ◽  
Depth Analysis ◽  
Potential Benefits ◽  
Emotional Dimensions

ABSTRACT INTRODUCTIONVery little is known how patients react to learning about their own doctors’ illnesses. Doctors can be uncertain if and when such disclosures can be helpful, and in what way, to patients. This paper attempts to bridge this gap by providing an in-depth analysis of one group of patients’ experiences with this type of disclosure. AIMTo understand from patients’ perspectives, the effects on them of doctors disclosing their own illnesses, to provide guidance concerning the uses of this disclosure for general practitioners. METHODSThis qualitative study was an exploration of 13 patients’ reactions to receiving such information, using semi-structured interviews and thematic analysis. RESULTSThe major themes were the emotional dimensions of illness and patienthood, the doctor–patient relationship and patients’ concerns about disclosures. Disclosures can have profound effects on patients with both negative and positive consequences. CONCLUSIONWe present suggestions about how to use such disclosures in primary care to minimise potential harms and emphasise potential benefits, based on these patients’ perspectives and the current literature.

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 Primary care doctors’ understandings of and strategies to tackle health inequalities: a qualitative study

2019 ◽  
Vol 20 ◽  
Author(s):  
Mark Exworthy ◽  
Victoria Morcillo
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
General Practitioners ◽  
Health Inequalities ◽  
Full Potential ◽  
Comparison Process ◽  
Structured Interviews ◽  
Policy And Practice ◽  
The Social ◽  
Primary Care Doctors

AbstractAimTo examine general practitioners’ knowledge of and their role in tackling health inequalities, in relation to their professional responsibilities.BackgroundPrimary care is often seen as being in the frontline of addressing health inequalities and the social determinants of health (SDH).MethodsA qualitative study with a maximum variety sample of English General Practitioners (GPs). In-depth, semi-structured interviews were held with 13 GPs in various geographical settings; they lasted between 30 and 70 min. Interviews were audio-recorded and transcribed. The analysis involved a constant comparison process undertaken by both authors to reveal key themes.FindingsGPs’ understanding of health inequalities reflected numerous perspectives on the SDH and they employ various different strategies in tackling them. This study revealed that GPs’ strategies were changing the nature of (medical) professionalism in primary care. We locate these findings in relation to Gruen’s model of professional responsibility (comprising a distinction between obligation and aspiration, and between patient advocacy, community participation and political involvement). We conclude that these GPs do not exploit the full potential of their contribution to tackling health inequalities. These findings have implication for policy and practice in other practitioners and in other health systems, as they seek to tackle health inequalities.

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.

scholarly journals Experiences of New Zealand Haemodialysis Patients in Relation to Food and Nutrition Management: A Qualitative Study

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2299
Author(s):  
Rachael M. McLean ◽  
Zhengxiu Xie ◽  
Vicky Nelson ◽  
Vili Nosa ◽  
Hla Thein ◽  
...  
Keyword(s):  
New Zealand ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Extended Family ◽  
Culturally Appropriate ◽  
Structured Interviews ◽  
Nutrition Management ◽  
Healthcare Needs ◽  
Food And Nutrition ◽  
Major Disruption

People receiving haemodialysis have considerable and complex dietary and healthcare needs, including co-morbidities. A recent New Zealand study has shown that few patients on haemodialysis are able to meet nutritional requirements for haemodialysis. This study aims to describe the perspectives and experiences of dietary management among patients on haemodialysis in New Zealand. This exploratory qualitative study used in-depth semi-structured interviews. Purposive sampling was used to recruit participants from different ethnic groups. Forty interviews were conducted, audio-recorded and transcribed verbatim. An inductive approach was taken using thematic analysis. Forty participants were interviewed. Participants spoke of major disruption to their lives as a result of their chronic kidney disease and being on haemodialysis, including loss of employment, financial challenges, loss of independence, social isolation and increased reliance on extended family. Most had received adequate dietary information, although some felt that more culturally appropriate support would have enabled a healthier diet. These findings show that further support to make the recommended dietary changes while on haemodialysis should focus on socio-cultural factors, in addition to the information already provided.

