scholarly journals How congenital Zika virus impacted my child’s functioning and disability: a Brazilian qualitative study guided by the ICF

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038228
Author(s):  
Taynah Neri Correia Campos ◽  
Veronica Schiariti ◽  
Melissa Gladstone ◽  
Adriana Melo ◽  
Jousilene Sales Tavares ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Qualitative Study ◽  
Focus Groups ◽  
Social Services ◽  
Outcome Measures ◽  
Zika Virus ◽  
Extended Family ◽  
Northeastern Brazil ◽  
International Classification Of Functioning ◽  
The Impact

IntroductionThe Zika virus outbreak in Brazil has had devasting social, medical and financial consequences for families. Both researchers and clinicians are measuring longer-term outcomes to understand the impact of the Zika on child development, functioning and disability. Outcomes and tools used to measure them are very varied and we are unclear how meaningful they are to families and children. This study aimed to identify the parents’ perspectives on relevant areas of functioning and disability that should be included as outcome measures for children with congenital Zika syndrome (CZS), as guided by the International Classification of Functioning, Disability and Health (ICF).MethodsThis qualitative study included parents or caregivers of children aged 0–5 years with confirmed CZS from two states in northeastern Brazil. Interviews were conducted using focus groups. Content mapping followed the WHO’s ICF linking rules. Three raters analysed the content using NVivo V.11.ResultsThirty-two caregivers participated in six focus groups, 88% were mothers with an average age of 30 years. Most children were male (59%) and all were level V (severe) to on the Gross Motor Function Classification System (GMFCS). Overall, 825 themes were mapped to 36 ICF categories. Although parents mentioned areas across all ICF domains, they reported that areas of mobility, eating and recreation were most relevant for them. In addition, environmental factors were highly identified as barriers, specifically services, policies and access to assistive devices. The most predominant facilitators within the environment were; immediate family support, kind relationships with therapists and support from the extended family.ConclusionsAlthough parents emphasised issues related to mobility, their greatest concerns involved environmental factors, such as access and quality of health and social services, systems and policies. These results reinforce the importance of including parents’ perspectives when selecting or developing outcome measures for CZS.

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

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.

scholarly journals Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rachelle Ashcroft ◽  
Catherine Donnelly ◽  
Maya Dancey ◽  
Sandeep Gill ◽  
Simon Lam ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Focus Groups ◽  
Care Delivery ◽  
Virtual Care ◽  
Primary Care Teams ◽  
The Impact

Abstract Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.

Seeking Sanctuary: Exploring the Changing Postcolonial and Racialised Politics of Belonging in East London

2008 ◽  
Vol 13 (5) ◽  
pp. 102-116 ◽  
Author(s):  
Shamser Sinha
Keyword(s):  
Young People ◽  
Social Services ◽  
Extended Family ◽  
Political Context ◽  
Skin Colour ◽  
Local Resistance ◽  
Immigration Status ◽  
Far Right ◽  
The Impact

This paper explores the changing postcolonial and racialised politics of belonging in East London. In particular it draws on research with multi-sector professionals and 15 to 18 year old young separated migrants. Separated from parents, these teenagers include those who had applied for asylum and were living under social services care as ‘unaccompanied’ and those living with their extended family. It also includes separated migrants wanting sanctuary, but who had insecure immigration status because their asylum claim had failed, or because they had not yet applied for asylum and had no other visa status. The research focuses on healthcare issues and the broader life-situations of young separated migrants as a way to examine the changing politics of belonging in East London. Features of this politics include a rise in popularity of the Far Right, the impact of immigration and healthcare legislation and practice, and racial hostility. As well as looking at this, there is an exploration of resistance to this racialised political context by teenagers and certain professionals, and the struggle for a convivial multiculture that is a feature of their resistance. The argument here is that the changing racialised politics of belonging in East London: (1) show how underdevelopment, geo-political and postcolonial forces contribute to shaping local experiences of racism (2) sometimes involves, rather than aggressively targets, British citizens from NCWP (New Commonwealth and Pakistani) backgrounds and their descendants, as skin colour becomes less of an articulated symbol of ‘otherness’ than immigration status (3) therefore excludes ‘new migrants’ and especially those seeking sanctuary, such as the young people in this paper, from belonging (4) faces local resistance. However resistance to this politics might be better informed by a greater understanding of how postcolonialism shapes local racism and militates against a convivial multiculture, with sociology playing a role in accomplishing this

scholarly journals Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

2020 ◽  
Author(s):  
Rachel Louise King ◽  
Emily Wood ◽  
Steve Robertson ◽  
Tony Ryan ◽  
Angela Tod
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Personal Development ◽  
Group Discussion ◽  
Policy And Practice ◽  
The North ◽  
Previous State ◽  
Academic Workload ◽  
The Uk ◽  
The Impact

