Models for Integrating Medical Acupuncture into Practice: An Exploratory Qualitative Study of Physicians— Experiences

2016 ◽  
Vol 34 (4) ◽  
pp. 280-289 ◽  
Author(s):  
Ellen T Crumley
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Full Time ◽  
Snowball Sampling ◽  
Core Concept ◽  
Structured Interviews ◽  
The Core ◽  
Individual Physician ◽  
Part Time ◽  
Medical Acupuncture

Background Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). Objective To examine how physicians integrate medical acupuncture into their practice. Methods Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of ‘helping’. Quotes were used to illustrate each model and its corresponding themes. Results There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Discussion Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice.

scholarly journals 301 Older Farmers' Experiences of Musculoskeletal Disorders

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
John Cunningham ◽  
Austin Kerin ◽  
Rose Galvin ◽  
Katie Robinson
Keyword(s):  
Qualitative Study ◽  
Musculoskeletal Disorders ◽  
Future Research ◽  
Full Time ◽  
Structured Interviews ◽  
Patient Centered ◽  
Part Time ◽  
Health Promoting ◽  
Time Basis ◽  
Older Farmers

Abstract Background Almost a third (n=41,000) of all Irish farm holders are aged 65 years or older. Older farmers are vulnerable to Musculoskeletal Disorders (MSD’s) both by virtue of the nature of their work and their age. MSD’s are a known risk factor for workplace accidents and farming is the highest risk occupation in Ireland. This study aimed to explore older farmers’ experiences of living with and accessing healthcare for MSD’s. Methods A qualitative study design employing semi-structured interviews was employed. Nine Irish farmers aged 65 years and over with current or previous experience of MSD's were recruited. All participants continued to farm on either a full-time or part-time basis. Data were analysed using thematic analysis. Results Four themes describing older farmers' experiences of MSD’s and healthcare were identified; (1) acceptance of MSD’s as inevitable (2) biomechanical and biological beliefs about MSD’s (3) resilience and a commitment to continuing work in response to MSD’s (4) scepticism and avoidance of healthcare. Conclusion To the best of our knowledge this is the first qualitative study of older Irish farmers’ experiences of MSD’s. Findings reveal that older farmer’s experiences differ significantly from those reported by other occupational groups. Commitment to continue working permeated the findings of this study and shaped older farmers' experiences and responses to MSD's. Older farmers accept MSD’s and pain as inevitable consequences of farming, and they respond to MSD’s with stoicism. Lack of healthcare provider knowledge about farming culture and practices contributes to older farmers' negative healthcare experiences and avoidance of healthcare. Given the prevalence of MSD’s in this population future research should focus on developing and evaluating appropriate health promoting and patient-centered interventions to support continued safe farming for older Irish farmers.

scholarly journals The Use of Kumpfer's Resilience Framework in Understanding the Breastfeeding Experience of Employed Mothers After Returning to Work: a Qualitative Study in China

2021 ◽  
Author(s):  
Hong Hua Guo ◽  
Rong Zhou ◽  
Min Xiang Li ◽  
Si Qi Zhang ◽  
Huan Ying Yi ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Working Mothers ◽  
Dynamic Interaction ◽  
Full Time ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Targeted Interventions ◽  
Employed Mothers ◽  
Returning To Work ◽  
Resilience Framework

Abstract Background: The increasing numbers of women in the workforce is an inevitable trend in China. More and more employed women stop breastfeeding because of working stressors. However, there are also many mothers overcoming many challenges to insist on breastfeeding after returning to work. Their individual experience of breastfeeding may provide a new insight to promote and support breastfeeding on employed mothers. This study sought to understand mothers’ experience with insisting on breastfeeding after returning to work based on Kumpfer’s Resilience Framework in Chinese context. Methods: This qualitative study was designed with semi-structured interviews. Purposive sampling and snowball sampling was employed to recruit 13 full-time working mothers with a stable job in the public sector who continued to breastfeed for 1 month or more after returning to work in Haikou, Hainan Province, China. Interviews were conducted from January to March 2020 to capture participants’ experiences of breastfeed after returning to work. Grounded theory and Kumpfer’s Resilience Framework were used to analyze data via a systematic and iterative process.Results: Employed mothers built resilience while continuing to breastfeed after returning to work. The core concept was "dynamic interaction". Other categories were the background and explanation of this phenomenon. For working mothers who continued to breastfeed, resilience involved "dynamic interaction", which started from "experiencing stressors" and "obtaining support", two factors that interacted with the individual to "stimulate resilience", which led to “behavioral resilience” during the ongoing dynamic interaction between resilience and environmental factors and ultimately led to three different "weaning outcomes", including natural weaning, active weaning, and forced weaning. Conclusions: This study identified the framework of resilience in mothers who insisted on breastfeeding after returning to work based on Kumpfer’s Resilience Framework. It may help midwives assess stressors and supports for employed mothers to continue to breastfeed after returning to work, determine the process by which resilience traits are stimulated in employed mothers, identify different phases of behavioral resilience, provide targeted interventions, and then promote favorable weaning outcomes.

