scholarly journals Understanding non-vaccinating parents’ views to inform and improve clinical encounters: a qualitative study in an Australian community

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026299 ◽  
Author(s):  
Catherine Helps ◽  
Julie Leask ◽  
Lesley Barclay ◽  
Stacy Carter
Keyword(s):  
Health Professionals ◽  
Personal Experience ◽  
Vaccine Safety ◽  
Structured Interviews ◽  
Purposive Sampling ◽  
Clinical Encounters ◽  
High Prevalence ◽  
Australian Community ◽  
Real Truth ◽  
Regional Australia

ObjectivesTo explain vaccination refusal in a sample of Australian parents.DesignQualitative design, purposive sampling in a defined population.SettingA geographically bounded community of approximately 30 000 people in regional Australia with high prevalence of vaccination refusal.ParticipantsSemi structured interviews with 32 non-vaccinating parents: 9 fathers, 22 mothers and 1 pregnant woman. Purposive sampling of parents who had decided to discontinue or decline all vaccinations for their children. Recruitment via local advertising then snowballing.ResultsThematic analysis focused on explaining decision-making pathways of parents who refuse vaccination. Common patterns in parents’ accounts included: perceived deterioration in health in Western societies; a personal experience introducing doubt about vaccine safety; concerns regarding consent; varied encounters with health professionals (dismissive, hindering and helpful); a quest for ‘the real truth’; reactance to system inflexibilities and ongoing risk assessment.ConclusionsWe suggest responses tailored to the perspectives of non-vaccinating parents to assist professionals in understanding and maintaining empathic clinical relationships with this important patient group.

scholarly journals Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital

2013 ◽  
Vol 21 (4) ◽  
pp. 948-955 ◽  
Author(s):  
Flavio Hiroshi Shirama ◽  
Adriana Inocenti Miasso
Keyword(s):  
Clinical Practice ◽  
Quantitative Analysis ◽  
General Hospital ◽  
Health Professionals ◽  
Common Mental Disorders ◽  
Roman Catholicism ◽  
Structured Interviews ◽  
Psychiatric Drugs ◽  
High Prevalence ◽  
Benzodiazepine Drugs

PURPOSES: to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. METHOD: this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. RESULTS: there was confirmation of a high prevalence of users of psychiatric drugs, which was associated to the female sex, to people who do not practice Roman Catholicism, and admittance to the clinic not covered by the Single Health System (Sistema Único de Saúde - SUS), as well as the presence of common mental disorders. Benzodiazepine drugs were the most commonly used psychiatric drugs. Among the total number of users, there has been the identification of patients who were not aware that they were receiving such medication. Doctors who are not psychiatrists were responsible for most prescriptions of psychiatric drugs. CONCLUSIONS: this signals the need to prepare health professionals to deal with psychological and social problems commonly found in clinical practice, in order to promote the rational use of psychiatric drugs.

scholarly journals Who knows best? Negotiations of knowledge in clinical decision making

2015 ◽  
Author(s):  
Charlotte Bredahl Jacobsen ◽  
Helle Max Martin ◽  
Vibe Hjelholt Baker
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Patient Involvement ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Shared Decision ◽  
Structured Interviews ◽  
Knowledge Domains ◽  
Clinical Encounters

 This article examines the conflicts which arise when patients with chronic disease engage in decision making with health professionals about their medication. These are conflicts in the sense of discrepancies or incompatibilities between perceptions or opinions of different people engaged in a common endeavour. The paper is based on three qualitative research studies and presents one case from each study to illustrate analytical findings. Data collected in the original studies consisted of observations of clinical encounters and semi-structured interviews; in total 45 interviews with patients and 23 with health professionals. The analysis shows different conflicts, which arise during the process of making decisions about medication. These conflicts arise when: 1) Patients deliberately hold back information about their medication for fear of challenging clinicians’ authority; 2) The decision making process takes place in an environment, which does not support patient involvement; and 3) Patients refer to pharmacological knowledge, but are considered ill-equipped to understand and apply this knowledge by health professionals. The article shows that these conflicts typically revolve around the legitimate access to and use of pharmacological knowledge. These results have important implications for the current discussions of shared decision making. In shared decision making, knowledge about medication is typically regarded as the domain of the doctor. We argue that there is a need for a widening of the concept of partnership, which is central to shared decision making, to encompass breadth of patient knowledge about his/her situation, disease and treatment. Patients with chronic diseases need to be actively invited to disclose the extensive clinical knowledge they acquire over time, thereby creating a legitimate space for this knowledge in clinical consultations, and avoiding that conflicts over knowledge domains lead to unnecessary suffering and wasted resources.

