Women’s experiences of ceasing to breastfeed: Australian qualitative study

ObjectiveTo investigate mothers’ infant feeding experiences (breastfeeding/formula milk feeding) with the aim of understanding how women experience cessation of exclusive breastfeeding.DesignMultimethod, qualitative study; questionnaire, focus groups and interviews.SettingNorthern and Southern Tasmania, Australia.Participants127 mothers of childbearing age from a broad sociodemographic context completed a questionnaire and participated in 22 focus groups or 19 interviews across Tasmania, 2011–2013.ResultsMothers view breastfeeding as ‘natural’ and ‘best’ and formula milk as ‘wrong’ and ‘unnatural’. In an effort to avoid formula and prolong exclusive breastfeeding, mothers will endure multiple issues (eg, pain, low milk supply, mastitis, public shaming) and make use of various forms of social and physical capital; resources such as father/partner support, expressing breast milk, bottles and dummies. The cessation of exclusive breastfeeding was frequently experienced as unexpected and ‘devastating’, leaving mothers with ‘breastfeeding grief’ (a prolonged sense of loss and failure).Conclusions and implicationsFor many mothers, the cessation of exclusive breastfeeding results in lingering feelings of grief and failure making it harmful to women’s emotional well-being. Reframing breastfeeding as a family practice where fathers/partners are incorporated as breastfeeding partners has the potential to help women negotiate and prolong breastfeeding. Proactive counselling and debriefing are needed to assist women who are managing feelings of ‘breastfeeding grief’.

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Receiving asylum seekers: Risks and resources of professionals

Health Psychology Open ◽

10.1177/2055102920920312 ◽

2020 ◽

Vol 7 (1) ◽

pp. 205510292092031 ◽

Cited By ~ 1

Author(s):

Caterina Gozzoli ◽

Amalia De Leo

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Asylum Seekers ◽

Well Being ◽

The North ◽

Professional Profile ◽

Increasing Risk ◽

Refugees And Asylum Seekers

This study focuses on the experiences of professionals working with refugees and asylum seekers in the North of Italy. In the last years, professionals who work in this sector have been exposed to an increasing risk of physical and emotional malaise because of the number of challenges they daily manage. A qualitative study has been conducted with the aim of exploring the resource and the fatigue factors of professionals, in relation to their state of well-being or discomfort. Eight focus groups with multi-professional teams were held in eight refugee centres, for a total of 28 professionals involved (16 males and 12 females). The results allowed the description of three different professional profile conditions: Fatigued, Idealizing and Engaged.

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Qualitative study exploring patients experiences of being diagnosed and living with primary bone cancer in the UK

BMJ Open ◽

10.1136/bmjopen-2018-028693 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028693 ◽

Cited By ~ 2

Author(s):

Ana Martins ◽

Jeremy S Whelan ◽

Lindsey Bennister ◽

Lorna A Fern ◽

Craig Gerrand ◽

...

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Lower Limb ◽

Social Life ◽

Bone Cancer ◽

Well Being ◽

Limb Amputation ◽

Primary Bone ◽

The Uk ◽

The Impact

ObjectiveThe aim of this study is to explore the experiences of patients with primary bone cancer.DesignQualitative study design using semistructured interviews and focus groups.SettingHospitals across the UK and recruitment through UK sarcoma charities and support groups.MethodsSemistructured telephone/face-to-face interviews and focus groups with a purposive sample of 26 participants. Data were analysed using Framework Analysis.ParticipantsPatients (n=26) with primary bone cancer aged 13–77 years. The majority were male (69%), white (85%); diagnosed within 4 years (54%); and had lower limb sarcoma (65%). Ten participants had undergone an upper/lower limb amputation (39%).ResultsThe health-related quality-of-life domains of physical, emotional and social well-being and healthcare professionals’ role were the overarching themes of analysis. The physical domain anchored patient experiences. The intensity and length of treatment, the severity of side-effects, the level of disability after surgery and the uncertainty of their prognosis had an impact on patient’s self-image, confidence, mood and identity, and caused disruption to various aspects of the patients’ social life, including their relationships (emotional and sexual) and participation in work/school and leisure activities. Adaptation was influenced by the way patients dealt with stress and adversity, with some finding a new outlook in life, and others struggling with finding their ‘new normal’. Family and friends were the main source of support. Healthcare professional’s expertise and support was critical. Rehabilitation services had a considerable role in patient’s physical and emotional well-being, but inequitable access to these services was apparent.ConclusionsThis study described the impact of primary bone cancer on patients’ well-being and adjustment over time with the identification of influencing factors of better/worse experiences. It showed that impact was felt after end of treatment and affected patients at different life stages. Holistic models of survivorship care are needed.