Complicated grief knowledge and practice: a qualitative study of general practitioners in Ireland

2021 ◽  
pp. 1-6
Author(s):  
Abiola Muhammed ◽  
Anne Dodd ◽  
Suzanne Guerin ◽  
Susan Delaney ◽  
Philip Dodd
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Current Knowledge ◽  
Complicated Grief ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Relevant Research ◽  
Loved One ◽  
Knowledge And Practice ◽  
Purposive Sample

Objective: Complicated grief is a debilitating condition that individuals may experience after losing a loved one. General practitioners (GPs) are well positioned to provide patients with support for grief-related issues. Traditionally, Irish GPs play an important role in providing patients with emotional support regarding bereavement. However, GPs have commonly reported not being aptly trained to respond to bereavement-related issues. This study explores GPs’ current knowledge of and practice regarding complicated grief. Methods: A qualitative study adopting a phenomenological approach to explore the experiences of GPs on this issue. Semi-structured interviews were carried out with a purposive sample of nine GPs (five men and four women) in Ireland. Potential participants were contacted via email and phone. Interviews were audio-recorded, transcribed and analysed using Braun & Clarke’s (2006) model of thematic analysis. Results: GPs had limited awareness of the concept of complicated grief and were unfamiliar with relevant research. They also reported that their training was either non-existent or outdated. GPs formed their own knowledge of grief-related issues based on their intuition and experiences. For these reasons, there was not one agreed method of how to respond to grief-related issues reported by patients, though participants recognised the need for intervention, onward referral and review. Conclusions: The research highlighted that GPs felt they required training in complicated grief so that they would be better able to identify and respond to complicated grief.

scholarly journals Exploring producers' motivations and challenges within a farmers' market

2020 ◽  
Vol 122 (7) ◽  
pp. 2089-2103
Author(s):  
Rosario Michel-Villarreal ◽  
Eliseo Luis Vilalta-Perdomo ◽  
Martin Hingley
Keyword(s):  
Design Methodology ◽  
Farmers Markets ◽  
Full Time ◽  
Structured Interviews ◽  
Farmers Market ◽  
Content Type ◽  
Food Supply Chains ◽  
Part Time ◽  
Short Food Supply Chains

PurposeThe purpose of this study is to explore food producers' motivations and challenges whilst participating in short food supply chains (SFSCs). This paper compares findings with previous literature and investigates the topic in the context of producers' motivations.Design/methodology/approachThe paper includes a literature review concerning producers' motivations to engage in SFSCs. A case study was designed to investigate motivations underlying producers' engagement in SFSCs, as well as the challenges that they face. Semi-structured interviews were conducted in a farmers' market located in Mexico. Thematic analysis is used to identify the principal issues for producers'. Propositions based on findings are presented.FindingsFindings suggest that small, large, part-time and full-time producers are willing to engage with farmers' markets for diverse primary economic and non-economic motivations. Individual and collective challenges were also identified.Originality/valueThis research helps to explain producers' motivations and challenges within SFSCs in an under-researched context, namely a focus on producers' and in the Global South.

scholarly journals Protective and Risk Factors of Italian Healthcare Professionals during the COVID-19 Pandemic Outbreak: A Qualitative Study

2021 ◽  
Vol 18 (2) ◽  
pp. 453
Author(s):  
Amalia De Leo ◽  
Eloisa Cianci ◽  
Paolo Mastore ◽  
Caterina Gozzoli
Keyword(s):  
Risk Factors ◽  
Qualitative Study ◽  
Extrinsic Motivation ◽  
Healthcare Professionals ◽  
Well Being ◽  
Organizational Level ◽  
Emotional Impact ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Interpersonal Level

