Violence against women during pregnancy and postpartum period: a mixed methods study protocol

IntroductionViolence against women is a public health problem that poses serious consequences for victims and their environments. The healthcare system struggles to assess this phenomenon during prenatal and postpartum care because of pregnant and postpartum women’s potential vulnerabilities. The research protocol presents the aims to evaluate the prevalence of violence, the period(s) in which it occurs, aggressors and forms it takes as well as to explore how violence against women is perceived among pregnant and postpartum women.Methods and analysisThis mixed methods study protocol uses an explanatory sequential design and is based on the establishment of meta-inferences that result from the combination of quantitative and qualitative approaches. Probabilistic sampling will be used to select the study participants: 584 women attending prenatal and/or postpartum care outpatient services at the University of Campinas Women’s Hospital, Brazil. The quantitative approach will consist of four validated questionnaires, and the qualitative approach will use focus groups that serve to deepen the understanding of participants’ views about the study topic. To create the focus groups, 72 study participants will be invited and divided into 6 groups (3 adolescents and 3 adults) based on age and pregnancy/postpartum condition. Descriptive analysis of sociodemographic characteristics and questionnaire results will be used to identify the prevalence and forms of violence experienced by women during the pregnancy-puerperal cycle, the relationships between women and their aggressors, and the existence of a history of violence. A bivariate and multivariate analysis will be performed to identify the association between sociodemographic factors and violence as an outcome. Qualitative data will be analysed through Grounded Theory to understand women’s perceptions of the phenomenon studied.Ethics and disseminationThe research protocol was approved by the Research Ethics Committee of the University of Campinas, Brazil number CAAE: 13426819.1.0000.5404. The results will be disseminated to the health science community.

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Tutor uncertainty in dealing with unprofessional behaviours of medical students and trainees: a mixed methods study

10.21203/rs.3.rs-55479/v1 ◽

2020 ◽

Author(s):

Dervla Kelly ◽

Diane O'Doherty ◽

Sarah Harney ◽

Natasha Slattery ◽

Louise Crowley ◽

...

Keyword(s):

Mixed Methods ◽

Medical Students ◽

Focus Groups ◽

Identity Formation ◽

Distinct Type ◽

Mixed Methods Study ◽

Medical Teacher ◽

Clinical Teachers ◽

Policies And Procedures ◽

The University

Abstract Background: Despite acknowledgement of medical students’ expected professional behaviours and attitudes, there remains widespread reluctance to report students that behave inappropriately. Existing literature focuses on why faculty fail to fail, overlooking the clinical teachers who deal with students day to day. We investigated how clinical teachers address inappropriate behaviours and attitudes in students and trainees.Methods: A mixed methods study was carried out consisting of a survey and two focus groups with clinical teachers. Seventeen clinical teachers from the at University of Limerick School of Medicine, Ireland, took part in the survey (n=22%) and eight clinical teachers participated in two focus groups during the 2018-2019 academic year.Results: Findings suggested that 59% of tutors would take a different approach in regards to professional identity formation (PIF) between addressing unprofessional behaviours witnessed in medical students and trainees. 88% of tutors said they intervened on a professionalism issue with 52% saying ‘once in a while’ In contrast to the survey, tutors in the focus groups expressed a lack of confidence in addressing some behaviors due to a lack of time, not seeing the outcome of process/remediation etc. Tutors indicated a strong preference for case-based training on assessing PIF.Conclusions: We found tutors typically work closely with students on a day-to-day basis and manage unprofessionalism issues. Clinical tutors valued regular communication about policies and procedures about appropriate conduct as well as support, advice and/or oversight from independent member of the university staff. This research also highlights the need for training designed for busy clinical tutors as a distinct type of medical teacher.

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An intervention to decrease burnout and increase retention of early career nurses: a mixed methods study of acceptability and feasibility

BMC Nursing ◽

10.1186/s12912-020-00524-9 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Judy Brook ◽

Leanne M. Aitken ◽

Julie-Ann MacLaren ◽

Debra Salmon

Keyword(s):