DINAMIKA PSIKOLOGIS PADA MANTAN PECANDU NAPZA YANG SEDANG MENJALANI PROGRAM SUBSTITUSI ORAL METADON (STUDI KASUS)

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Wina Lova Riza
Keyword(s):  
Sampling Technique ◽  
Drug Addicts ◽  
Structured Interviews ◽  
Probability Sampling ◽  
Purposive Sampling ◽  
Case Study Analysis ◽  
Analysis Technique ◽  
Depth Interview ◽  
Psychological Dynamics ◽  
Depth Interviews

 This study aims to determine the psychological dynamics of former drug addicts, starting from drug abuse until they become addicted, deciding to stop using them. This study uses a qualitative approach, the subject or informant is determined using a non-probability sampling technique with a purposive sampling type based on predetermined criteria, which involves one informant, namely a male (F) aged 42 years. Data collection methods used in this study are in-depth interviews (in depth interviews), where researchers will interview informants with semi-structured interviews. In addition, researchers also used observation and psychological tests, which are graphic tests in the form of DAM (Draw a Man) and BAUM (tree drawing) tests, and intelligence tests using WAIS. The data analysis technique used is case study analysis of case / incident patterns. Based on the results of research F became a drug addict because of the learning process, where the enjoyment and lack of parental supervision is a reinforcement to continue using drugs. Generalization of people, places, pleasure makes it difficult for F to stop using drugs.   Keywords: Psychological Dynamics, Drug Addicts. Penelitian ini bertujuan untuk mengetahui dinamika psikologis mantan pecandu napza, dimulai dari awal menyalahgunan napza hingga menjadi kecanduan, memutuskan untuk berhenti memakai. Penelitian ini menggunakan pendekatan kualitatif, Subjek atau informan ditentukan dengan menggunakan tehnik sampling non-probability sampling dengan tipe purposive sampling berdasarkan kriteria yang telah ditentukan, yaitu melibatkan satu informan, yaitu laki-laki (F) yang berusia 42 tahun. Metode pengumpulan data yang digunakan dalam penelitian ini adalah dengan wawancara secara mendalam (in depth interview), dimana peneliti akan menwawancarai informan dengan wawancara semi terstruktur. Selain itu peneliti juga menggunakan observasi serta menggunakan tes-tes psikologi, yaitu tes grafis berupa tes DAM (Draw a Man) dan BAUM (tes menggambar pohon), serta tes inteligensi dengan menggunakan WAIS. Tehnik analisis data yang digunakan adalah menggunakan analisis studi kasus pola kasus/kejadian. Berdasarkan hasil penelitian F menjadi pecandu narkoba karena adanya proses belajar, dimana kenikmatan dan kurangnya pengawasan orang tua merupakan reinforcement untuk terus menggunakan napza. Adanya generalisasi terhadap people, place, pleasure menyebabkan F sulit untuk berhenti menggunakan napza. Kata Kunci: Dinamika Psikologis, Mantan Pengguna Napza

scholarly journals Post-stroke fatigue: an exploratory study with patients and health professionals to develop a patient-reported outcome measure

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ingrid Johansen Skogestad ◽  
Marit Kirkevold ◽  
Petra Larsson ◽  
Christine Råheim Borge ◽  
Bent Indredavik ◽  
...  
Keyword(s):  
Future Development ◽  
Health Professionals ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Post Stroke ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Initial Hospital

Abstract Background Post-stroke fatigue (PSF) is commonly reported and described as disabling by patients recovering from stroke. However, a major challenge is how to accurately diagnose and assess PSF. Therefore, the aim of this study was to explore PSF as it is experienced by stroke survivors and described by health professionals to guide future development of a PSF-specific PROM. Methods Individual semi-structured interviews were conducted with stroke survivors experiencing PSF (n = 9) and three focus groups were conducted with health professionals (n = 16). Data were analyzed through inductive content analysis. Results The analysis revealed four themes illustrating the experience and descriptions of PSF: 1) PSF characteristics, 2) interfering and aggravating factors, 3) management, and 4) PSF awareness, which refers to stroke survivors first becoming aware of PSF after their initial hospital admission. Conclusion This study highlights the complexity and multidimensionality of PSF. The results from this study will guide future development of a PSF-PROM and support its content validity.

