scholarly journals Compliance with smoke-free policy at tuberculosis facilities in Armenia: a mixed-methods study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Z Grigoryan ◽  
V Hayrumyan ◽  
Z h Sargsyan ◽  
A Harutyunyan
Keyword(s):  
Mixed Methods ◽  
Policy Implementation ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Mixed Methods Study ◽  
Healthcare Facilities ◽  
Smoke Free Policy ◽  
Sequential Mixed Methods ◽  
Free Environment ◽  
Indoor Smoking

Abstract Background Smoke-free environments in tuberculosis (TB) facilities promote a tobacco-free lifestyle among patients and healthcare providers and advance their healthy image. Though the national law of Armenia prohibits indoor smoking in healthcare facilities, enforcement of the law is still insufficient. This study aimed to explore compliance with the smoke-free policy in TB facilities in Armenia. Methods An exploratory sequential mixed-methods study was conducted. Overall 21 TB physicians and five key informants in the field of TB and tobacco control participated in qualitative interviews. To further quantify and validate the findings, structured observations of smoke-free policy implementation were conducted in 36 facilities. Results All physicians expressed a positive attitude towards the smoke-free environment and were satisfied with the level of implementation of a smoke-free policy in their TB facilities. According to the respondents, they already have smoke-free environments established in their facilities. “No smoking” signs, warnings about health consequences and financial penalties, and pictures of damaged lungs were the most common measures against indoor smoking. However, only in 17.1% (n = 6) and 8.6% (n = 3) of observed TB facilities there were posted “No smoking” signs and financial penalties, respectively. In 5.7% (n = 2) of facilities, the research team found ashtrays inside the building, and in 20.0% (n = 7) of facilities, there were smoking patients, physicians, and visitors. Conclusions While the qualitative study indicated good compliance, the quantitative findings were controversial with this regard. In fact, in most of the facilities, the smoke-free policy was not properly implemented and enforced. Additional efforts are needed to harmonize the current practices with national policies and recommendations. Key messages There was a discrepancy between practices reported by physicians and the actual observed compliance. Further interventions are needed to ensure 100% compliance with smoke-free policy in TB healthcare facilities.

scholarly journals Knowledge, Attitudes, Perception and Reported Practices of Healthcare Providers on Antibiotic Use and Resistance in Pregnancy, Childbirth and Children under Two in Lao PDR: A Mixed Methods Study

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1462
Author(s):  
Vanphanom Sychareun ◽  
Amphoy Sihavong ◽  
Anna Machowska ◽  
Xanded Onthongdee ◽  
Kongmany Chaleunvong ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Lao Pdr ◽  
Antibiotic Use ◽  
Mixed Methods Study ◽  
Medical Doctors ◽  
Structured Interviews ◽  
Urban District ◽  
Drug Sellers

Background: Overuse and misuse of antibiotics contribute unnecessarily to antibiotic resistance (ABR), and are thereby global health threats. Inappropriate prescriptions of antibiotics during pregnancy, delivery and early childhood are widespread across the world. This study aimed to assess knowledge, attitudes, and reported practices of healthcare providers (HCPs) and to explore their perceptions regarding antibiotic use and ABR related to pregnancy, childbirth, and children under two in Lao PDR. Methods: This is a mixed methods study with data collection in 2019 via structured interviews among 217 HCPs (medical doctors/assistant doctors, midwives/nurses, pharmacists/assistant pharmacists and drug sellers), who prescribed/dispensed antibiotics in one rural and one urban district in Vientiane province and individual qualitative interviews with 30 HCPs and stakeholders. Results: Of the HCPs, 36% had below average knowledge regarding antibiotic use and ABR, and 67% reported prescribing antibiotics for uncomplicated vaginal delivery. Half of the HCPs did not believe that their prescribing contributed to ABR, and only 9% had participated in antibiotic education. Conclusion: A substantial number of HCPs had suboptimal knowledge and prescribed antibiotics unnecessarily, thereby contributing to ABR. Continuous education and regular supervision of HCPs is recommended to improve the use of antibiotics related to pregnancy, childbirth, and young children.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

scholarly journals Nurses’ educational needs when dealing with aggression from patients and their families: a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041711
Author(s):  
Kana Sato ◽  
Yoshimi Kodama
Keyword(s):  
Mixed Methods ◽  
Nursing Students ◽  
Phase I ◽  
Phase Ii ◽  
Mixed Methods Study ◽  
Self Awareness ◽  
Two Phase ◽  
Sequential Mixed Methods ◽  
Nursing Professionals ◽  
Educational Contents