Abstract Background: The nursing associate role was developed in England in response to the ‘Shape of Caring’ review. It has been implemented to fulfil two aims; to bridge the gap between registered nurses and healthcare assistants, and to provide an alternative route into registered nursing in light of workforce shortages. Other high income countries deploy second level nurses within their healthcare systems, however the UK has a turbulent history with such roles. The previous state enrolled nurse was phased out in the 1990s, and more recently the assistant practitioner (AP) role has faced wide variation in titles, scope and pay. Little is known about those who have embarked on the new nursing associate training course and their experiences of the role. Methods: An exploratory qualitative study was undertaken using focus groups of trainee nursing associates to generate in-depth discussion about their motivations, experiences of training, and career aspirations.Three focus groups (n=15) took place in December 2018 using a purposive sample of trainee nursing associates registered at a University in the North of England. Two researchers facilitated each group discussion at a time and place convenient for participants. The discussions were audio recorded, transcribed and data was analysed thematically.Results: This study found that trainee nursing associates are motivated by affordable, local, career development. During training they face challenges relating to clinical support, academic workload and uncertainty about future career opportunities. They experience role ambiguity both individually and across the wider organisation. Trainee nursing associates rely on broad support networks to build their occupational identity.Conclusions: The barriers and facilitators of trainee nursing associate personal development have implications for policy and practice relating to recruitment and retention. The results increase our understanding of this emerging role, and have informed the development of a larger longitudinal cohort study. Further research is required to evaluate the impact of this new role.

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

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028693 ◽  
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.

scholarly journals Muslim immigrant men's and women's attitudes towards intimate partner violence

2017 ◽  
Vol 13 (4) ◽  
pp. 688-707 ◽  
Author(s):  
Marialuisa Gennari ◽  
Cristina Giuliani ◽  
Monica Accordini
Keyword(s):  
Intimate Partner Violence ◽  
Focus Groups ◽  
Partner Violence ◽  
Extended Family ◽  
Intimate Partner ◽  
Family Responsibilities ◽  
Deviant Behaviors ◽  
Muslim Immigrants ◽  
Gender Based ◽  
The Impact

This study aims to study the attitudes towards Intimate Partner Violence (IPV) in a group of Muslim immigrants. To this end, six focus-groups were conducted involving 42 first-generation Muslim immigrants (21 males and 21 females) from Pakistan, Egypt and Morocco. Focus groups transcripts were then analyzed using the software ATLAS.ti. Irrespectively of nationality, couples replicate relational models learnt in their country of origin, implying a rigid gender-based role division. Women are considered less socially competent if compared to men and therefore in need of protection. Divorce is possible only in case of severe danger: women have to stand beside their husbands and maintain family unity. Even though they are not directly related to IPV, these factors may be key in determining its onset and perpetration. With regards to ethnic background, Pakistani interviewees not only seem to acknowledge the possible occurrence of violence within couple relationships, they also accept it as a mean to regulate socially dysfunctional behaviors. Both Moroccan males and females denounce the impact of post migration stressors as potential triggers of IPV. The distance from one’s family of origin in migration is perceived as problematic by both men and women, however, while males’ distance from their kin might make them feel overwhelmed with family responsibilities and give way to deviant behaviors, women suffer from the lack of support and protection by their extended family. Implications for practice are also discussed.

scholarly journals Young people’s perspectives on patient-reported outcome measures in inflammatory arthritis: results of a multicentre European qualitative study from a EULAR task force

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001517
Author(s):  
Erika Mosor ◽  
Paul Studenic ◽  
Alessia Alunno ◽  
Ivan Padjen ◽  
Wendy Olsder ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Young People ◽  
Qualitative Study ◽  
Focus Groups ◽  
Outcome Measures ◽  
Inflammatory Arthritis ◽  
Positive Attitude ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported

IntroductionAlthough patient-reported outcome measures (PROMs) are increasingly used in clinical practice and research, it is unclear whether these instruments cover the perspective of young people with inflammatory arthritis (IA). The aims of this study were to explore whether PROMs commonly used in IA adequately cover the perspective of young people from different European countries.MethodsA multinational qualitative study was conducted in Austria, Croatia, Italy and the Netherlands. Young people with either rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), Still’s disease, psoriatic arthritis (PsA) or spondyloarthritis (SpA), aged 18–35 years, participated in semistructured focus group interviews. Thematic analysis was used and data saturation was defined as no new emergent concepts in at least three subsequent focus groups.ResultsFifty-three patients (21 with RA/JIA/Still’s, 17 with PsA, 15 with SpA; 72% women) participated in 12 focus groups. Participants expressed a general positive attitude towards PROMs and emphasised their importance in clinical practice. In addition, 48 lower level concepts were extracted and summarised into 6 higher level concepts describing potential issues for improvement. These included: need for lay-term information regarding the purpose of using PROMs; updates of certain outdated items and using digital technology for data acquisition. Some participants admitted their tendency to rate pain, fatigue or disease activity differently from what they actually felt for various reasons.ConclusionsDespite their general positive attitude, young people with IA suggested areas for PROM development to ensure that important concepts are included, making PROMs relevant over the entire course of a chronic disease.