Mixed Methods ◽

Nursing Students ◽

Focus Groups ◽

Academic Staff ◽

Skills Training ◽

Early Career ◽

Mixed Methods Study ◽

Healthcare Organisation ◽

Structured Interviews ◽

Over Time

Abstract Aims To understand the experiences of nursing students and academic staff of an intervention to decrease burnout and increase retention of early career nurses, in order to identify acceptability and feasibility in a single centre. Background Internationally, retention of nurses is a persistent challenge but there is a dearth of knowledge about the perspectives of stakeholders regarding the acceptability and feasibility of interventions to resolve the issue. This study reports an intervention comprising of mindfulness, psychological skills training and cognitive realignment to prepare participants for early careers as nurses. Methods This is an explanatory sequential mixed methods study, conducted by a UK university and healthcare organisation. Participants were final year pre-registration nursing students (n = 74) and academics (n = 7) involved in the implementation of the intervention. Pre and post measures of acceptability were taken using a questionnaire adapted from the Theoretical Framework of Acceptability. Wilcoxon Signed Ranks test was used to assess change in acceptability over time. Qualitative data from semi-structured interviews, focus groups and field notes were thematically analysed, adhering to COREQ guidelines. Data were collected February to December 2019. Results One hundred and five questionnaires, 12 interviews with students and 2 focus groups engaging 7 academic staff were completed. The intervention was perceived as generally acceptable with significant positive increases in acceptability scores over time. Student nurses perceived the intervention equipped them with skills and experience that offered enduring personal benefit. Challenges related to the practice environment and academic assessment pressures. Reported benefits align with known protective factors against burnout and leaving the profession. Conclusion Planning is needed to embed the intervention into curricula and maximise relationships with placement partners. Evaluating acceptability and feasibility offers new knowledge about the value of the intervention for increasing retention and decreasing burnout for early career nurses. Wider implementation is both feasible and recommended by participants.

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BaSAlt — A mixed-methods study protocol on setting-based physical activity promotion and counseling in nursing homes

Contemporary Clinical Trials Communications ◽

10.1016/j.conctc.2021.100828 ◽

2021 ◽

pp. 100828

Author(s):

A. Thiel ◽

G. Sudeck ◽

A. Niess ◽

G.W. Eschweiler ◽

D. Altmeier ◽

...

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Nursing Homes ◽

Study Protocol ◽

Physical Activity Promotion ◽

Mixed Methods Study ◽

Activity Promotion

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A baseline mixed-methods study on postpartum care among health professionals in Tanzania

African Journal of Midwifery and Women s Health ◽

10.12968/ajmw.2017.11.3.115 ◽

2017 ◽

Vol 11 (3) ◽

pp. 115-122 ◽

Cited By ~ 2

Author(s):

Eunice Pallangyo ◽

Columba Mbekenga ◽

Pia Olsson ◽

Carina Källestål

Keyword(s):

Mixed Methods ◽

Health Professionals ◽

Postpartum Care ◽

Mixed Methods Study

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Characteristics of value-based health and social care from organisations’ perspectives (OrgValue): a mixed-methods study protocol

BMJ Open ◽

10.1136/bmjopen-2018-022635 ◽

2018 ◽

Vol 8 (4) ◽

pp. e022635 ◽

Cited By ~ 1

Author(s):

Lena Ansmann ◽

Hendrik Ansgar Hillen ◽

Ludwig Kuntz ◽

Stephanie Stock ◽

Vera Vennedey ◽

...

Keyword(s):

Mixed Methods ◽

Study Protocol ◽

Social Care ◽

Mixed Methods Study ◽

Health And Social Care

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Drivers of ‘clinically unnecessary’ use of emergency and urgent care: the DEUCE mixed-methods study

Health Services and Delivery Research ◽

10.3310/hsdr08150 ◽

2020 ◽

Vol 8 (15) ◽

pp. 1-256

Author(s):

Alicia O’Cathain ◽

Emma Knowles ◽

Jaqui Long ◽

Janice Connell ◽

Lindsey Bishop-Edwards ◽

...

Keyword(s):

