scholarly journals Getting to the Emergency Department in Time: Interviews With Patients and Their Caregivers on the Challenges to Emergency Care Utilization in Rural Uganda - a Grounded Theory Approach

2021 ◽  
Author(s):  
Ashley E Pickering ◽  
Heather Dreifuss ◽  
Charles Ndyamwijuka ◽  
Mark Nichter ◽  
Bradley Dreifuss
Keyword(s):  
Emergency Department ◽  
Grounded Theory ◽  
Emergency Care ◽  
Treatment Delay ◽  
Chief Complaint ◽  
Care Utilization ◽  
Local Health ◽  
Theory Approach ◽  
Structural Factors ◽  
Grounded Theory Approach

Objectives Karoli Lwanga Hospital and Global Emergency Care, a 501(c)(3) nongovernmental organization, operate an Emergency Department (ED) in Uganda's rural Rukungiri District. Despite available emergency care (EC), preventable death and disability persist due to delayed patient presentations. Implementation of effective EC requires assessment of socioeconomic, cultural, and structural factors leading to treatment delay. Methods We purposefully sampled and interviewed patients and caregivers presenting to the ED more than 12 hours after onset of chief complaint in January-March 2017 to include various ages, genders, and complaints. Semistructured interviews addressing actions taken before seeking EC and delays to presentation once the need for EC was recognized were conducted. Interviews were audio recorded, translated, and transcribed, enabling the interdisciplinary and multicultural research team to conduct thematic analysis utilizing a grounded theory approach. Results The 50 ED patients for whom care was sought (mean age 33) had approximately even distribution of gender, as well as occupation (none, subsistence farmers and small business owner). Interviews were conducted with 37 caregivers and 13 ED patients. The majority of interviewees (mean age 38 years) were women with a primary education. The median duration of patients' chief complaint on ED presentation was 5.5 days. On average, participants identified severe symptoms necessitating EC 1 day before presentation. Four themes of treatment delay before and after severity were recognized were identified: 1) Cultural factors and limited knowledge of emergency signs and initial actions to take ; 2) Use of local health facilities despite perception of inadequate services; 3) Lack of resources to cover the anticipated cost of obtaining EC; 4) Inadequate transportation options. Conclusions Interventions are warranted to address each of the four major reasons for treatment delay. The next stage of formative research will generate intervention strategies and assess the opportunities and challenges to implementation with community and health system stakeholders.

scholarly journals Psychological Distress Model Among Iranian Pre-Hospital Personnel in Disasters: A Grounded Theory Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Maryam Azizi ◽  
Abbas Ebadi ◽  
Abbas Ostadtaghizadeh ◽  
Abbasali Dehghani Tafti ◽  
Juliet Roudini ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Psychological Distress ◽  
Mental Health Problems ◽  
Hospital Staff ◽  
Structured Interview ◽  
Theory Approach ◽  
Structural Factors ◽  
Short Term ◽  
Psychological Issues ◽  
Grounded Theory Approach

Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents and mental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective.Methods: A grounded theory methodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020.Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approachConclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.

scholarly journals Emergency nurses’ strategies in addressing uncertainty and change in the management of emerging infectious diseases: A grounded theory approach

2019 ◽  
Author(s):  
Stanley Kam Ki Lam ◽  
Enid Wai Yung Kwong ◽  
Maria Shuk Yu Hung ◽  
Samantha Mei Che Pang ◽  
Wai Tong Chien
Keyword(s):  
Grounded Theory ◽  
Emergency Care ◽  
Emerging Infectious Diseases ◽  
Theory Approach ◽  
Emergency Nurses ◽  
Individual Interviews ◽  
Core Category ◽  
Study Results ◽  
Training Schemes ◽  
Grounded Theory Approach

