scholarly journals Narrative evaluation in patient feedback

2021 ◽  
Author(s):  
Gavin Brookes ◽  
Tony McEnery ◽  
Mark McGlashan ◽  
Gillian Smith ◽  
Mark Wilkinson
Keyword(s):  
Social Practice ◽  
Social Dynamics ◽  
Healthcare Services ◽  
Structural Elements ◽  
Corpus Linguistic ◽  
Patient Feedback ◽  
Online Comments ◽  
Technological Affordances ◽  
Narrative Evaluation

Abstract This study examines how patients use narratives to evaluate their experiences of healthcare services online. The analysis draws on corpus linguistic techniques, specifically annotation, applying Labov and Waletzky’s (1967) framework to a sample of online comments about the NHS in England. Narratives are pervasive in this context, being present more than absent in the patients’ comments, but are particularly prominent in comments which evaluate care negatively. Evaluations can be accomplished through all the structural elements of the narrative, including in combination with one another. However, the presence and ordering of these elements does not seem to be influenced by the type of evaluation given (i.e. positive, negative or more neutral). As mediated social practice, the narratives are shaped by the technological affordances and social dynamics of this context, for instance in the placement of particular structural elements and the design of narratives for particular “imagined” audiences.

Reconsidering Taíno Social Dynamics after Spanish Conquest: Gender and Class in Culture Contact Studies

2004 ◽  
Vol 69 (4) ◽  
pp. 597-626 ◽  
Author(s):  
Kathleen Deagan
Keyword(s):  
Native Americans ◽  
Social Practice ◽  
Social Dynamics ◽  
Analytical Framework ◽  
Cultural Practice ◽  
Culture Contact ◽  
Contact Period ◽  
Cultural Elements ◽  
Mitigating Factors ◽  
Before And After

Despite the fact that the Taíno people of the Caribbean were the first Native Americans to encounter and coexist with Europeans after 1492, there has been almost no archaeology of Taíno response to that encounter. This study explores the reasons for (and consequences of) this neglect, and their larger implications for American contact-period archaeology. It also challenges prevailing historical models of Taíno social disintegration, drawing upon six years of archaeological work at the En Bas Saline site in Haiti, the only extensively excavated Taíno townsite occupied both before and after contact. Our results, organized by a household-scale analytical framework emphasizing Taíno constructions of gender and class, suggest that there were few major alterations to traditional Taíno social practice during the post-contact period, and most of these were related to activities thought to have been the domain of non-elite Taíno men. It is suggested that the relatively nonspecialized gender roles among the Taíno, as well as the clearly differentiated nature of their social classes, may have served as mitigating factors in the disruption of Taíno cultural practice under Spanish domination. This work also reveals a marked Taíno resistance to the incorporation of European cultural elements, which provides a striking contrast to the Spanish patterns documented in contact-era European towns, and underscores the critical importance of incorporating gender relations into studies of culture contact.

scholarly journals A qualitative focus group study concerning perceptions and experiences of Nigerian mothers on stillbirths

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. Milton ◽  
F. I. Alkali ◽  
F. Modibbo ◽  
J. Sanders ◽  
A. S. Mukaddas ◽  
...  
Keyword(s):  
Focus Group ◽  
Social Dynamics ◽  
Healthcare Facility ◽  
Healthcare Services ◽  
Northern Nigeria ◽  
Health Seeking ◽  
Focus Group Study ◽  
Major Barrier ◽  
Societal Factors ◽  
Tertiary Healthcare

Abstract Objective To explore the experiences and perceptions of stillbirth among mothers from a tertiary medical centre in Kano, Northern Nigeria. Design Qualitative, interpretative. Setting Tertiary healthcare facility, Murtala Muhammad Specialist Hospital (MMSH), Kano, Northern Nigeria. Sample Mothers who had given birth to a liveborn baby at the MMSH in the prior 6 months (n = 31). In order to capture the experiences and perception of stillbirth within this cohort we approached mothers who had in a previous pregnancy experienced a stillbirth. Of the 31 who attended 16 had a previous stillbirth. Methods Semi-structured Focus Group Discussions, consisting of open-ended questions about stillbirth, beliefs, experiences and influences were held in MMSH, conducted over 1 day. Results Our findings highlight that this is a resource-poor tertiary facility serving an ever-growing population, increasing strain on the hospital and healthcare workers. Many of the participants highlighted needing permission from certain family members before accessing healthcare or medical treatment. We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority. Judgement and blame was a common theme, yet a complex area entwined with traditions, superstitions and the pressure to procreate with many mothers described being made to feel useless and worthless if they did not birth a live baby. Conclusions As access to healthcare becomes easier, there are certain traditions, family and social dynamics and beliefs which conflict with scientific knowledge and act as a major barrier to uptake of healthcare services. The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour. Stillbirths are occurring in this area of the world unnecessarily, globally there has been extensive research conducted on stillbirth prevention. This research has highlighted some of the areas which can be tackled by modifying existing successful interventions to work towards reducing preventable stillbirths.