General Practice ◽

Mixed Methods ◽

General Practitioner ◽

Health Service ◽

Health Services ◽

Focus Groups ◽

Emergency Departments ◽

Help Seeking ◽

Mixed Methods Study ◽

Coping Capacity

Background There is widespread concern about the pressure on emergency and urgent services in the UK, particularly emergency ambulances, emergency departments and same-day general practitioner appointments. A mismatch between supply and demand has led to interest in what can be termed ‘clinically unnecessary’ use of services. This is defined by the research team in this study as ‘patients attending services with problems that are classified as suitable for treatment by a lower urgency service or self-care’. This is a challenging issue to consider because patients may face difficulties when deciding the best action to take, and different staff may make different judgements about what constitutes a legitimate reason for service use. Objectives To identify the drivers of ‘clinically unnecessary’ use of emergency ambulances, emergency departments and same-day general practitioner appointments from patient and population perspectives. Design This was a sequential mixed-methods study with three components: a realist review; qualitative interviews (n = 48) and focus groups (n = 3) with patients considered ‘clinically unnecessary’ users of these services, focusing on parents of young children, young adults and people in areas of social deprivation; and a population survey (n = 2906) to explore attitudes towards seeking care for unexpected, non-life-threatening health problems and to identify the characteristics of someone with a tendency for ‘clinically unnecessary’ help-seeking. Results From the results of the three study components, we found that multiple, interacting drivers influenced individuals’ decision-making. Drivers could be grouped into symptom related, patient related and health service related. Symptom-related drivers were anxiety or need for reassurance, which were caused by uncertainty about the meaning or seriousness of symptoms; concern about the impact of symptoms on daily activities/functioning; and a need for immediate relief of intolerable symptoms, particularly pain. Patient-related drivers were reduced coping capacity as a result of illness, stress or limited resources; fear of consequences when responsible for another person’s health, particularly a child; and the influence of social networks. Health service-related drivers were perceptions or previous experiences of services, particularly the attractions of emergency departments; a lack of timely access to an appropriate general practitioner appointment; and compliance with health service staff’s advice. Limitations Difficulty recruiting patients who had used the ambulance service to the interviews and focus groups meant that we were not able to add as much as we had anticipated to the limited evidence base regarding this service. Conclusions Patients use emergency ambulances, emergency departments and same-day general practitioner appointments when they may not need the level of clinical care provided by these services for a multitude of inter-related reasons that sometimes differ by population subgroup. Some of these reasons relate to health services, in terms of difficulty accessing general practice leading to use of emergency departments, and to population-learnt behaviour concerning the positive attributes of emergency departments, rather than to patient characteristics. Social circumstances, such as complex and stressful lives, influence help-seeking for all three services. Demand may be ‘clinically unnecessary’ but completely understandable when service accessibility and patients’ social circumstances are considered. Future work There is a need to evaluate interventions, including changing service configuration, strengthening general practice and addressing the stressors that have an impact on people’s coping capacity. Different subgroups may require different interventions. Study registration This study is registered as PROSPERO CRD42017056273. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 15. See the NIHR Journals Library website for further project information.

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Burnout, resilience, and perception of mindfulness programmes among GP trainees: a mixed-methods study

BJGP Open ◽

10.3399/bjgpopen20x101058 ◽

2020 ◽

Vol 4 (3) ◽

pp. bjgpopen20X101058

Author(s):

Petra Hanson ◽

Amy Clarke ◽

Manuel Villarreal ◽

Majid Khan ◽

Jeremy Dale

Keyword(s):

Mixed Methods ◽

Focus Groups ◽

Help Seeking ◽

High Stress ◽

Mixed Methods Study ◽

Mindfulness Practice ◽

Negative Effects ◽

High Prevalence ◽

High Level ◽

And Coping

BackgroundTrainee GPs are at risk of developing burnout as a result of high stress levels. Improving resilience may prevent the negative effects of stress on wellbeing, morale, and patient care, thereby supporting recruitment to general practice.AimTo explore experiences of stress and burnout among GP trainees, and their level of interest in undertaking a mindfulness programme.Design & settingA qualitative study was performed with a cohort of GP trainees in Coventry and Warwickshire.MethodThis mixed-methods study utilised a survey with validated measures to investigate the prevalence of burnout, state of wellbeing, and resilience in GP trainees. Focus groups were also used to explore experiences of stress and burnout, and perceptions of mindfulness practice.ResultsIn total, 47 (response rate 39%) trainees completed the survey and 14 participated in focus groups. There was a high prevalence of disengagement (n = 36; 80%) and emotional exhaustion (n = 35; 77%), with 29 (64%) scoring above the cut-off value for both. While 16 (34%) reported already practising mindfulness, 39 (83%) described interest in engaging in mindfulness practice. The focus groups identified a range of issues relating to how trainees recognise stress and burnout, their help-seeking and coping strategies, the perceived barriers to practising self-care, and motivations for participating in mindfulness training.ConclusionThis study confirms the degree of stress and burnout that GP trainees experience, and their desire for greater wellbeing and resilience support. It identified a high level of interest in attending a mindfulness programme, but also barriers to engagement. Results of this research shaped the Mindful Practice Curriculum programme, which was later provided to this cohort of trainees.

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