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Exploring the Perceived Barriers to Following a Mediterranean Style Diet in Childbearing Age: A Qualitative Study

Nutrients ◽

10.3390/nu10111694 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1694 ◽

Cited By ~ 9

Author(s):

Harriet Kretowicz ◽

Vanora Hundley ◽

Fotini Tsofliou

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Mediterranean Diet ◽

Maternal Obesity ◽

Information Source ◽

Perceived Barriers ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Nulliparous Women ◽

Practical Factors

A considerable amount of research has focused on interventions in pregnancy to promote health in current and future generations. This has yielded inconsistent results and focus has turned towards improving health in the preconception period. Promotion of healthy dietary patterns similar to a Mediterranean diet in the preconception years has been suggested as a dietary strategy to prevent maternal obesity and optimize offspring health. However, it is uncertain whether adoption is acceptable in women of childbearing age. This qualitative study aims to investigate the perceived barriers to following a Mediterranean diet in women of childbearing age. Semi-structured focus groups were used to generate deep insights to be used to guide the development of a future intervention. Nulliparous women aged between 20 and 47 years were recruited (n = 20). Six focus groups were digitally audio recorded and transcribed verbatim by the researcher. Thematic analysis was used to analyze data, which occurred in parallel with data collection to ascertain when data saturation was reached. Five core themes were identified: Mediterranean diet features, perceived benefits, existing dietary behavior and knowledge, practical factors, and information source. The present study highlights that a Mediterranean diet is acceptable to childbearing-aged women, and the insights generated will be helpful in developing an intervention to promote Mediterranean diet adoption.

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Patient, Caregiver, and Provider Perspectives on Challenges and Solutions to Individualization of Care in Hemodialysis: A Qualitative Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120970715 ◽

2020 ◽

Vol 7 ◽

pp. 205435812097071

Author(s):

Rachelle Sass ◽

Juli Finlay ◽

Krista Rossum ◽

Kaytlynn V. Soroka ◽

Michael McCormick ◽

...

Keyword(s):