Abstract Background Uncertainty and change are the inevitable challenges facing emergency nurses, as they are bound by the nature of emergency care. During an epidemic event, emergency care settings are intertwined with urgency, uncertainty, and change, which continuously pose challenges to emergency nurses on their capacity to act on their duties in a well-planned and systematic manner. However, there has been a paucity of understanding concerning emergency nurses’ actions and strategies to address the instabilities and vulnerabilities of the circumstance. The present study aimed to explore emergency nurses’ behaviours and strategies in addressing the challenges of uncertainty and change during an epidemic event. Methods A qualitative design based upon a Straussian grounded theory approach was selected as the method of inquiry. A total of 26 emergency nurses from Hong Kong were recruited in the study by purposive and theoretical sampling strategies. Semi-structured, face-to-face, individual interviews were conducted for data collection. The data were transcribed verbatim and analysed through the grounded theory coding procedures. The COREQ guidelines were applied in the reporting of the present study. Results Rehearsing for improvisation was revealed as the core category. Four interplaying sub-categories were identified: (a) sensing the unclear situation, (b) equipping for the impending battle, (c) calibrating to the evolving guidelines, and (d) navigating the new role and duties. The nurses demonstrated their prudence to orientate themselves to an ambiguous work situation and displayed the flexibility to embrace changes in their practice, roles, and duties. Conclusions The findings delineate that emergency nurses were required to prepare and equip themselves with skills and strategies to improvise and adapt to the management of an epidemic event. The findings also offer insights into the development of education and training schemes that allow emergency nurses to acquire and augment their abilities of decision-making and problem-solving in public health responses.

The Analysis of Nurses’ Positive Deviance Behaviours as a Measure in Preventing the Transmission of Healthcare-Associated Infections (HAIs) at M. Djamil Hospital, Padang, West Sumatera

2018 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Esthika Ariany Maisa ◽  
Yulastri Arif ◽  
Wawan Wahyudi
Keyword(s):  
Grounded Theory ◽  
Wound Care ◽  
Positive Deviance ◽  
Care Practice ◽  
Theory Approach ◽  
Nursing Managers ◽  
Theoretical Sampling ◽  
Develop Theory ◽  
Healthcare Associated ◽  
Grounded Theory Approach

Purpose: To explore the nurses’ positive deviance behaviors as an effort to provide solutions in preventing and controlling infections in the hospital. Method: This is a qualitative research using grounded theory approach. Thirteen nurses from Dr.M.Djamil hospital were selected based on theoretical sampling in order to develop theory as it appears. Nurses were interviewed from June to September 2014. Interviews were thematically analyzed using techniques of grounded theory to then generate a theory from themes formed. Findings: The modes of positive deviance behavior identified were practicing hand hygiene beyond the standards (bringing handsanitizer from home), applying nursing art in wound care practice, placing patients with MRSA infections at the corner side, giving a red mark on a MRSA patient’s bed for easy identification by nurses, changing clothes and shoes in hospital, reducing hooks on the wall, and cleaning the ward on scheduled days. Conclusion: The study shows that nurses have a number of positive deviance behaviors to prevent infection transmission in the wards. It is sugested that the hospital management and nursing managers adopt some of the uncommon solution highlighted by the nurses to solve the HAIs problems in the hospital.

Analysis of Entrepreneurship Education Model of Technology-Driven Agri-Food Industry Applying Line-by-line Coding Method of Grounded Theory

2019 ◽  
Vol 118 (8) ◽  
pp. 266-274
Author(s):  
Byung- MoonSeol ◽  
Young-Lag KIM
Keyword(s):  
Grounded Theory ◽  
Comparative Analysis ◽  
Statistical Analysis ◽  
Food Industry ◽  
Entrepreneurship Education ◽  
Theory Approach ◽  
Coding Method ◽  
Open Coding ◽  
Education Model ◽  
Grounded Theory Approach

Background/Objectives: This paper investigated and analyzed the phenomena in implementing the curriculum and characteristics of an entrepreneurship education model existing technology-driven agri-food industry. Methods/Statistical analysis: The line-by-line coding method of grounded theory approach by Strauss & Corbin was applied for this study and the collected data was analyzed with the NVIVO 12 program from QSR which is a tool for analyzing quality comparative analysis for better efficiency in open coding.

Sign in / Sign up

Export Citation Format

Share Document