Structuralism and poststructuralism

2017 ◽  
Author(s):  
Anastasia Marinopoulou
Keyword(s):  
Social Practice ◽  
Gilles Deleuze ◽  
A Priori ◽  
Scientific Work ◽  
Theory And Practice ◽  
Structural Elements ◽  
Parallel Lines ◽  
Phenomenological Perspective ◽  
Epistemological Understanding

This chapter focuses mostly on the epistemological thought of Pierre Bourdieu and Gilles Deleuze in terms of their persistence in constructing an epistemological understanding of social practice that is free from the burdens of dialectics, reason and rationality.The main bone of contention for structuralism, and soon afterwards, if not concurrently, for poststructuralism, remains the understanding of theory as the bearer of practice or the prioritization of practice instead of theory.In this chapter, I argue that no matter how hard the structuralists and poststructuralists try to avoid dealing with scientific dialectics, or as much as they merely reject it, their thinking still remains within the confines of dialectics. This is especially the case with regard to theory and practice, or the potential of the sciences to realize truth and adopt a certain methodology that relates scientific work to truth.Following parallel lines of evolution, structuralism and poststructuralism relate to a phenomenological perspective on the sciences that intends to reveal a more rigorous science, which is achieved either a priori, as in Husserl, or a posteriori, as in ethnomethodology. Furthermore, structuralism emphasizes the relations of structural elements within a systemic formation, be that of a social, political or scientific nature.

Development of prehospital care quality indicators for the Australian setting: a modified RAND/UCLA appropriateness method

2021 ◽  
pp. emermed-2020-210455
Author(s):  
Robin Pap ◽  
Craig Lockwood ◽  
Matthew Stephenson ◽  
Paul Simpson
Keyword(s):  
Quality Indicators ◽  
Prehospital Care ◽  
Quality Measurement ◽  
Healthcare Services ◽  
Care Quality ◽  
Structural Elements ◽  
Time Intervals ◽  
Process Indicators ◽  
Evidence Summaries ◽  
General Time

BackgroundGlobally, the measurement of quality is an important process that supports the provision of high-quality and safe healthcare services. The requirement for valid quality measurement to gauge improvements and monitor performance is echoed in the Australian prehospital care setting. The aim of this study was to use an evidence-informed expert consensus process to identify valid quality indicators (QIs) for Australian prehospital care provided by ambulance services.MethodsA modified RAND/UCLA appropriateness method was conducted with a panel of Australian prehospital care experts from February to May 2019. The proposed QIs stemmed from a scoping review and were systematically prepared within a clinical and non-clinical classification system, and a structure/process/outcome and access/safety/effectiveness taxonomy. Rapid reviews were performed for each QI to produce evidence summaries for consideration by the panellists. QIs were deemed valid if the median score by the panel was 7–9 without disagreement.ResultsOf 117 QIs, the expert panel rated 84 (72%) as valid. This included 26 organisational/system QIs across 7 subdomains and 58 clinical QIs within 10 subdomains.Most QIs were process indicators (n=62; 74%) while QIs describing structural elements and desired outcomes were less common (n=13; 15% and n=9; 11%, respectively). Non-exclusively, 18 (21%) QIs addressed access to healthcare, 21 (25%) described safety aspects and 64 (76%) specified elements contributing to effective services and care. QIs on general time intervals, such as response time, were not considered valid by the panel.ConclusionThis study demonstrates that with consideration of best available evidence a substantial proportion of QIs scoped and synthesised from the international literature are valid for use in the Australian prehospital care context.

scholarly journals Using Always Events to derive patient-centred quality improvement priorities in a specialist primary care service providing care to a homeless population

2019 ◽  
Vol 8 (1) ◽  
pp. e000507
Author(s):  
Marianne McCallum ◽  
Duncan McNab ◽  
John Mckay
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
General Practitioner ◽  
Thematic Analysis ◽  
Care Service ◽  
Healthcare Services ◽  
Homeless Population ◽  
Vulnerable Group ◽  
Patient Feedback ◽  
High Engagement

Background‘Always Events’ (AE) is a validated quality improvement (QI) method where patients, and/or carers, are asked what is so important that it should ‘always’ happen when they interact with healthcare services. Answers that meet defined criteria can be used to direct patient-centred QI activities. This method has never, to our knowledge, been applied in the care of a UK homeless population. We aimed to test the aspects of the acceptability and feasibility of the AE method to inform on its potential application to improve care for this vulnerable group of patients.MethodsAll patients attending three consecutive drop-in clinics at a specialist homeless general practitioner service in Glasgow, who agreed to participate, were interviewed. Anonymised responses were transcribed and coded and a thematic analysis performed. Themes were summarised to generate candidate AE using the patient’s own words. The authors then determined if they met the AE criteria.ResultsTwenty out of 22 eligible patients were interviewed. Oral transcribing was found to be an acceptable way to gather data in this group. Nine candidate AEs were generated, of which five fitted the criteria to be used as metrics for future QI projects. This project generated AEs and QI targets, and highlighted issues of importance to patients that could be easily addressed.ConclusionIn the homeless context, obtaining high engagement and useful patient feedback, in a convenient way, is difficult. The AE method is an acceptable and feasible tool for generating QI targets that can lead to improvements in care for this vulnerable group.