Health Care ◽

Qualitative Study ◽

Focus Groups ◽

Health Care Providers ◽

Self Care ◽

Well Being ◽

Treatment Goals ◽

Care Providers ◽

Provider Perspectives ◽

Set Up

Background: Clinical settings often make it challenging for patients with kidney failure to receive individualized hemodialysis (HD) care. Individualization refers to care that reflects an individual’s specific circumstances, values, and preferences. Objective: This study aimed to describe patient, caregiver, and health care professional perspectives regarding challenges and solutions to individualization of care in people receiving in-center HD. Design: In this multicentre qualitative study, we conducted focus groups with individuals receiving in-center HD and their caregivers and semi-structured interviews with health care providers from May 2017 to August 2018. Setting: Hemodialysis programs in 5 cities: Calgary, Edmonton, Winnipeg, Ottawa, and Halifax. Participants: Individuals receiving in-center HD for more than 6 months, aged 18 years or older, and able to communicate in English were eligible to participate, as well as their caregivers. Health care providers with HD experience were recruited using a purposive approach and snowball sampling. Methods: Two sequential methods of qualitative data collection were undertaken: (1) focus groups and interviews with HD patients and caregivers, which informed (2) individual interviews with health care providers. A qualitative descriptive methodology guided focus groups and interviews. Data from all focus groups and interviews were analyzed using conventional content analysis. Results: Among 82 patients/caregivers and 31 health care providers, we identified 4 main themes: session set-up, transportation and parking, socioeconomic and emotional well-being, and HD treatment location and scheduling. Particular challenges faced were as follows: (1) session set-up: lack of preferred supplies, machine and HD access set-up, call buttons, bed/chair discomfort, needling options, privacy in the unit, and self-care; (2) transportation and parking: lack of reliable/punctual service, and high costs; (3) socioeconomic and emotional well-being: employment aid, finances, nutrition, lack of support programs, and individualization of treatment goals; and (4) HD treatment location and scheduling: patient displacement from their usual spot, short notice of changes to dialysis time and location, lack of flexibility, and shortages of HD spots. Limitations: Uncertain applicability to non-English speaking individuals, those receiving HD outside large urban centers, and those residing outside of Canada. Conclusions: Participants identified challenges to individualization of in-center HD care, primarily regarding patient comfort and safety during HD sessions, affordable and reliable transportation to and from HD sessions, increased financial burden as a result of changes in functional and employment status with HD, individualization of treatment goals, and flexibility in treatment schedule and self-care. These findings will inform future studies aimed at improving patient-centered HD care.

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Experiences and views of patients, carers and healthcare professionals on using modems in domiciliary non-invasive ventilation (NIV): a qualitative study

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2019-000510 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000510

Author(s):

Stephanie K Mansell ◽

Cherry Kilbride ◽

Martin J Wood ◽

Francesca Gowing ◽

Swapna Mandal

Keyword(s):

Clinical Practice ◽

Qualitative Study ◽

Focus Groups ◽

Healthcare Professionals ◽

Well Being ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Registration Number ◽

The Impact

BackgroundAdvances in technology means that domiciliary non-invasive ventilation (NIV) devices can be remotely monitored via modems in patients’ homes. Possible benefits and challenges of modem technology have yet to be established. This study explored the perspectives and experiences of patients, their carers and healthcare professionals (HCPs) on the addition of modem technology in managing home NIV.MethodsA qualitative study using a combination of focus groups for HCPs and interviews for carers/patients was undertaken. 12 HCPs and 22 patients/carers participated. These focus groups and interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsFive main themes were identified. ‘Surveillance: a paradox of findings’: HCPs were concerned about unduly scrutinising patients’ lives, potentially impacting on HCP patient relationships. Conversely, patients welcomed modem monitoring and did not express concerns regarding invasion of privacy. ‘Sanctions’: HCPs reported the modem increased access to care and allowed appropriate assessment of ongoing treatment. ‘Complacency and ethics’: HCPs expressed concerns patients may become complacent in seeking help due to expectations of modem monitoring, as well as being concerned regarding the ethics of modems. There was a suggestion patients and carers' expectations of monitoring were different to that of clinical practice, resulting in complacency in some cases. ‘Increased time for patient focused care’: HCPs in the focus groups described a number of ways in which using modems was more efficient. ‘Confidence: can be improved with technology’: patients and carers were positive about the impact of the modems on their health and well-being, particularly their confidence.ConclusionHCPs expressed concerns about surveillance were not corroborated by patients, suggesting acceptability of remote monitoring. Data suggests a need for increased clarity to patients/carers regarding clinical practice relating to responsiveness to modem data. The issue of complacency requires further consideration. Modem technology was acceptable and considered a useful addition by HCPs, patients and carers.Trial registration numberNCT03905382

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PERBEDAAN FREKUENSI DIARE ANTARA BAYI YANG DIBERI ASI EKSKLUSIF DENGAN BAYI YANG DIBERI SUSU FORMULA PADA RENTANG USIA 2- 4 BULAN DI WILAYAH KERJA PUSKESMAS KLATEN TENGAH

Biomedika ◽

10.23917/biomedika.v4i2.255 ◽

2012 ◽

Vol 4 (2) ◽

Author(s):

Putri Rahmitasari ◽

Burhannudin Ichsan ◽

Sahilah Ermawati

Keyword(s):

