Exploration of GP perspectives on deprescribing antidepressants: a qualitative study

ObjectiveOur aim was to explore general practitioners’ (GPs) perceptions and experiences of discontinuing antidepressants.Study designA qualitative study using semistructured interviews was undertaken between July 2019 and March 2020. The interviews were transcribed and analysed using a thematic analysis framework.SettingGPs affiliated with a university education and research network for general practice in Ireland.ParticipantsA purposive sample of GPs (n=10).ResultsFive themes emerged: shared decision-making; personalised therapy; medication-tapering toolkit; health service factors and concerns around tapering. GPs described being less likely to engage in deprescribing for patients with long-term and/or recurrent depression, older patients and those with comorbidities due to fear of relapse. Access to evidence-based psychological therapies, guidelines, information on rates of relapse, patient leaflets on discontinuing antidepressants and reminder prompts on GP-prescribing software were suggested to optimise appropriate antidepressant discontinuation. There was some suggestion that patients may use antidepressants for longer when talk therapy is not available or taken up.ConclusionsGPs are largely confident in their role of managing mild-to-moderate depression and deprescribing antidepressants. This study provides an insight into factors that influence GPs’ decisions to deprescribe antidepressants. More information on rates of relapse after discontinuation would be helpful to inform decision-making.

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Long COVID and the role of physical activity: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2020-047632 ◽

2021 ◽

Vol 11 (3) ◽

pp. e047632

Author(s):

Helen Humphreys ◽

Laura Kilby ◽

Nik Kudiersky ◽

Robert Copeland

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Lived Experience ◽

Well Being ◽

Telephone Interviews ◽

Semistructured Interviews ◽

The Usa ◽

The Uk ◽

Insight Into

ObjectivesTo explore the lived experience of long COVID with particular focus on the role of physical activity.DesignQualitative study using semistructured interviews.Participants18 people living with long COVID (9 men, 9 women; aged between 18–74 years; 10 white British, 3 white Other, 3 Asian, 1 black, 1 mixed ethnicity) recruited via a UK-based research interest database for people with long COVID.SettingTelephone interviews with 17 participants living in the UK and 1 participant living in the USA.ResultsFour themes were generated. Theme 1 describes how participants struggled with drastically reduced physical function, compounded by the cognitive and psychological effects of long COVID. Theme 2 highlights challenges associated with finding and interpreting advice about physical activity that was appropriately tailored. Theme 3 describes individual approaches to managing symptoms including fatigue and ‘brain fog’ while trying to resume and maintain activities of daily living and other forms of exercise. Theme 4 illustrates the battle with self-concept to accept reduced function (even temporarily) and the fear of permanent reduction in physical and cognitive ability.ConclusionsThis study provides insight into the challenges of managing physical activity alongside the extended symptoms associated with long COVID. Findings highlight the need for greater clarity and tailoring of physical activity-related advice for people with long COVID and improved support to resume activities important to individual well-being.

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Exploring novice Indian school counsellors’ experiences collaborating with teachers and administrators

Journal of Psychologists and Counsellors in Schools ◽

10.1017/jgc.2021.13 ◽

2021 ◽

pp. 1-15

Author(s):

Aashna Sadana ◽

Aneesh Kumar

Keyword(s):

School Climate ◽

Qualitative Study ◽

Thematic Analysis ◽

Training Programs ◽

Indian School ◽

School Counsellors ◽

Improved Outcomes ◽

Semistructured Interviews ◽

Collaboration Strategies

Abstract Previous studies have shown that collaboration between school counsellors and other stakeholders such as teachers and administrators leads to improved outcomes for students and a better school climate. The current qualitative study explored the experiences and perceptions of novice school counsellors in India regarding collaboration with teachers and administrators. The sample included 11 novice school counsellors working in five different cities who were recruited using purposive sampling. The thematic analysis of the data collected via semistructured interviews revealed six main themes: ‘Counsellors’ perceptions about collaboration’, ‘Collaboration with teachers’, ‘Collaboration with administrators’, ‘Challenges faced during collaboration’, ‘Strategies helpful in collaboration’ and ‘Impact of training’. Implications discussed include the need for school counsellors to advocate for their role, the need for training programs to prepare stakeholders for collaboration, and the need for policies to integrate the role of a school counsellor into schools.