Healthcare and Terrorism: The Lebanese Experience

2021 ◽  
pp. 1-4
Author(s):  
Nooreddine Iskandar ◽  
Tatiana Rahbany ◽  
Ali Shokor
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Terrorist Attacks ◽  
Analysis Method ◽  
Structured Interviews ◽  
Security Issues ◽  
The Face ◽  
The Common ◽  
First Time

Abstract Background: Due to the common instability caused by political and security issues, Lebanese hospitals have experienced acts of terrorism multiple times. The most recent Beirut Explosion even forced several hospitals to cease operations for the first time in decades—but studies show the preparedness levels for such attacks in similar countries are low. Objective: The aim of this study is to explore the experience of Lebanese hospitals with terrorist attacks. Methods: This qualitative study used semi-structured interviews with various stakeholders to assess their experience with terrorist bombings. Data was analyzed using the thematic analysis method. Results: The researchers found that Lebanese hospitals vary greatly in their structures and procedures. Those differences are a function of 3 contextual factors: location, culture, and accreditation status. Hospitals found near ‘dangerous zones’ were more likely to be aware and to have better response to such events. A severe lack of communication, unity of command, and collaboration between stakeholders has made the process fragmented. Conclusion: The researchers recommend a larger role for the Ministry of Public Health (MOPH) in this process, and the creation of a platform where Lebanese organizations can share their experiences to improve preparedness and resilience of the Lebanese healthcare system in the face of terrorism.

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.

scholarly journals Primary care-led survivorship care for patients with colon cancer and the use of eHealth: a qualitative study on perspectives of general practitioners

BMJ Open ◽  
2016 ◽  
Vol 6 (4) ◽  
pp. e010777 ◽  
Author(s):  
Laura A M Duineveld ◽  
Thijs Wieldraaijer ◽  
Jan Wind ◽  
Irma M Verdonck-de Leeuw ◽  
Henk C P M van Weert ◽  
...  
Keyword(s):  
Primary Care ◽  
Colon Cancer ◽  
Qualitative Study ◽  
General Practitioners ◽  
Survivorship Care

scholarly journals An exploration of the attitudes and views of general practitioners on the use of video consultations in a primary healthcare setting: a qualitative pilot study

2018 ◽  
Vol 20 ◽  
Author(s):  
Ratan S. Randhawa ◽  
Joht S. Chandan ◽  
Tom Thomas ◽  
Surinder Singh
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Healthcare Setting ◽  
List Type ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Telephone Consultation ◽  
Video Consultation ◽  
Mixed Feelings ◽  
The Government

AbstractBackgroundIn 2014, in the United Kingdom, the government made a commitment to spend £3.6 million on the introduction of Skype video calling consultations in general practice, however the efficacy of such technology has not yet been explored fully.AimThe study aimed to explore the views and attitudes of General Practitioners (GPs) towards video consultation in primary care; specifically, in three broad areas∙The benefits of video consultations to patients and healthcare professionals.∙Potential problems with video consultation and its implementation.∙The cost-effectiveness of video consultation in this setting.MethodA convenience sample of the views of 12 general practitioners across two primary care centres in North London were identified using topic guide based semi-structured interviews. A thematic framework approach was used to analyse the data collected to isolate main and sub-themes.FindingsThree main themes were identified1.Technology – GPs expressed concerns about the ability of patients to use technology, the availability of technology and the quality of technology available.2.Utility – encompassing GP’s ideas about the usefulness of video consultations to patients, practitioners and the doctor–patient relationship. GPs presented mixed views on the extent to which video consultation would be useful.3.Practicality – covering the views of GPs on implementation and effects on workload. GPs unanimously felt that it was not a practical substitute for face-to-face consultation. There were mixed feelings about it being used as an alternative to telephone consultation.ConclusionGPs did see potential benefits to using video consultations but also expressed concerns that need to be addressed if they are to have full confidence in the system. The views of those who are going to use video consultation as a means of increasing patient access are paramount if such tools are to be a core part of primary care.

scholarly journals Social Nurses’ Descriptions of Nursing: A Qualitative Study of What Social Nursing is and Does?