scholarly journals Motivations, experiences and aspirations of Trainee Nursing Associates in England. A qualitative study

2020 ◽  
Author(s):  
Rachel Louise King ◽  
Tony Ryan ◽  
Emily Wood ◽  
Angela Tod ◽  
Steve Robertson
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Personal Development ◽  
Group Discussion ◽  
Policy And Practice ◽  
The North ◽  
Previous State ◽  
Academic Workload ◽  
The Uk ◽  
The Impact

Abstract BackgroundThe nursing associate role was developed in England in response to the ‘Shape of Caring’ review. It has been implemented to fulfil two aims; to bridge the gap between registered nurses and healthcare assistants, and to provide an alternative route into registered nursing in light of workforce shortages.Other high income countries deploy second level nurses within their healthcare systems, however the UK has a turbulent history with such roles. The previous state enrolled nurse was phased out in the 1990s, and more recently the assistant practitioner (AP) role has faced wide variation in titles, scope and pay. Little is known about those who have embarked on the new nursing associate training course and their experiences of the role.MethodsAn exploratory qualitative study was undertaken using focus groups of trainee nursing associates to generate in-depth discussion about their motivations, experiences of training, and career aspirations.Three focus groups (n=15) took place in December 2018 using a purposive sample of trainee nursing associates registered at a University in the North of England. Two researchers facilitated each group discussion at a time and place convenient for participants. The discussions were audio recorded, transcribed and data was analysed thematically.ResultsThis study found that trainee nursing associates are motivated by affordable, local, career development. During training they face challenges relating to clinical support, academic workload and uncertainty about future career opportunities. They experience role ambiguity both individually and across the wider organisation. Trainee nursing associates rely on broad support networks to build their occupational identity.ConclusionsThe barriers and facilitators of trainee nursing associate personal development have implications for policy and practice relating to recruitment and retention. The results increase our understanding of this emerging role, and have informed the development of a larger longitudinal cohort study. Further research is required to evaluate the impact of this new role.

scholarly journals Veteran families with complex needs: a qualitative study of the veterans’ support system

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Angela M. Maguire ◽  
Julieann Keyser ◽  
Kelly Brown ◽  
Daniel Kivlahan ◽  
Madeline Romaniuk ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Social Services ◽  
Support System ◽  
Care Coordination ◽  
Service Providers ◽  
Systems Of Care ◽  
Full Time ◽  
Complex Needs ◽  
Health And Wellbeing

Abstract Background Families with complex needs face significant challenges accessing and navigating health and social services. For veteran families, these challenges are exacerbated by interactions between military and civilian systems of care, and the density of the veterans’ non-profit sector. This qualitative study was designed to gather rich, detailed information on complex needs in veteran families; and explore service providers’ and families’ experiences of accessing and navigating the veterans’ support system. Methods The study comprised participant background questionnaires (n = 34), focus groups with frontline service providers (n = 18), and one-on-one interviews with veteran families (n = 16) in Australia. The semi-structured focus groups and interviews were designed to gather rich, detailed information on four study topics: (i) health and wellbeing needs in veteran families; (ii) service-access barriers and facilitators; (iii) unmet needs and gaps in service provision; and (iv) practical solutions for improving service delivery. The study recruited participants who could best address the focus on veteran families with complex needs. The questionnaire data was used to describe relevant characteristics of the participant sample. The focus groups and interviews were audio-recorded, transcribed, and a reflexive thematic analysis was conducted to identify patterns of shared meaning in the qualitative data. Results Both service providers and families found the veterans’ support system difficult to access and navigate. System fragmentation was perceived to impede care coordination, and delay access to holistic care for veteran families with complex needs. The medico-legal aspects of compensation and rehabilitation processes were perceived to harm veteran identity, and undermine health and wellbeing outcomes. Recovery-oriented practice was viewed as a way to promote veteran independence and self-management. Participants expressed a strong preference for family-centred care that was informed by an understanding of military lifestyle and culture. Conclusion The health and wellbeing needs of veteran families intensify during the transition from full-time military service to civilian environments, and service- or reintegration-related difficulties may emerge (or persist) for a significant period of time thereafter. Veteran families with complex needs are unduly burdened by care coordination demands. There is a pressing need for high-quality implementation studies that evaluate initiatives for integrating fragmented systems of care.

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