Complex patients’ effect on family physicians: high cognitive load and negative emotional impact

2020 ◽  
Author(s):  
Steven E Roskos ◽  
Laurie Fitzpatrick ◽  
Bengt Arnetz ◽  
Judy Arnetz ◽  
Shiva Shrotriya ◽  
...  
Keyword(s):  
Health Care ◽  
Cognitive Load ◽  
Family Physicians ◽  
Structured Interview ◽  
Emotional Impact ◽  
Physician Burnout ◽  
Medical Problems ◽  
Team Members ◽  
Complex Patients ◽  
Interview Guide

Abstract Background and objectives Complex patients present an increasing challenge to the health care system and family physicians play an important role in their care. As part of a larger project exploring family physicians’ perceptions of complex patients, we sought to understand how complex patients affect family physicians and if these effects might be related to physician burnout. Methods We conducted a qualitative study involving interviews with family physicians from various practice settings. We invited the physicians to choose three of their patients between the ages of 18 and 64 whom they considered to have complex medical problems and to have access to their medical records during a telephone interview using a semi-structured interview guide. Interviews were audio-recorded, professionally transcribed and coded. Using qualitative analytical software, research team members worked together to analyse the interview data and determine emerging themes. Results Eleven family physicians participated in the interviews and described 29 unique complex patients, including challenges and effects on them personally. Analysis of the available 10 family physicians’ interviews revealed two themes related to complexity’s impact on physicians: (i) high cognitive load and (ii) negative emotional impact. Conclusion Although preliminary, this study offers a previously unconsidered understanding of drivers of physician burnout, including high cognitive load and negative emotional impact on family physicians created by caring for complex patients. Interventions to improve health care, including addressing physician wellness and burnout, should include the provision of resources to assist them with decreasing cognitive load and negative emotional impact when caring for complex patients.

scholarly journals “‘You lose your hair, what’s the big deal?’ I was so embarrassed, I was so self-conscious, I was so depressed:” a qualitative interview study to understand the psychosocial burden of alopecia areata

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Natalie V. J. Aldhouse ◽  
Helen Kitchen ◽  
Sarah Knight ◽  
Jake Macey ◽  
Fabio P. Nunes ◽  
...  
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Disease Recurrence ◽  
Structured Interview ◽  
Emotional Impact ◽  
Psychosocial Effects ◽  
Psychosocial Burden ◽  
Qualitative Interview Study ◽  
Interview Guide ◽  
Expert Clinician

Abstract Background Alopecia areata (AA) is characterized by hair loss that can affect the scalp and body. This study describes the psychosocial burden of AA. Methods Participants diagnosed with AA who had experienced ≥50% scalp hair loss according to the Severity of Alopecia Tool (SALT) were identified by clinicians. A semi-structured interview guide, developed with expert clinician input, included open-ended questions to explore patients’ experiences of living with AA. Data were thematically analyzed to identify concepts and relationships. Results Participants (n = 45, 58% female, mean age 33.3 years [range 15–72], mean SALT 67.2 [range 0–100]) described the AA diagnosis as “devastating”. Both males and females reported emotional and psychological impacts of AA including feeling sad/depressed (n = 21), embarrassed/ashamed (n = 10) and angry/frustrated (n = 3). Patients felt helpless (n = 5) due to the unpredictability of disease recurrence, and anxious (n = 19) about judgement from others. Many patients avoided social situations (n = 18), which impaired relationships and increased isolation. Coping strategies included concealment of hair loss through wigs or make-up, although fear of the displacement of these coverings also caused anxiety and the avoidance of activities that could result in scalp exposure (n = 22). Some patients became more accepting of AA over time, which lessened the emotional impact, though efficacious treatment was still desired. A conceptual framework was developed, and a conceptual model was created to depict the relationship between the physical signs/symptoms and the associated psychosocial effects of AA. Conclusion AA impairs patients’ emotional and psychological wellbeing, relationships and lifestyles. Greater disease awareness and effective treatments are needed.

scholarly journals Experiences and Motivations of Male Nurses in a Tertiary Hospital in Ghana

2021 ◽  
Vol 7 ◽  
pp. 237796082110445
Author(s):  
Stella Appiah ◽  
Evans O. Appiah ◽  
Valentina N.L. Lamptey
Keyword(s):  
Health Care ◽  
Nurse Managers ◽  
Structured Interview ◽  
Tertiary Hospital ◽  
Nursing Profession ◽  
Male Nurses ◽  
Factors Affecting ◽  
Descriptive Research ◽  
Interview Guide ◽  
Qualitative Descriptive