2019 ◽  
Vol 13 (1) ◽  
pp. 228-236
Author(s):  
Tine Louise Dideriksen ◽  
Marianne Lisby ◽  
Nina Brünés ◽  
Pia Dreyer
Keyword(s):  
Qualitative Study ◽  
Health Inequalities ◽  
Common Goal ◽  
Structured Interviews ◽  
Holistic Nursing ◽  
Encounter Complex ◽  
The Social ◽  
Potential Benefits ◽  
Female Nurses ◽  
Insight Into

Background: In the meeting between socially marginalised patients and somatic hospitals, healthcare systems often encounter complex challenges related to health inequalities that are difficult to resolve. To help reduce these challenges, a nursing approach employing a nurse (RN) with in-depth knowledge of socially marginalised patients and competences in rehabilitation (“social nurse”) has contributed to diminish health inequalities. However, further insight into the potential benefits of social nursing is required. Aim: To examine how social nurses describe and experience the social nursing approach situated at somatic hospitals. Methods: A qualitative study of social nurses’ descriptions and experiences with a social nurse approach included eight Danish hospitals. One male and 12 female nurses (n=13) employed as social nurses at somatic hospitals participated. Thirteen semi structured interviews were conducted using the methodological frameworks of phenomenology and hermeneutics. The interviews were analysed employing a method inspired by the French philosopher Paul Ricoeur’s theory of interpretation. Results: Four themes emerged from the analysis: 1) A unique expertise encompassing experience and evidence-based knowledge 2) coordination towards a common goal to reduce patients’ vulnerability, 3) to see and understand patients as whole persons, thereby assuring successful treatment and 4) working with the system to avoid losing the patients. The themes describe a unique expertise emerging from focusing healthcare efforts on the socially marginalised patients and the system in charge. Conclusion: The study indicated that the social nurse approach is a holistic nursing approach. Applying this approach allows for optimised treatment that fosters a more equal outcome across the spectrum of socially marginalised patients. The social nurse approach may contribute to diminishing health inequalities.

An Encounter with the Other: A Thematic Analysis of Accounts of DMT Experiences from a Naturalistic Field Study

2021 ◽  
Author(s):  
Pascal Michael ◽  
David Luke ◽  
Oliver Robinson
Keyword(s):  
Field Study ◽  
Thematic Analysis ◽  
Conscious Experience ◽  
The Other ◽  
Structured Interviews ◽  
Depth Analysis ◽  
Death Experience ◽  
Extraordinary Experiences ◽  
Alien Abduction ◽  
Increasing Trends

Introduction: N, N-Dimethyltryptamine (DMT) is an endogenous serotonergic psychedelic capable of producing radical shifts in conscious experience. Increasing trends in its use, as well as new trials administering DMT to patients, indicate the growing importance of a thorough elucidation of the phenomenology the drug may occasion. This is particularly in light of the hyper-real, otherworldly, and often ontologically challenging yet potentially transformative, nature of the experience, not least encounters with apparently non-self social agents. Laboratory studies have been limited by clinical setting and lacking qualitative analyses, while online surveys’ limitations lie in retrospective design, recreational use, and both of which not guaranteeing ‘breakthrough’ experiences. Methods: We report on the first naturalistic field study of DMT use including its qualitative analysis. Screened, healthy, anonymised and experienced DMT users (40-75mg inhaled) were observed during their non-clinical use of the drug at home. Semi-structured interviews using the micro-phenomenological technique were employed immediately after their experience. This paper reports on the thematic analysis of one major domain of the breakthrough experiences elicited; the ‘other’. Thirty-six post-DMT experience interviews with mostly Caucasian (83%) males (8 female) of average 37 years were predominantly inductively coded. Results: Invariably, profound and highly intense experiences occurred. The main overarching category comprised the encounter with other ‘beings’ (94% of reports), with further subordinate themes including the entities’ role, appearance, demeanour, communication and interaction; while the other over-arching category comprised experiences of emerging into other ‘worlds’ (100% of reports), in turn consisting of the scene, the content and quality of the immersive spaces. Discussion: The present study provides a systematic and in-depth analysis of the features of the otherworldly encounter within the breakthrough DMT experience, as well as elaborating on the resonances with both previous DMT studies and other types of extraordinary experiences which also entail entity encounters. These include the alien abduction, folkloric, shamanic and near-death experience. Putative neural mechanisms of these features of the DMT experience and its promise as a psychotherapeutic agent are discussed in light of such findings.

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