The COVID-19 pandemic put the Italian health system under great stress. The sudden reorganization of work practices and the emotional impact of the large number of the victims had many consequences on the well-being of the healthcare professionals (HCPs) involved in managing the crisis. In the available literature, most studies have focused on the risk aspects while only few studies also take into account protective factors. For this reason, it was decided to conduct, within psycho-sociological perspective, a qualitative study with the aim to explore in depth the protective and risk factors as experienced by HCPs who worked in the Italian healthcare system during the COVID-19 outbreak. A total of 19 semi-structured interviews were conducted with HCPs–9 nurses and 10 physicians (7M and 12F) with an average age of 43 (SD = 13.4)–selected using snowball sampling. Considering three different levels of analysis the results highlight the protective and risk factors: personal history level (intrinsic/ethical motivation and flexible role versus extrinsic motivation and static role), interpersonal level (perception of supportive relationships with colleagues, patients, and family versus bad relationships), and organizational level (good leadership and sustainable work purpose versus absence of support from management and undefined or confused tasks).

scholarly journals MOTHERS CARING FOR CHILDREN LIVING WITH CEREBRAL PALSY: SUGGESTIONS FOR PSYCHO-SOCIAL SUPPORT

2021 ◽  
Vol 57 (3) ◽  
Author(s):  
Phumudzo Raphulu ◽  
Modjadji Linda Shirindi ◽  
Mankwane Daisy Makofane
Keyword(s):  
Social Support ◽  
Cerebral Palsy ◽  
Data Analysis ◽  
Qualitative Study ◽  
Social Workers ◽  
Health Professionals ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Children With Cerebral Palsy ◽  
Thematic Data

Caring for children with cerebral palsy presents numerous circumstances which may contribute to mothers’ inability to cope with the demands of meeting their children’s needs. A qualitative study supported by explorative, descriptive and contextual designs was undertaken. Purposive and snowball sampling facilitated the identification of twelve participants who were interviewed through semi-structured interviews. The enquiry was based on the ecosystems approach. Thematic data analysis was followed through Tesch’s eight steps and Guba’s model was used for data verification. The findings highlighted the necessity to enhance the psycho-social functioning of mothers through collaboration of social workers, health professionals and various organisations.

scholarly journals Experts' views on the implementation of the prenatal screening decision aid in Iran: A qualitative study

2021 ◽  
Author(s):  
Razieh Zahedi ◽  
Leila Nemati-Anaraki ◽  
Shahram Sedghi ◽  
Mamak Shariat
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Decision Aids ◽  
Personal Factors ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Patient Decision Aids ◽  
Patient Decision

Background & Aim: Patient decision aids are detailed and personalized health education materials that assist patients in decision making. According to expert viewpoints, this study aimed to determine important factors in implementing the prenatal screening decision aid in Iran. Methods & Materials: In this qualitative study, 24 experts, including seven obstetricians, four information scientists, five managers or policymakers, and eight midwives, were selected using purposive and snowball sampling approaches. Semi-structured interviews were conducted to collect the data between January 2020 and June 2020 in Tehran, Iran. A prenatal screening decision aid was presented to the participants, and we asked them to raise their concerns and thoughts regarding the factors influencing the implementation of patient decision aids. We used MAXQDA 10 and applied conventional content analysis for data analysis. Results: Two organizational and personal factors themes were identified to implement Iran's prenatal screening decision aids. Conclusion: We identified the viewpoints of experts regarding major factors in patient decision aids implementation for prenatal screening. Before implementing prenatal screening decision aids in Iran, it would be helpful to consider these organizational and personal factors. Prenatal screening decision aids can provide better information for pregnant women and strengthen their decision-making ability.

scholarly journals Processes and determinants of integration of eGFR in physicians’ drug prescriptions: a qualitative study of semi-structured interviews

2019 ◽  
Vol 20 ◽  
Author(s):  
Louis Lefèvre ◽  
Maud Jourdain ◽  
Jean-Pascal Fournier
Keyword(s):  
Qualitative Study ◽  
Adverse Drug Reactions ◽  
Healthcare Professionals ◽  
Drug Prescriptions ◽  
Theory Approach ◽  
Snowball Sampling ◽  
Drug Reactions ◽  
Structured Interviews ◽  
Training Professional ◽  
Grounded Theory Approach