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'To do or not to do'? The neurobiology of decision-making in daily life: I. Getting the basics

Dementia & Neuropsychologia ◽

10.1590/s1980-57642008dn10100003 ◽

2007 ◽

Vol 1 (1) ◽

pp. 10-17 ◽

Cited By ~ 1

Author(s):

André Palmini ◽

Victor Geraldi Haase

Keyword(s):

Decision Making ◽

Everyday Life ◽

Theory And Practice ◽

Moral Issues ◽

Temporal Perspective ◽

Prefrontal Cortical ◽

Cortical Regions

Abstract The constant conflict between decisions leading to immediate pleasurable consequences versus behaviors aiming at long-term social advantages is reviewed here in the framework of the evolutionary systems regulating behavior. The inescapable temporal perspective in decision-making in everyday life is highlighted and integrated with the role of the executive functions in the modulation of subcortical systems. In particular, the representations of the 'non-existent' future in the prefrontal cortical regions and how these representations can bridge theory and practice in everyday life are addressed. Relevant discussions regarding the battle between emotions and reasons in the determination of more complex decisions in the realm of neuroeconomics and in moral issues have been reserved for a second essay.

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Investigating sponsor decision-making: the role of schema theory, agency conflicts, and signaling theory in the persistence of naming rights agreements

International Journal of Sports Marketing and Sponsorship ◽

10.1108/ijsms-06-2019-0067 ◽

2020 ◽

Vol 21 (3) ◽

pp. 467-486 ◽

Cited By ~ 1

Author(s):

Jonathan A. Jensen ◽

David Head ◽

Christopher Mergy

Keyword(s):

Decision Making ◽

Schema Theory ◽

Agency Conflicts ◽

Data Set ◽

Content Type ◽

Naming Rights ◽

High Level ◽

Sport Facilities

PurposeNaming rights sponsorships of sport facilities are among the most highly visible marketing agreements in the world. However, factors that may lead one sponsorship to persist for decades, while others end after just a few years, have yet to be investigated. Thus, this study examines the decision-making of brand marketers by investigating the predictors of a sponsoring brand's decision to either continue or dissolve such agreements.Design/methodology/approachUtilizing a global data set of 219 naming rights agreements, an empirical approach is utilized to isolate whether a variety of factors increase or decrease the probability of sponsorship dissolution.FindingsResults indicate that agreements entered into with new, as of yet-unnamed facilities lead to a reduction in the probability of dissolution, with a high level of brand equity also reducing the probability of dissolution. Agency conflicts may also play a role, as the sponsoring firm being headquartered in the same metropolitan area as the facility also contributes to the persistence of such agreements.Originality/valueThese results are intended to assist both sides of what is ideally a long-term relationship in better understanding the factors that may either contribute to or inhibit longer-term partnerships.

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Tempering Expectations: A Qualitative Study of Prosecutorial Reform

Journal of Research in Crime and Delinquency ◽

10.1177/0022427820940739 ◽

2020 ◽

Vol 58 (1) ◽

pp. 41-73

Author(s):

Rebecca Richardson ◽

Besiki Luka Kutateladze

Keyword(s):

Decision Making ◽

Criminal Justice ◽

Qualitative Study ◽

Criminal Justice System ◽

Justice System ◽

Path Dependence ◽

Effective Implementation ◽

Semistructured Interviews ◽

Communication Challenges

Objectives: We investigate path dependence and barriers to the acceptance and implementation of reform-minded prosecution, which focuses on reducing unnecessary incarceration, promoting fairness, engaging with the community, and improving accountability in the criminal justice system. Method: Using semistructured interviews with 47 prosecutors in two Florida jurisdictions, both with newly elected state attorneys, we explore reform-minded prosecution priorities and barriers to their effective implementation. Results: Findings suggest that though reform-minded priorities are present in the study prosecutor’s offices, existing prosecutorial norms, case-focused decision-making, policy ambiguities, and communication challenges serve as barriers to their effective implementation. Conclusions: The study highlights the role that line agents play in determining the success of reform-minded prosecution. It also identifies key barriers to reform that reform-minded prosecutors must overcome if they are to achieve meaningful changes toward greater effectiveness, transparency, and impartiality in prosecution.