Introduction Nurses make up the largest portion of the health care system throughout the world, hence, making the profession the backbone of health care. The nursing workforce is made up of both males and females. However, the majority of nurses are predominately females with the number of male nurses reported to be unappreciable. Objective The study therefore aimed to explore the experiences and motivation of male nurses in a tertiary hospital in Ghana. Methods A qualitative descriptive research design was employed to explore the lived experiences of male nurses. A total of 20 male nurses were purposively selected, and in-depth interviews were conducted with a semi-structured interview guide. The interviews were tape-recorded, transcribed verbatim, and analyzed using content analysis. Results The findings revealed 2 major themes: motivation and experiences of male nurses. The subthemes were individual motivations, external influence, intersecting social reactions and public perceptions, mixed encounters with patients, and satisfaction with the profession. Conclusion Male nurses are motivated to a large extent to be part of the nursing profession but will be deeply involved in the profession if some factors affecting them are addressed. Future studies may address the roles of nurse managers in mentoring more males to be involved in the nursing profession.

scholarly journals Complexity Theory: Insights from a Canadian ERP Project Implementation

2019 ◽  
Vol 14 (6) ◽  
pp. 84
Author(s):  
Sreekumar A. Menon ◽  
Marc Muchnick ◽  
Clifford Butler ◽  
Tony Pizur
Keyword(s):  
Complexity Theory ◽  
Enterprise Resource Planning ◽  
Oil And Gas ◽  
Resource Planning ◽  
Oil And Gas Industry ◽  
Structured Interview ◽  
Project Managers ◽  
Gas Industry ◽  
Team Members ◽  
Interview Guide

This research paper explores complexity theory based on insights from an Enterprise Resource Planning (ERP) implementation in the Canadian oil and gas industry. The qualitative exploratory case study was conducted in a Canadian case organization using a semi-structured interview guide with a total of twenty interviews from members of four project role groups of senior leaders, project managers, project team members, and business users. Besides interview responses, the study also collected and reviewed ERP project documents for triangulation purposes. The research showed the importance of complexity theory to ERP projects, and the relationship between critical challenges and complex categories of human behavior, system behavior, and ambiguity. The study findings also evoked rich and comprehensive data related to the phenomenon of critical challenges in ERP.

Construction of citizenship in hospitalized children, Peru

2019 ◽  
Vol 1 (1) ◽  
pp. 31
Author(s):  
Fernando Ledesma Perez ◽  
Maria Caycho Avalos ◽  
Juana Cruz Montero ◽  
Andrea Ayala Sandoval
Keyword(s):  
Structured Interview ◽  
Health Condition ◽  
Qualitative Approach ◽  
Fundamental Rights ◽  
Hospitalized Children ◽  
Health Institute ◽  
Interview Guide ◽  
Communication Interaction ◽  
The Individual

Citizenship is the exercise of the fundamental rights of people in spaces of participation, opinion and commitments, which can not be violated by any health condition in which the individual is. This research aims to interpret the process of construction of citizenship in hospitalized children, was developed through the qualitative approach, ethnomethodological method, synchronous design, with a sample of three students hospitalized in a health institute specializing in childhood, was used Observation technique and a semi-structured interview guide were obtained as results that hospitalized children carry out their citizenship construction in an incipient way, through the communication interaction they make with other people in the environment where they grow up.

Patients’ Perceptions of Caring and Uncaring Nursing Encounters in Inpatient Rehabilitation Settings

2019 ◽  
Vol 21 (2) ◽  
Author(s):  
Joan C Cheruiyot ◽  
Petra Brysiewicz
Keyword(s):  
South Africa ◽  
Content Analysis ◽  
Inpatient Rehabilitation ◽  
Structured Interview ◽  
The Self ◽  
Personal Relationships ◽  
Individual Interviews ◽  
Textual Data ◽  
Interview Guide ◽  
Being There

This study explores and describes caring and uncaring nursing encounters from the perspective of the patients admitted to inpatient rehabilitation settings in South Africa. The researchers used an exploratory descriptive design. A semi-structured interview guide was used to collect data through individual interviews with 17 rehabilitation patients. Content analysis allowed for the analysis of textual data. Five categories of nursing encounters emerged from the analysis: noticing and acting, and being there for you emerged as categories of caring nursing encounters, and being ignored, being a burden, and deliberate punishment emerged as categories of uncaring nursing encounters. Caring nursing encounters make patients feel important and that they are not alone in the rehabilitation journey, while uncaring nursing encounters makes the patients feel unimportant and troublesome to the nurses. Caring nursing encounters give nurses an opportunity to notice and acknowledge the existence of vulnerability in the patients and encourage them to be present at that moment, leading to empowerment. Uncaring nursing encounters result in patients feeling devalued and depersonalised, leading to discouragement. It is recommended that nurses strive to develop personal relationships that promote successful nursing encounters. Further, nurses must strive to minimise the patients’ feelings of guilt and suffering, and to make use of tools, for example the self-perceived scale, to measure this. Nurses must also perform role plays on how to handle difficult patients such as confused, demanding and rude patients in the rehabilitation settings.

