scholarly journals Strategies used by emergency care professionals to handle interpersonal difficulties with patients: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042362
Author(s):  
Philippe Charrier ◽  
Pauline Occelli ◽  
Karine Buchet-Poyau ◽  
Marion Douplat ◽  
Marine Delaroche-Gaudin ◽  
...  

ObjectivesIdentify the strategies implemented by emergency care professionals when facing tension and interpersonal violence from patients and their friends and family.DesignDescriptive qualitative study based on 38 semidirective interviews.ParticipantsDoctors, nurses, nursing assistants and administrative staff.SettingFour emergency departments (EDs) from three French university hospitals.ResultsAccording to the medical professionals interviewed, the difficulties that they encounter with patients or their accompanying family members can be explained by a lack of understanding of the functioning of EDs, by a general increase in individualistic behaviours leading to a lack of civility or by deviant behaviours (related to toxic substance abuse or mental illness). While managing deviant behaviours may sometimes require a collective intervention, ED staff also implement what are essentially individual communication strategies (with the use of rational explanation, seduction and empathy), confrontation or flight to deal with interpersonal difficulties.ConclusionsStrategies used by staff members tend to be individualised for the most part, and some, such as confrontational or escape strategies, may not be adapted to all situations. In the face of difficulties between staff and patients, mediators, specialised in resolving conflict, could entrust some cases to professionals.Trial registration numberClinicalTrials.gov Registry (NCT03139110).

2018 ◽  
Vol 86 (24) ◽  
Author(s):  
Débora Thaise Freires de Brito ◽  
Glenda Agra ◽  
Maria Vitória de Souza Medeiros ◽  
Irys Karla Cosmo Pereira ◽  
Elton de Lima Macedo ◽  
...  

O objetivo é compreender os sentimentos de enfermeiras no cuidado de pessoas com feridas neoplásicas durante arealização do curativo. Trata-se de um estudo exploratório, de natureza qualitativa, realizado com 20 enfermeirasassistenciais de um hospital filantrópico da Paraíba que presta cuidados a pacientes com doença oncológica avançada.Os dados foram coletados no período de abril a junho de 2016, por meio de entrevistas norteadas por um roteirosemiestruturado, após aprovação do Comitê de Ética em Pesquisa do Hospital Universitário Alcides Carneiro sob parecern.º 1.320.367 e analisadas por meio da Técnica de Análise do Conteúdo de Bardin. Os discursos apontaram sentimentospositivos e negativos, percebidos durante a realização dos curativos, onde o sentimento tristeza obteve o maiorpercentual de respostas. Evidenciou-se que as enfermeiras desenvolvem habilidades empáticas diante do sofrimento dopaciente, promovendo ações de solicitude com vistas ao conforto físico e psíquico do mesmo.Palavras-chave: Oncologia; Enfermagem Oncológica; Neoplasias Cutâneas. AbstractThe aim is to understand the nurses’ feelings in the care of people with neoplastic wounds during the dressing. This is anexploratory qualitative study carried out with 20 nursing assistants from a philanthropic hospital in Paraíba that providescare to patients with advanced cancer disease. The data were collected from April to June 2016, through interviewsguided by a semi-structured script, after approval of the Research Ethics Committee of the Alcides Carneiro UniversityHospital under opinion No. 1,320,367 and analyzed by means of the Technique of Bardin Content Analysis. The speechespointed to positive and negative feelings, perceived during the dressings accomplishment, where the sad feeling obtainedthe highest percentage of responses. It was evidenced that the nurses develop empathic abilities in the face of thepatient's suffering, promoting solicitude actions with a view to the physical and psychic comfort of the same.Keywords: Oncology; Oncological Nursing; Cutaneous Neoplasms


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Emma Toman ◽  
Claire Goddard ◽  
Frederick Berki ◽  
William Garratt ◽  
Teresa Scott ◽  
...  