Public Health ◽

Breast Milk ◽

Infant Feeding ◽

Infant Formula ◽

Breast Feeding ◽

Exclusive Breastfeeding ◽

Formula Milk ◽

Cross Sectional ◽

Main Indicator ◽

Milk Feeding

The main indicator of public healths degree is infant mortility rate (IMR). One of the main things that cause infant mortility is diarrhea. The existence of diarrheas incidence in infants can be caused due to errors in the form of food other than breast milk feeding at the age of 4 months or the practise of infant feeding with formula milk (replacement feeding). This research was an observational analytic research with cross sectional approach. Samples obtained amounted to 80 respondents who are infants aged 2-4 months in various posyandu in the area of Central Klaten. This sample had fulfiilled the predetermined criteria. The research instrument used a questionnaire. for the result, there were 21 respondents of 80 respondents obtained who had diarrhea. Respondents of exclusive breastfeeding who had frequency of diarrhea is rarely as many as 5 babies, whereas 1 baby for often category. Respondents of infant formula who had frequency of diarrhea is rarely as many as 12 babies, whereas 3 babies for often category. There were significant differences between infants who were breastfed exclusively with formula-fed infants againts diarrhea frequency indicated by the value of p = 0,032.Keywords: Frequency of Diarrhea, Exclusive Breast Feeding, Formula Feeding Infant, Infants Aged 2-4 Months

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A Qualitative Study of the Mistreatment of Medical Students by Their Lecturers in Polish Medical Schools

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312271 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12271

Author(s):

Marta Makowska ◽

Joanna Wyleżałek

Keyword(s):

Medical Students ◽

Qualitative Study ◽

Focus Groups ◽

Well Being ◽

Medical Schools ◽

Self Esteem ◽

Verbal Abuse ◽

Grading System ◽

Not Given ◽

Negative Consequences

Objective: To describe experiences of mistreatment among Polish medical students. Methods: Nine focus groups were carried out with 92 students from three medical universities in Poland (in Gdansk, Krakow, and Warsaw). Results: The mistreatment of medical students included verbal abuse, disregard, and obstacles to pass exams. Students experienced humiliation, belittlement, insults, criticism, shouting, and indecent comments. The lecturers did not respect the students’ time; they did not show understanding for their absences; sometimes, they came to class unprepared while other times, they showed indifference regarding the well-being of students. Respondents stated that they were given enormous amounts material such that they found it far beyond their ability to learn; they were not given information about which textbooks were to be used; exams were incredibly detailed and difficult; and the grading system was unfair. In general, most students did not report the mistreatment. The respondents noticed the negative consequences of their mistreatment, which included a decrease in self-esteem and increased levels of anxiety and stress. This may translate into a lack of empathetic approach to patients. Conclusions: The phenomenon of the mistreatment of medical students requires more attention in Poland. It is important to raise awareness of the significant consequences of this.

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59. General medicine residents' perception of the mini-CEXs

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2820 ◽

2007 ◽

Vol 30 (4) ◽

pp. 61

Author(s):

S. Malhotra ◽

R. Hatala ◽

C.-A. Courneya

Keyword(s):

Internal Medicine ◽

Medical Education ◽

Focus Group ◽

Qualitative Study ◽

Focus Groups ◽

General Medicine ◽

Clinical History ◽

Phenomenological Approach ◽

Medical Teacher ◽

The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

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Perceived Facilitators and Barriers to Implementation of a Decision Support Tool for Adolescent Depression and Suicidality Screening: A Qualitative Study (Preprint)

10.2196/preprints.26035 ◽

2020 ◽

Author(s):

Ana Radovic ◽

Nathan Anderson ◽

Megan Hamm ◽

Brandie George-Milford ◽

Carrie Fascetti ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Qualitative Study ◽