ObjectivesTo explore the type of education needed for nurses when dealing with aggression from patients and their families.DesignA two-phase sequential mixed-methods study.SettingThis study was conducted in Japan, with phase I from March to November 2016 and phase II in November 2018.Main outcome measuresThe challenges faced by nurses when dealing with incidents of aggression from the neutral perspective of neither nurse nor patient/family and perceptions of the educational contents developed in this study. Descriptive analyses were used to examine the data retrieved from both phases.ParticipantsPhase I entailed semistructured interviews among 11 neutral-party participants who observed aggressive incidents between nurses and patients/families. Phase II consisted of a web survey conducted among 102 nursing students and 308 nursing professionals.ResultsPhase I resulted in the identification of the following five main educational components: understanding the mechanisms of anger and aggression, maintaining self-awareness, observant listening, managing the self-impression, and communicating based on specific disease characteristics. Each component was related to improved communication through self-awareness. The results of phase II indicated that participants positively perceived these educational contents as likely to be effective for dealing with aggression from patients/families.ConclusionsThis study clarified the type of education needed for nurses when dealing with aggression based on multiple viewpoints. Specifically, neutral-party interviews revealed that communication should be improved through self-awareness. A subsequent survey among nurses and nursing students showed that the identified educational contents were positively received.

Management of e-resources in academic libraries in Ghana: Copyright implications

IFLA Journal ◽  
2021 ◽  
pp. 034003522110271
Author(s):  
Theresa L Adu ◽  
Thomas B van der Walt
Keyword(s):  
Distance Education ◽  
Mixed Methods ◽  
Distance Learning ◽  
Academic Libraries ◽  
Online Courses ◽  
Qualitative Interviews ◽  
Digital Resources ◽  
Mixed Methods Approach ◽  
Sequential Mixed Methods ◽  
Library Staff

This study investigated the copyright issues surrounding the management of e-resources in academic libraries in Ghana. Forty-seven library staff and head librarians from four academic libraries were engaged using questionnaires and qualitative interviews in a sequential mixed-methods approach to generate data for this study. The findings indicate that in all four institutions copyright issues arose with the provision of distance learning, online courses and e-reserves services. All the respondents stated that they or their colleagues had had faculty ask questions on copyright issues. However, the professional librarians indicated that the library was not consulted and the instructors for online courses or distance education programmes did not cooperate with librarians; rather, the department posting the materials made the decisions on copyright regarding the usage of digital resources for distance learning, online courses or e-reserves. This does not augur well for the management of copyright of e-resources in academic libraries in Ghana.

scholarly journals Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

2020 ◽  
Author(s):  
Joshua P Murphy ◽  
Aneesa Moolla ◽  
Sharon Kgowedi ◽  
Constance Mongwenyana ◽  
Sithabile Mngadi ◽  
...  
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Policy Implementation ◽  
Community Health ◽  
Resource Constraints ◽  
Health Workers ◽  
Healthcare Providers ◽  
Successful Implementation ◽  
Programme Implementation ◽  
Healthcare Facilities

Abstract South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning. We conducted a qualitative study among a sample of Department of Health Managers at the National, Provincial and District level, healthcare providers, implementing partners [including non-governmental organizations (NGOs) who worked with CHWs] and CHWs themselves. Data were collected between April 2018 and December 2018. We conducted 65 in-depth interviews (IDIs) with healthcare providers, managers and experts familiar with CHW work and nine focus group discussions (FGDs) with 101 CHWs. We present (i) current models of CHW policy implementation across South Africa, (ii) facilitators, (iii) barriers to CHW programme implementation and (iv) respondents’ recommendations on how the CHW programme can be improved. We chronicled the differences in NGO involvement, the common facilitators of purpose and passion in the CHWs’ work and the multitude of barriers and resource limitations CHWs must work under. We found that models of implementation vary greatly and that adaptability is an important aspect of successful implementation under resource constraints. Our findings largely aligned to existing research but included an evaluation of districts/provinces that had not previously been explored together. CHWs continue to promote health and link their communities to healthcare facilities, in spite of lack of permanent employment, limited resources, such as uniforms, and low wages.