scholarly journals POS0160-HPR THE CARE PROCESS OF HIP AND KNEE OSTEOARTHRITIS: GIVING AN ACCOUNT OF PATIENTS’ EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 292.2-293
Author(s):  
S. Battista ◽  
M. Manoni ◽  
A. Dell’isola ◽  
M. Englund ◽  
A. Palese ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Health Professionals ◽  
Emotional Experience ◽  
Functional Limitations ◽  
Care Quality ◽  
Care Process ◽  
Exact Science ◽  
Structured Interviews ◽  
Patients Experience

Background:The care process is often a complex and intimate process experienced by patients. Osteoarthritis (OA) care is usually characterised by multimodal interventions that consider the broader array of symptoms and functional limitations and often require a high level of patients’ compliance. Despite efforts to improve the quality of care of patients suffering from OA, and the publication of state-of-the-art clinical practice guidelines [1], the quality of the care process, as experienced by patients, seems to be suboptimal [2]. Hence, it is essential to investigate how patients experience this process to highlight potential elements that can enhance or spoil it to optimise the care quality.Objectives:To explore the patients’ experience of the received OA care process.Methods:Qualitative study, 10 semi-structured interviews were performed. The interview guide was created by a pool of healthcare professionals (physiotherapists, psychologists, nurses) and expert patients. It investigated the emotional experience, beliefs, expectations, perceived barriers and facilitators towards conservative treatments perceived by patients suffering from OA. The interviews lasted approximately one hour, were transcribed verbatim and analysed independently by two authors, who labelled their core parts to find categories and subcategories. A theme-based analysis was performed following an ecological paradigm, naturalistic epistemology, philosophy of phenomenological research.Results:Our analysis revealed 7 main categories with several subcategories (Fig. 1). 1) Uncertainty as some patients perceived treatment choice not to be based on medical evidence “there is an almost religious way of thinking on how to deal with the pathology. It is not an exact science when you choose the physicians you choose the treatment”. 2) Relationship with the self and the others as some patients did not feel understood or even shameful and hopeless about their condition. 3) Patients’ and Health Professionals’ beliefs about the pathology management where common thoughts were the perceived (ab)use of passive therapies, the movement as something dangerous and that OA is “something that you try to resist to, but (surgery) is your destiny”. 4) facilitators and 5) barriers of the adherence to therapeutic exercise that revolve around the cost of the therapy, the time needed and the willingness to change life habits. 6) Patients’ attitudes towards pathology in which the oldest patients perceive OA as “something I have to accept since I am getting old” and the youngest as “Something I have to fight”. 7) Relationship with food in which diet is seen as something that “you force yourself to follow” which is useful only to lose weight and not to preserve a high health status and where overeating is used “to eat your feelings”.Figure 1.Categories and Subcategories stemmed from the analysis of the patients’ interviewsConclusion:Patients suffering from hip and knee OA seem to experience an uncertain care process. The lack of clear explanations and the attitude towards conservative treatment, which is considered as “a pastime while waiting for surgery,” fosters the importance of providing patients with adequate information about the treatment, to shift their beliefs and improve their awareness. This will enhance a patient-centred and shared decision-making treatments.References:[1]Fernandes L, Hagen KB, Bijlsma JWJ, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann. Rheum. Dis. 2013;72:1125–35.[2]Basedow M, Esterman A. Assessing appropriateness of osteoarthritis care using quality indicators: a systematic review. J Eval Clin Pract 2015;21:782–9.Acknowledgements:This work is part of the project funded by EULAR Health Professionals Research Grant 2020.Disclosure of Interests:None declared

scholarly journals Associations between News Media Coverage of the 11 September Attacks and Depression in Employees of New York City Area Businesses

2021 ◽  
Vol 11 (3) ◽  
pp. 29
Author(s):  
Betty Pfefferbaum ◽  
Jayme M. Palka ◽  
Carol S. North
Keyword(s):  
New York ◽  
New York City ◽  
News Media ◽  
York City ◽  
Media Coverage ◽  
Structured Interviews ◽  
Mass Trauma ◽  
High Prevalence ◽  
General Populations ◽  
Disaster Trauma