Abstract Aim: Our objective was to explore the processes and determinants leading physicians to integrate estimated glomerular filtration rate (eGFR) in their drug prescriptions Background: Access to patients’ eGFR would allow primary care pharmacists to optimise their role in the procedure of safe prescribing. Some rare physicians actively integrate eGFR in their prescriptions, in a sporadically and uncoordinated manner. Methods: Qualitative study using semi-directed interviews conducted among 12 French physicians who integrated eGFR in their drug prescriptions, (February 2016–April 2017). These voluntary participants were recruited through different means: Twitter®, forums, direct contact and snowball sampling. Data analysis was based on the grounded theory approach, underpinned by a comprehensive perspective of interactionist orientation. Findings: Residency and training, professional experience – including experiences of adverse drug reactions – and the membership in various communities of professionals were key drivers for the integration of eGFR in prescriptions. The theoretical aim was above all safe prescribing in order to reduce adverse drug reactions, with the control by a dispensing pharmacist and/or other healthcare professionals. Nevertheless, none of the physicians had received any feedback from any healthcare professionals. Despite their disappointment, the physicians remained convinced of the interest of integrating eGFR in their prescriptions and would continue to do so. Characteristics associated with integration of eGFR in drug prescriptions belong partly to Roger’s theory of innovations. If a widespread diffusion of this habit takes place, it will be necessary to evaluate its adoption by both physicians and pharmacists.

Key Considerations for Advancing Women in Coaching

2019 ◽  
Vol 27 (2) ◽  
pp. 128-135 ◽  
Author(s):  
Jenessa Banwell ◽  
Gretchen Kerr ◽  
Ashley Stirling
Keyword(s):  
Gender Equity ◽  
Thematic Analysis ◽  
Mentoring Relationships ◽  
Future Research ◽  
Full Time ◽  
Structured Interviews ◽  
Part Time ◽  
Business Engineering ◽  
Female Coaches

Women remain underrepresented in the coaching domain across various levels of sport both in Canada and internationally. Despite the use of mentorship as a key strategy to support female coaches, little progress has been seen in achieving parity. At the same time, greater advances in gender equity have occurred in other non-sport sectors such as business, engineering, and medicine. The purpose of this study, therefore, was to learn from non-sport domains that have seen advances in gender equity to inform mentorship for women in coaching. A mixed-methods methodology was employed and consisted of distributing mentorship surveys to female coaches (n = 310) at various competitive levels, representing current (88%), former (12%), full-time (26%), part-time (74%), paid (54%), and unpaid (46%) coaching status. In addition, eight in-depth semi-structured interviews were also conducted with women in senior-level positions across various non-sport domains, including business (n = 1), media (n = 1), engineering (n = 2), higher education (n = 1), law (n = 1), and medicine (n = 2), regarding the role of mentorship in advancing women in their field. A descriptive and thematic analysis of the survey and interview data were conducted and findings are interpreted to suggest considerable variation in the characteristics of female coaches’ mentoring relationships, as well as the need to move beyond mentorship to sponsorship for advancing women in coaching. Recommendations for future research and advancing women in coaching are provided.

scholarly journals General practitioners’ concepts on issuing out-of-pocket prescriptions for hypnotics and sedatives in Germany

2019 ◽  
Vol 36 (6) ◽  
pp. 785-790
Author(s):  
Katharina Schmalstieg-Bahr ◽  
Christiane A Müller ◽  
Eva Hummers
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
General Practitioners ◽  
Statutory Health Insurance ◽  
Medication Use ◽  
Hypnotics And Sedatives ◽  
Structured Interviews ◽  
Medication Costs ◽  
Prescription Form ◽  
To Receive

Abstract Background In Germany, almost 50% of prescriptions for benzodiazepines and drugs as Zolpidem and Zopiclone are as out-of-pocket (OOP) prescriptions—requiring patients to buy the drug at their own expense—although almost 90% of the population has statutory health insurance covering medication costs. Objective To understand why general practitioners (GPs) choose this prescribing method since needed medications are insurance covered, and unnecessary drugs should not be prescribed at all. Methods In this qualitative study, 17 semi-structured interviews with GPs were conducted, audio recorded and transcribed verbatim. Transcripts were analysed with grounded theory to extract a model explaining the described behaviour. Results Knowing the significant medical risks and insecurity about regulations makes GPs wish to avoid hypnotics and sedatives. They achieve this by ‘Creating a barrier’ (central phenomenon) and employing the strategy ‘Using an out-of-pocket prescription’, which not only generates costs for the patient but also reduces the physicians´ legal and financial accountability. The perceived patient type, expected problem duration and diagnosis influence the decision about the prescription form: patients with an alcohol or drug addiction or those with ‘uncomplicated’ insomnia are more likely to receive an OOP prescription. Patients with any psychiatric diagnosis will likely receive a statutory health insurance prescription. Discussion Current regulations do not provide guidance to GPs regarding hypnotics and sedatives. A clear regulatory framework and guidelines could possibly reduce physicians’ defensive attitudes about these drugs and their use of OOP prescriptions. The approach to use OOP prescriptions as a barrier to reduce patients’ medication use lacks evidence regarding effectiveness.

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