Abstract INTRODUCTION Controversy exists as to whether telephone clinics are appropriate in neurosurgical-oncology. The COVID-19 pandemic forced neuro-oncology services worldwide to re-design and at the University Hospitals Birmingham UK, telephone clinics were quickly implemented in select patients to limit numbers of patients attending hospital. It was important to determine how these changes were perceived by patients. METHODS A 20-question patient satisfaction questionnaire was distributed to patients who attended neuro-oncology clinic in person (“face-to-face”), or via the telephone. Fisher’s exact test was used to determine significance, which was set at p< 0.05. RESULTS Eighty questionnaires were distributed between June 2020 and August 2020. Overall, 50% (n=40) of patients returned the questionnaire, 50% (n=23) of face-to-face and 50% (n=17) telephone patients. Of those who received telephone consultations, 88% (n=15) felt the consultation was convenient, 88% (n=15) were satisfied with their consultation and 18% (n=3) felt they would have preferred to have a face-to-face appointment. Of those who attended clinic in person, 96% (n=22) felt their consultation was convenient, 100% (n=23) were satisfied with their consultation and 13% (n=3) would have preferred a telephone consultation. Within the face-to-face clinic attendees, only 13% (n=3) were concerned regarding the COVID risk associated with attending hospital. There was no significant difference in patient convenience or satisfaction (p=0.565 and p=0.174 respectively) between face-to-face and telephone clinics. There was no significant difference in whether patients would’ve preferred the alternative method of consultation (p > 0.999). CONCLUSION Our study suggests that careful patient selection for neuro-oncology telephone clinic is not inferior to face-to-face clinic. Telephone clinic during COVID-19 pandemic proved to be convenient, safe and effective. This global health crisis has transformed telephone neuro-oncology consultations from an experimental innovation into established practice and should be continued beyond the pandemic in select cases.


Author(s):  
Nooreddine Iskandar ◽  
Tatiana Rahbany ◽  
Ali Shokor

Abstract Background: Due to the common instability caused by political and security issues, Lebanese hospitals have experienced acts of terrorism multiple times. The most recent Beirut Explosion even forced several hospitals to cease operations for the first time in decades—but studies show the preparedness levels for such attacks in similar countries are low. Objective: The aim of this study is to explore the experience of Lebanese hospitals with terrorist attacks. Methods: This qualitative study used semi-structured interviews with various stakeholders to assess their experience with terrorist bombings. Data was analyzed using the thematic analysis method. Results: The researchers found that Lebanese hospitals vary greatly in their structures and procedures. Those differences are a function of 3 contextual factors: location, culture, and accreditation status. Hospitals found near ‘dangerous zones’ were more likely to be aware and to have better response to such events. A severe lack of communication, unity of command, and collaboration between stakeholders has made the process fragmented. Conclusion: The researchers recommend a larger role for the Ministry of Public Health (MOPH) in this process, and the creation of a platform where Lebanese organizations can share their experiences to improve preparedness and resilience of the Lebanese healthcare system in the face of terrorism.


2020 ◽  
pp. 073401682095770
Author(s):  
Kate Kelly ◽  
Nai Soto ◽  
Nadi Damond Wisseh ◽  
Shaina A. Clerget

Although often left out of public health efforts and policy decisions, prisons, jails, and detention centers are integral to community health. With an average of 650,000 citizens returning home from prison each year in the United States, and thousands of correctional staff members returning home every night, there are millions of touchpoints between outside communities and carceral settings. For this reason, carceral communities should be central to planning and policy making in response to the spread of the COVID-19 illness. As social workers and clinicians, we are urgently concerned that efforts to prevent COVID-19 infections in prisons are underdeveloped and inadequate in the face of a fast-spreading virus. In this commentary, we outline a set of public health, policy, and clinical recommendations based upon the existing literature to mitigate various risks to the well-being of carceral communities.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033061
Author(s):  
Mark Lown ◽  
Christopher R Wilcox ◽  
Stephanie Hughes ◽  
Miriam Santer ◽  
George Lewith ◽  
...  

ObjectivesThere has been increased interest in screening for atrial fibrillation (AF) with commissioned pilot schemes, ongoing large clinical trials and the emergence of inexpensive consumer single-lead ECG devices that can be used to detect AF. This qualitative study aimed to explore patients’ views and understanding of AF and AF screening to determine acceptability and inform future recommendations.SettingA single primary care practice in Hampshire, UK.Participants15 participants (11 female) were interviewed from primary care who had taken part in an AF screening trial. A semistructured interview guide was used flexibly to enable the interviewer to explore any relevant topics raised by the participants. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.ResultsParticipants generally had an incomplete understanding of AF and conflated it with other heart problems or with raised blood pressure. With regards to potential drawbacks from screening, some participants considered anxiety and the cost of implementation, but none acknowledged potential harms associated with screening such as side effects of anticoagulation treatment or the risk of further investigations. The screening was generally well accepted, and participants were generally in favour of engaging with prolonged screening.ConclusionsOur study highlights that there may be poor understanding (of both the nature of AF and potential negatives of screening) among patients who have been screened for AF. Further work is required to determine if resources including decision aids can address this important knowledge gap and improve clinical informed consent for AF screening.Trial registration numberISRCTN 17495003.