Research has examined the association between contact with media coverage of mass trauma events and various psychological outcomes, including depression. Disaster-related depression research is complicated by the relatively high prevalence of the major depressive disorder in general populations even without trauma exposure. The extant research is inconclusive regarding associations between disaster media contact and depression outcomes, in part, because most studies have not distinguished diagnostic and symptomatic outcomes, differentiated postdisaster incidence from prevalence, or considered disaster trauma exposures. This study examined these associations in a volunteer sample of 254 employees of New York City businesses after the 11 September 2001, terrorist attacks. Structured interviews and questionnaires were administered 35 months after the attacks. Poisson and logistic regression analyses revealed that post-9/11 news contact significantly predicted the number of postdisaster persistent/recurrent and incident depressive symptoms in the full sample and in the indirect and unexposed groups. The findings suggest that clinical and public health approaches should be particularly alert to potential adverse postdisaster depression outcomes related to media consumption in disaster trauma-unexposed or indirectly-exposed groups.

scholarly journals Oral health promotion practices of Australian community mental health professionals: a cross sectional web-based survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Roisin McGrath ◽  
Rodrigo Marino ◽  
Julie Satur
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Oral Health ◽  
Community Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Oral Health Promotion ◽  
Mental Health Consumers ◽  
Australian Community ◽  
Health Support

Abstract Background This study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI). Methods An anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants’ self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher’s exact and Mann–Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers. Results A total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed (‘Agreed’ or ‘Strongly agreed’) that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, ‘lack of consumer interest’ was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25–9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629–10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77–8.65, p = 0.001). Conclusion The results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.

Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Early Career ◽  
Evidence Based ◽  
Structured Interviews ◽  
Early Career Psychologists ◽  
University Training

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.

scholarly journals Changing relationships: how does patient involvement transform professional identity? An ethnographic study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045520
Author(s):  
Marie-Pierre Codsi ◽  
Philippe Karazivan ◽  
Ghislaine Rouly ◽  
Marie Leclaire ◽  
Antoine Boivin
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Health Professionals ◽  
Clinical Care ◽  
Ethnographic Study ◽  
Structured Interviews ◽  
Administrative Team ◽  
Nurse Clinician ◽  
New Perspective ◽  
Relational Framework

ObjectivesTo understand identity tensions experienced by health professionals when patient partners join a quality improvement committee.DesignQualitative ethnographic study based on participatory observation.SettingAn interdisciplinary quality improvement committee of a Canadian urban academic family medicine clinic with little previous experience in patient partnership.ParticipantsTwo patient partners, seven health professionals (two family physicians, two residents, one pharmacist, one nurse clinician and one nurse practitioner) and three members of the administrative team.Data collectionData collection included compiled participatory observations, logbook notes and semi-structured interviews, collected between the summer of 2017 to the summer of 2019.Data analysisGhadiri’s identity threats theoretical framework was used to analyse qualitative material and to develop conceptualising categories, using QDA Miner software (V.5.0).ResultsAll professionals with a clinical care role and patient partners (n=9) accepted to participate in the ethnographic study and semi-structured interviews (RR=100%). Transforming the ‘caregiver–patient’ relationship into a ‘colleague–colleague’ relationship generated identity upheavals among professionals. Identity tensions included competing ideals of the ‘good professional’, challenges to the impermeability of the patient and professional categories, the interweaving of symbols associated with one or the other of these identities, and the inner balance between the roles of caregiver and colleague.ConclusionThis research provides a new perspective on understanding how working in partnership with patients transform health professionals’ identity. When they are called to work with patients outside of a simple therapeutic relationship, health professionals may feel tensions between their identity as caregivers and their identity as colleague. This allows us to better understand some underlying tensions elicited by the arrival of different patient engagement initiatives (eg, professionals’ resistance to working with patients, patients’ status and remuneration, professionals’ concerns toward patient ‘representativeness’). Partnership with patients imply the construction of a new relational framework, flexible and dynamic, that takes into account this coexistence of identities.

Teaching Vaccine Safety Communication to Medical Students and Health Professionals

2015 ◽  
Vol 10 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Barbara Rath ◽  
Susann Muhlhans ◽  
Gerhard Gaedicke
Keyword(s):  
Medical Students ◽  
Health Professionals ◽  
Vaccine Safety ◽  
Safety Communication
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