Focus Groups ◽

Decision Support Tool ◽

Depression Screening ◽

Self Disclosure ◽

Support Tool ◽

Adolescent Parent ◽

Barriers To Implementation

BACKGROUND Screening Wizard (SW) is a technology-based decision support tool aimed at guiding primary care providers (PCPs) to respond to depression and suicidality screens in adolescents. Separate screens assess adolescents’ and parents’ reports on mental health symptoms, treatment preferences, and potential treatment barriers. A detailed summary is provided to PCPs, also identifying adolescent-parent discrepancies. The goal of SW is to enhance decision making to increase utilization of evidence-based treatments. OBJECTIVE We describe a multi-stakeholder qualitative study with adolescents, parents, and providers to understand potential barriers to implementation of SW. METHODS We interviewed 11 parents and 11 adolescents, and conducted 2 focus groups with 17 healthcare providers (PCPs, nurses, therapists, staff) across 2 pediatric practices. Participants described previous experiences with screening for depression and were shown a mock-up of SW and asked for feedback. Interviews and focus groups were transcribed verbatim, and codebooks inductively developed based on content. Transcripts were double-coded, and disagreements adjudicated to full agreement. Completed coding was used to produce thematic analyses of interviews and focus groups. RESULTS We identified five main themes across the interviews and focus groups: (1) parents, adolescents, and pediatric PCPs agree that depression screening should occur in pediatric primary care; (2) there is concern that accurate self-disclosure does not always occur during depression screening; (3) Screening Wizard is viewed as a tool that could facilitate depression screening, and which might encourage more honesty in screening responses; (4) parents, adolescents and providers do not want Screening Wizard to replace mental health discussions with providers; and (5) providers want to maintain autonomy in treatment decisions. CONCLUSIONS We identified that providers, parents, and adolescents all have concerns with current screening practices, mainly regarding inaccurate self-disclosure. They recognized value in SW as a computerized tool that may elicit more honest responses and identify adolescent-parent discrepancies. Surprisingly, providers did not want the SW report to include treatment recommendations, and all groups did not want the SW report to replace conversations with the PCP about depression. While SW was originally developed as a treatment decision algorithm, this qualitative study has led us to remove this component, and instead focus on aspects identified as most useful by all groups. We hope that this initial qualitative work will improve future implementation of SW.

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Older Adults’ Subjective Well-being Following an Exergame Intervention “Bandit the Dolphin”: Focus Group Findings

Innovation in Aging ◽

10.1093/geroni/igaa057.549 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 169-170

Author(s):

Brittany Drazich ◽

Breanna Crane ◽

Kyle Moored ◽

Karl Shieh ◽

Janiece Taylor ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Mental Illness ◽

Focus Groups ◽

Well Being ◽

Community Dwelling ◽

Mental Illness Stigma ◽

Subjective Well Being ◽

Future Health ◽

Adult Participants

Abstract Due to generational mental illness stigma and under diagnosis of mental illness, older adults do not always receive the mental health help that they need. One unique technology that has the potential to improve mood in older adults is exergames, or exercise video games. The objective of this sub-study (main study: Stimulation With Intricate Movements “SWIM” Study) was to explore older adults’ mood following an exergame intervention called “Bandit the Dolphin,” created by the Johns Hopkins KATA Studio. Researchers conducted three focus groups with 14 community-dwelling older adult participants who took part in the SWIM Study exergame intervention. The semi-structured focus groups were transcribed, coded, and analyzed using deductive and inductive techniques described by Ray Maietta’s “sort and sift, think and shift” method. Three themes related to playing “Bandit the Dolphin” and mood emerged. First, participants described their perceived association between activity and mood. Participants felt that both active and passive activities, “Bandit the Dolphin” and otherwise, improved their mood through the “fun” factor, and through feelings of achievement. Second, the participants described that the competition and frustration of playing “Bandit the Dolphin” increased eventual feelings of achievement. Third, participants described how feelings of immersion, or being absorbed in the game, helped them forget their other life concerns. These findings provide a better understanding of older adults’ perceived relationship between an exergame intervention, “Bandit the Dolphin,” and short-term improved mood. Future health and engineering researchers should explore exergames as a potential tool to improve the mental health of older adults.

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