scholarly journals Interviews as sites of ideological work

2018 ◽  
Vol 15 (1) ◽  
pp. 54-76 ◽  
Author(s):  
Rosina Márquez Reiter
Keyword(s):  
Social Practice ◽  
Social Dynamics ◽  
Interview Data ◽  
The Social ◽  
Ideological Work

Abstract This paper maintains that the interview, understood as an interactionally achieved social practice, can be a locus for ideological work. It shows how a differentiated understanding of stance, alignment and the discourse identities that the participants assume and leave in interaction, can bring into focus aspects of ideology that would be difficult to capture otherwise. Specifically, the paper shows how mis- and realigning actions with respect to the stances conveyed by the interview participants relative to a given subject or from a given discourse identity can lead to the construction of ideology, encouraging (or not) movement along a given interview trajectory. The ideological work observed is contingent on how the participants locate themselves and others in the interview where tensions between legitimised linguistic views and discourse identity adoption, as well as contradictions with regard to other circulating discourses emerge. The paper thus suggests that (language ideological) analyses of interview data can and should be focused on the social dynamics of the participants and how their ideological presuppositions play out in the situated interaction of the interview.

The Social Realities of Honor

2018 ◽  
Author(s):  
Robert Paul Churchill
Keyword(s):  
Social Practice ◽  
Social Dynamics ◽  
Self Esteem ◽  
Social Contexts ◽  
Individual Identity ◽  
Sex And Gender ◽  
Honor Killings ◽  
The Social ◽  
Honor Killing ◽  
And Gender

This chapter examines the cultural and social contexts in which honor killings occur. Honor killing is a social practice in which complex psychological, interpersonal, and social dynamics are unified and replicated over time. The chapter first illuminates the general features of social practices, then analyzes features critical for honor killing as a social practice, beginning with the salience of norms of honor and shame in what are called honor–shame communities. The chapter analyzes sharaf, an important general honor concept, and ‘ird or ‘ard, the conception of honor relating to sex and gender behaviors, and most important when concerns about honor offenses arise. The latter pertain to the chastity and obedience of females and male responsibilities as guardians of females and as enforcers of communal honor norms. The constitutive features of honor–shame communities are identified, and the interrelationship between collective social elements and individual identity and self-esteem are discussed.

Linking Criminal Theory and Social Practice

2017 ◽  
Author(s):  
Meda Chesney-Lind
Keyword(s):  
Social Practice ◽  
Social Dynamics ◽  
Court System ◽  
Pyramid Model ◽  
Women And Girls ◽  
And Gender

In this chapter, Meda Chesney-Lind responds to Alexandra Natapoff’s essay. Chesney-Lind notes that the pyramid model resonates with longstanding concerns in criminology, particularly the attempt to measure the effects of race, class, and gender. The chapter offers concrete examples of the pyramid’s operation for women and girls in Honolulu’s court system. Chesney-Lind challenges criminology to do more to unearth these specific social dynamics.

scholarly journals Knowledge, evidence, expertise? The epistemics of experience in contemporary healthcare

2020 ◽  
Vol 16 (2) ◽  
pp. 267-284
Author(s):  
Fadhila Mazanderani ◽  
Tehseen Noorani ◽  
Farzana Dudhwala ◽  
Zara Thokozani Kamwendo
Keyword(s):  
Personal Experience ◽  
Healthcare Services ◽  
Evidence Based ◽  
Mutual Aid ◽  
Policy And Practice ◽  
User Experiences ◽  
Patient Feedback ◽  
Self Help ◽  
The Status ◽  
Patient Activism

This paper explores how personal experience acquires the status of knowledge and/or evidence in contemporary healthcare contexts that emphasise being both patient-centred and evidence-based. Drawing on a comparative analysis of three case studies ‐ self-help and mutual aid groups; online patient activism; and patient feedback in healthcare service delivery ‐ we foreground: a) the role that different technologies and temporalities play in how experience is turned (or fails to be turned) into knowledge or evidence; b) the role that experts-of-experience, in addition to the more frequently referenced experts-by-experience, play in mediating how, when and why experience is turned into an epistemic resource; and finally, c) how the need to be ‘evidence-based’ remains a persistent, yet at times productive, challenge to how patient and user experiences are incorporated in contemporary healthcare policy and practice. Throughout the paper, we argue that it is necessary to look at both democratic and epistemic imperatives for including patient and service users in healthcare services and policymaking based on their experience.

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