2013 ◽  
Vol 5 (4) ◽  
pp. 374-381 ◽  
Author(s):  
Fanny Airosa ◽  
Torkel Falkenberg ◽  
Gunnar Öhlén ◽  
Maria Arman

2019 ◽  
Vol 32 (2) ◽  
pp. 228
Author(s):  
Juliane Regina Trevisol ◽  
Leonardo Da Silva ◽  
Raquel Carolina Ferraz D'Ely

Considering the growth of distance education, this qualitative study investigated learners’ perceptions of the implementation of traveling-themed tasks (ELLIS, 2003) in a virtual course of English as a foreign language.  The course was offered to university staff members for a semester. Four participants took part in it. Instruments were a consent form, two questionnaires, and a Skype interview. Results suggest learners perceived the course as motivating, noticing their task engagement from the perspective of “l’education integrale” (LONG, 2015) and “learning by doing”. Furthermore, learning was related to cultural aspects noticed, interesting sites, and the connection with previous traveling experiences.


2018 ◽  
Vol 103 (12) ◽  
pp. 1132-1137 ◽  
Author(s):  
Netty G P Bos-Veneman ◽  
Marrit Otter ◽  
Sijmen A Reijneveld

ObjectivesTo assess the effectiveness and potential side effects of formula feeding to reduce pain during vaccination among infants.Study designIn the setting of well-baby clinics we recruited a community-based sample of full-term born infants who were already formula fed by the choice of the parents (n=48, aged 4–10 weeks) and received their first DTaP-IPV-HepB-Hib and pneumococcal vaccinations and randomised them into two groups. To evaluate pain experienced during vaccination we compared infants who drank formula feeding before, during and after vaccination with infants who did not. Outcomes were observed cry duration and pain scores measured by means of the Neonatal Infant Pain Scale (NIPS) and the Face, Legs, Activity, Cry and Consolability (FLACC) scale. Side effects of drinking during vaccination were recorded. We performed intention-to-treat analyses using regression models, crude and adjusted for sex and age of the infant.ResultsPain at the moment of the second injection did not differ between groups. Drinking infants cried 33.5 s shorter (−56.6; −10.3). In the first minute after injection drinking infants experienced a faster pain reduction on the NIPSΔt: regression coefficient 3.86 (95% CI 2.70 to 5.02) and FLACCΔt: 4.42 (95% CI 2.85 to 5.99).ConclusionsIn line with findings of previous studies regarding breast feeding, formula feeding reduced vaccination pain in the recovery phase in full-term born infants receiving their first vaccinations between ages 4 and 10 weeks with no adverse effects. Professionals should discuss this non-costly and feasible pain-reducing intervention with parents of infants who receive vaccinations.Trial registration numberIRCTN 31383, post-results


2021 ◽  
Vol 27 (8) ◽  
pp. 1-8
Author(s):  
Chris Harvey ◽  
Simon Froggatt ◽  
Bryan Lightowler ◽  
Andrew Hodge

Background/Aims The demand from care homes on NHS services continues to rise, with little evidence of ambulance service contribution in this area. The Yorkshire Ambulance Service provides an advanced practitioner model to support care homes in Sheffield, as an alternative to calling 999. This study investigated the experiences and needs of the care home staff who use the ambulance service advanced practitioner model. Methods This qualitative study conducted semi-structured, face-to-face interviews with 19 staff members from 10 different care home settings. Thematic analysis using a combination of NVivo and manual coding was undertaken. Results The three key themes from the interviews were variations in service demand, the service user's expectations and experience, and benefits to residents. Participants reported that good community services reduced the need to call 999, empowering carers to support residents to remain in the community. Conclusions Care homes require comprehensive services that meet their needs. The advanced practitioner model provided by the ambulance service supports this, preventing unnecessary 999 calls and fitting with other community service provision.


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