scholarly journals How clinical teaching teams deal with educational change: ‘we just do it’

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
L. Bank ◽  
M. Jippes ◽  
T. R. van Rossum ◽  
C. den Rooyen ◽  
A. J. J. A. Scherpbier ◽  
...  
Keyword(s):  
Educational Change ◽  
Curriculum Change ◽  
Clinical Teaching ◽  
Postgraduate Medical Education ◽  
Structured Interview ◽  
Program Director ◽  
Local Context ◽  
Team Members ◽  
Teaching Teams ◽  
Medical Education Program

Abstract Background In postgraduate medical education, program directors are in the lead of educational change within clinical teaching teams. As change is part of a social process, it is important to not only focus on the program director but take their other team members into account. The purpose of this study is to provide an in-depth insight into how clinical teaching teams manage and organize curriculum change processes, and implement curriculum change in daily practice. Methods An explorative qualitative semi-structured interview study was conducted between October 2016 and March 2017. A total of six clinical teaching teams (n = 6) participated in this study, i.e. one program director, one clinical staff member, and one trainee from each clinical teaching team (n = 18). Data were analysed and structured by means of thematic analysis. Results The analysis yielded to five factors that positively impact change: shared commitment, reinvention, ownership, supportive structure and open culture. Factors that negatively impact change were: resistance, behaviour change, balance between different tasks, lack of involvement, lack of consensus, and unsafe culture and hierarchy. Overall, no clear change strategy could be recognized. Conclusions Insight was gathered in factors facilitating and hindering the implementation of change. It seems particularly important for clinical teaching teams to be able to create a sense of ownership among all team members by making a proposed change valuable for their local context as well as to be capable of working together as a team. Cultural factors seem to be particularly relevant in a team’s ability to accomplish this.

scholarly journals Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2093
Author(s):  
Tina Vilovic ◽  
Josko Bozic ◽  
Marino Vilovic ◽  
Doris Rusic ◽  
Sanja Zuzic Furlan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Perceived Stress ◽  
Depression Scale ◽  
Family Physicians ◽  
Knowledge Score ◽  
Well Being ◽  
Anxiety And Depression ◽  
Event Scale ◽  
The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

scholarly journals Family Physician’s and Primary Care Team’s Perspectives on Supporting Family Caregivers in Primary Care Networks

2021 ◽  
Vol 18 (6) ◽  
pp. 3293
Author(s):  
Jasneet Parmar ◽  
Sharon Anderson ◽  
Marjan Abbasi ◽  
Saeed Ahmadinejad ◽  
Karenn Chan ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Caregivers ◽  
Healthcare Providers ◽  
Family Physicians ◽  
Care Team ◽  
Primary Care Team ◽  
Caregiver Support ◽  
Team Members ◽  
Primary Care Teams ◽  
Support Family

Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.

Perspectives of community members on homeless people with mental illness in Nsawam, Ghana

2020 ◽  
pp. 002076402098419
Author(s):  
Kwamina Abekah-Carter ◽  
George Ofosu Oti
Keyword(s):  
Mental Illness ◽  
Homeless People ◽  
Structured Interview ◽  
Homeless Persons ◽  
Community Members ◽  
Qualitative Research Design ◽  
People With Mental Illness ◽  
Interview Guide ◽  
Audio Data ◽  
Good Food

Background: Homelessness among people with mental illness has grown to become a common phenomenon in many developed and developing countries. Just like in any other country, the living conditions of homeless people with mental illness in Ghana are unwholesome. Despite the increased population of these vulnerable individuals on the streets, not much is known about the perspectives of the general public towards this phenomenon in Ghana. Aim: This research was conducted to explore the perspectives of community members on homeless people with mental illness. The main study objectives were (a) to find out the impacts of the presence of persons with mental illness on the streets and (b) to ascertain the reasons accounting for homelessness among persons with mental illness. Method: Utilizing a qualitative research design, twenty community members were sampled from selected suburbs in Nsawam and interviewed with the use of a semi-structured interview guide. The audio data gathered from the interviews were transcribed verbatim and analysed thematically. Results: Majority of the participants asserted that homeless people with mental illness had no access to good food, shelter, and health care. They further stated that some homeless people with mental illness perpetrated physical and sexual violence against the residents. Moreover, the participants believed that persons with mental illness remained on the streets due to neglect by their family members, and limited access to psychiatric services. Conclusion: This paper concludes by recommending to government to make mental health services accessible and affordable to homeless persons with mental illness nationwide.

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