The experience of care coordination for people living with multimorbidity at risk of hospitalisation: an interpretative phenomenological analysis

2020 ◽  
Vol 35 (10) ◽  
pp. 1228-1248
Author(s):  
Annette Peart ◽  
Chris Barton ◽  
Virginia Lewis ◽  
Grant Russell
Author(s):  
Gareth Edward Ross ◽  
Jonathan Michael Auty

Purpose Democratic Therapeutic Communities (TCs) provide an environment for offenders to work on longstanding emotional and relational problems and address their offending behaviour. The purpose of this paper is to explore the experience of making psychological changes on a TC from the perspective of residents. Design/methodology/approach Interpretative Phenomenological Analysis was used to explore the experience of five former residents of the TC at HMP Gartree. Findings Four main themes emerged, each with two sub-themes: Motivation to Change (sub-themes: Engagement, Determination); Environment (sub-themes: Boundaries, Experience of care); Removal of Masks (sub-themes: Embracing vulnerability, Emerging authenticity) and Relationships (sub-themes: Re-enacting the past, Challenge from peers). Findings are discussed in relation to existing literature. Research limitations/implications Understanding service users perspectives on what helps facilitate change can help staff empathise with their experiences and strengthen their relationships. The importance of clear and consistent boundaries that are perceived as fair and the development of meaningful relationships with staff in creating an atmosphere that enables change has implications for other therapeutic or supportive environments. This research represents the experiences of five participants who were motivated to take part and comfortable to speak to a professional about their experiences. As such, generalisations about the wider TC population should be made cautiously and further research would be beneficial. Originality/value The research adds to the underrepresented area of service user perspectives in a forensic TC. It contributes a rich account of the experience of psychological change that can help staff working in TCs understand and relate to their residents experiences.


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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