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Chronic disease management and dementia: a qualitative study of knowledge and needs of staff

Australian Journal of Primary Health ◽

10.1071/py18197 ◽

2019 ◽

Vol 25 (4) ◽

pp. 359 ◽

Cited By ~ 1

Author(s):

Chelsea Baird ◽

Marta H. Woolford ◽

Carmel Young ◽

Margaret Winbolt ◽

Joseph Ibrahim

Keyword(s):

Cognitive Impairment ◽

Chronic Disease ◽

Disease Management ◽

Qualitative Study ◽

Cognitive Abilities ◽

Chronic Disease Management ◽

Self Management ◽

Semistructured Interviews ◽

Management Approaches

Effective self-management is the cornerstone of chronic disease self-management. However, self-management of chronic disease in patients with comorbid dementia is particularly challenging. It is vital that clinicians, patients and carers work collaboratively to tailor self-management programs to each patient with dementia. This study aimed to identify barriers and facilitators of successful self-management in the context of cognitive impairment in order to optimise the capacity for self-management for persons with dementia (PWD). A qualitative study based on semistructured interviews was conducted in Victoria, Australia. Interviews were conducted with 12 people (employed in the ambulatory and dementia care sectors), representing six health services. Participants identified a healthcare system that is complex, not dementia friendly and not accommodating the needs of PWD who have comorbidities. Individual and systemic barriers contributed to ineffective self-management. Chronic disease support programs do not routinely undertake cognitive assessment or have guidelines for modified management approaches for those with cognitive impairment. Support needs to be long-term and requires a specialised skillset that recognises not only chronic disease management, but also the effect of cognition on self-management. Although formal guidelines are needed, care also needs to be tailored to individual cognitive abilities and deficits.

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Relationships Stretched Thin: Social Support Mobilization in Poverty

The Annals of the American Academy of Political and Social Science ◽

10.1177/0002716220911913 ◽

2020 ◽

Vol 689 (1) ◽

pp. 65-88

Author(s):

Miranda J. Lubbers ◽

Hugo Valenzuela García ◽

Paula Escribano Castaño ◽

José Luis Molina ◽

Antònia Casellas ◽

...

Keyword(s):

Social Support ◽

Network Size ◽

Support Networks ◽

Informal Networks ◽

Mixed Methods Design ◽

Income Volatility ◽

Poor Households ◽

Semistructured Interviews

Research on how the poor “make ends meet” typically shows that they are able to do so by relying on dense support networks of family and close friends. Recent research suggests, however, that these networks play a limited role. This article examines the role of informal networks in how sixty-one households in Barcelona, Spain, cope with poverty. We use a mixed-methods design that combines structured network delineation with semistructured interviews about the processes of support mobilization. Findings show a great variation in network size and resource capacity among households and in the kinds of ties that offer support. Social support was regarded as essential among members of poor households, but mobilized networks were often insufficient for covering even the most basic needs, and prolonged network mobilization could cause strain and long-term conflict. This analysis suggests that support networks may help people to cope with income volatility while simultaneously increasing the potential for social exclusion and isolation.

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How adolescents understand their values: A qualitative study

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104520964506 ◽

2020 ◽

pp. 135910452096450 ◽

Cited By ~ 1

Author(s):

Iona Lewis-Smith ◽

Laura Pass ◽

Shirley Reynolds

Keyword(s):

Decision Making ◽

Young People ◽

Qualitative Study ◽

Behaviour Change ◽

Thematic Analysis ◽

Personal Values ◽

Childhood And Adolescence ◽

Growing Up ◽

Individual Interviews ◽

Psychological Therapies

An important component of some psychological therapies is the use of clients’ values to motivate behaviour change. Values are understood to be developed during childhood and adolescence but there has been limited exploration of how young people experience values and their function across contexts. This study aimed to explore adolescents’ understanding of the concept of ‘values’ and to elicit their experiences of values. Semi-structured, individual interviews were conducted with 11 adolescents aged 12–17 years. Thematic analysis was used to identify themes. Young people were readily able to discuss the meaning of ‘values’ and their own personal values. Three main themes were identified: (1) what values are (in general, and specific to themselves), (2) where values come from (relationships, education, growing up), and (3) why values are important (prioritising/decision making, reflecting on values is helpful). The adolescents in this study demonstrated an in-depth understanding of the meaning, origins and functions of values. The results suggest young people may welcome and benefit from opportunities to discuss their values, including in therapy.

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