How the environment is conceptualised and represented globally in social work codes of ethics

2021 ◽  
pp. 002087282110200
Author(s):  
Kang Liu ◽  
Catherine A Flynn
Keyword(s):  
Human Rights ◽  
Social Justice ◽  
Social Work ◽  
Mixed Methods ◽  
Physical Environment ◽  
Codes Of Ethics ◽  
Mixed Methods Study ◽  
Sequential Mixed Methods ◽  
The Social ◽  
Holistic Understanding

While the environment is fundamental to humankind’s wellbeing, to date, social work has been largely focused on the social, rather than the physical, environment. To map how the broader environment is captured in the profession’s foundational documents, an exploratory sequential mixed methods study (QUAL → quan) analysed data from 64 social work codes of ethics. Findings indicate that although the environment is mentioned in the majority of these, there is a continued focus on the social, overlooking to some degree the physical, predominantly the built, environment. A more holistic understanding of the environment would enable social work to better fulfil its commitment to human rights and social justice.

First Nations students’ perceptions of school nutrition policy implementation: A mixed methods study

2018 ◽  
Vol 75 (5) ◽  
pp. 533-540 ◽  
Author(s):  
Christina Gillies ◽  
Anna Farmer ◽  
Katerina Maximova ◽  
Noreen D. Willows ◽  
Keyword(s):  
Mixed Methods ◽  
Policy Implementation ◽  
First Nations ◽  
Nutrition Policy ◽  
School Nutrition ◽  
Mixed Methods Study ◽  
Perceptions Of School

scholarly journals Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study.

2020 ◽  
Author(s):  
Chisato Masuda ◽  
Shirley Kristine Ferolin ◽  
Ken Masuda ◽  
Chris Smith ◽  
Mitsuaki Matsui
Keyword(s):  
Mixed Methods ◽  
Associated Factors ◽  
Healthcare Providers ◽  
The Philippines ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Factors Associated ◽  
Second Stage ◽  
Assisted Delivery ◽  
Fundal Pressure

Abstract Background Evidenced-based practice is a key component of quality care. However, studies in the Philippines have identified gaps between evidence and actual maternity practices. This study aims to describe the practice of evidence-based intrapartum care and its associated factors, as well as exploring the perceptions of healthcare providers in a tertiary hospital in the Philippines. Methods A mixed-methods study was conducted, which consisted of direct observation of intrapartum practices during the second and third stages, as well as semi-structured interviews and focus group discussions with care providers to determine their perceptions and reasoning behind decisions to perform episiotomy or fundal pressure. Univariate and multivariate logistic regression were used to analyse the relationship between observed practices and maternal, neonatal, and environmental factors. Qualitative data were parsed and categorised to identify themes related to the decision-making process. Results A total of 170 deliveries were included. Recommended care, such as prophylactic use of oxytocin and controlled cord traction in the third stage, were applied in almost all the cases. However, harmful practices were also observed, such as intramuscular or intravenous oxytocin use in the second stage (14%) and lack of foetal heart rate monitoring (57%). Of primiparae, 92% received episiotomy and 31% of all deliveries received fundal pressure. Factors associated with the implementation of episiotomy included primipara (adjusted Odds Ratio [aOR] 62.3), duration of the second stage of more than 30 minutes (aOR 4.6), and assisted vaginal delivery (aOR 15.0). Factors associated with fundal pressure were primipara (aOR 3.0), augmentation with oxytocin (aOR 3.3), and assisted delivery (aOR 4.8). Healthcare providers believe that these practices can prevent laceration. The rate of obstetric anal sphincter injuries (OASIS) was 17%. Associated with OASIS were assisted delivery (aOR 6.0), baby weights of more than 3.5 kg (aOR 7.8), episiotomy (aOR 26.4), and fundal pressure (aOR 6.2). Conclusions Our study found that potentially harmful practices are still conducted that contribute to the occurrence of OASIS. The perception of these practices is divergent with current evidence, and empirical knowledge has more influence. To improve practices the scientific evidence and its underlying basis should be understood among providers.

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