The significance of small things for dignity in psychiatric care

2014 ◽  
Vol 22 (7) ◽  
pp. 754-764 ◽  
Author(s):  
Frode Skorpen ◽  
Arne Rehnsfeldt ◽  
Arlene Arstad Thorsen
Keyword(s):  
Psychiatric Care ◽  
Methodological Approach ◽  
Qualitative Interviews ◽  
Psychiatric Hospitals ◽  
Main Theme ◽  
Protection Agency ◽  
Staff Members ◽  
Regional Committee ◽  
Small Things ◽  
Medical Research Ethics

Background: This study is based on the ontological assumption about human interdependence, and also on earlier research, which has shown that patients in psychiatric hospitals and their relatives experience suffering and indignity. Aim: The aim of this study is to explore the experience of patients and relatives regarding respect for dignity following admission to a psychiatric unit. Research design: The methodological approach is a phenomenological hermeneutic method. Participants and research context: This study is based on qualitative interviews conducted with six patients at a psychiatric hospital and five relatives of patients who experienced psychosis. Ethical consideration: Permission was given by the Regional Committee for Medical Research Ethics in Western Norway, the Norwegian Data Protection Agency and all wards within the hospital in which the patients were interviewed. Findings: The analysis revealed one main theme: ‘The significance of small things for experiencing dignity’ and four subthemes described as follows - ‘to be conscious of small things’, ‘being conscious of what one says’, ‘being met’ and ‘to be aware of personal chemistry’. Discussion and conclusion: Staff members seem not to give enough attention to the importance of these small things. Staff members need to explore this phenomenon systematically and expand their own understanding of it.

"Jedes starre Konzept ist schlecht und passt net' in diese Welt"

2007 ◽  
Vol 37 (148) ◽  
pp. 369-381 ◽  
Author(s):  
Wolfgang Ludwig-Mayerhofer ◽  
Ariadne Sondermann ◽  
Olaf Behrend
Keyword(s):  
Public Management ◽  
New Public Management ◽  
Qualitative Interviews ◽  
Unemployed People ◽  
Staff Members ◽  
Public Employment Service ◽  
New Public ◽  
Recent Reform ◽  
The Unemployed ◽  
New Procedures

The recent reform of the Bundesagentur fijr Arbeit, Germany's Public Employment Service (PES), has introduced elements of New Public Management, including internal controlling and attempts at standardizing assessments ('profiling' of unemployed people) and procedures. Based on qualitative interviews with PES staff, we show that standardization and controlling are perceived as contradicting the 'case-oriented approach' used by PES staff in dealing with unemployed people. It is therefore not surprising that staff members use considerable discretion when (re-)assigning unemployed people to one of the categories pre-defined by PES headquarters. All in all, the new procedures lead to numerous contradictions, which often result in bewilderment and puzzlement on the part of the unemployed.

scholarly journals Gender and global health education, what is it about the Global South

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Atobrah
Keyword(s):  
Health Education ◽  
Global Health ◽  
Gender Stereotypes ◽  
Methodological Approach ◽  
Qualitative Interviews ◽  
Global South ◽  
Ethnographic Study ◽  
Cultural Issues ◽  
Research Participants ◽  
Global Health Education

Abstract Background International policy frameworks have strengthened advocacy for gender equality, as agreed in SDG 3. However, gender considerations in research and the related methodological approaches often focus on gender-oriented topics in the global North with little attention on gender perspectives in ostensibly neutral disciplines such as health, and with even less consideration in African societies. The aim is to illustrate how feminist research principles, sensitivity to gender relations and gender performance are cross-cutting and integral in the use of patient-centered methods, ethics and culture. Methods Material was taken from an ethnographic study based on in-depth qualitative interviews conducted with cancer patients in Accra, Ghana. Eight cases studies of women diagnosed of breast cancer, ovarian, endometrium or cervical cancer were selected for the present analysis. Results In highly gendered societies like Africa health research is shaped by the peculiar ethical considerations on gender and cultural issues. This leads to a situation where female researchers may have favourable opportunities for gathering qualitative material because of gender stereotypes. However, they face gendered expectations of their research participants during data collection periods, and this may provoke adverse reactions, if the researcher does not meet the expectations. Education into patient-centred methods, therefore, must strengthen competencies of health professionals to critically reflect their own gendered realities and confront masculinity and femininity reactions by research participants, while being culturally sensitive and ethical at the same time. Conclusions Advocacy for gender approaches in global health education is important but not sufficient. Action is needed to develop a methodological approach sensitive to the gendered conditions of patient-centred research in the Global South.

scholarly journals A systematic PRISMA review of individuals with autism spectrum disorder in secure psychiatric care: prevalence, treatment, risk assessment and other clinical considerations

2018 ◽  
Vol 8 (1) ◽  
pp. 58-79 ◽  
Author(s):  
Clare S. Allely
Keyword(s):  
Autism Spectrum Disorder ◽  
Psychiatric Care ◽  
Psychiatric Hospitals ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Bibliographic Databases ◽  
Future Research ◽  
Content Type ◽  
Secure Psychiatric Care

Purpose Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings. Design/methodology/approach Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Findings A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed. Originality/value To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings.

Prescribing practices in psychiatric hospitals in Eastern Europe

2011 ◽  
Vol 26 (7) ◽  
pp. 414-418 ◽  
Author(s):  
V. Jordanova ◽  
N.P. Maric ◽  
V. Alikaj ◽  
M. Bajs ◽  
T. Cavic ◽  
...  
Keyword(s):  
Eastern Europe ◽  
Western Europe ◽  
Atypical Antipsychotics ◽  
Psychiatric Care ◽  
Anticholinergic Drug ◽  
Psychiatric Hospitals ◽  
Evidence Based ◽  
Prescribing Practices ◽  
The Mean ◽  
Clinical Records

AbstractBackgroundThere has been no evidence about the prescribing practices in psychiatric care in Eastern Europe.AimsTo examine the patterns of psychotropic prescribing in five countries of Eastern Europe.MethodWe conducted a one-day census of psychiatric treatments used in eight psychiatric hospitals in Albania, Croatia, Macedonia, Serbia and Romania. We examined clinical records and medication charts of 1304 patients.ResultsThe use of polypharmacy was frequent across all diagnostic groups. Only 6.8% of patients were on monotherapy. The mean number of prescribed drugs was 2.8 (SD 0.97) with 26.5% receiving two drugs, 42.1% receiving three drugs and 22.1% being prescribed four or more psychotropic drugs. Typical antipsychotics were prescribed to 63% and atypical antipsychotics to 40% of patients with psychosis. Older generations of antidepressants were prescribed to 29% of patients with depression. Anxiolitic drugs were prescribed to 20.4% and benzodiazepines to 68.5% of patients. One third of patients received an anticholinergic drug on a regular basis.ConclusionsOlder generation antipsychotics and antidepressants were used more frequently than in the countries of Western Europe. Psychotropic polypharmacy is a common practice. There is a need for adopting more evidence-based practice in psychiatric care in these countries.

scholarly journals Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland

2022 ◽  
Vol 12 ◽  
Author(s):  
Julian Schwarz ◽  
Andrzej Cechnicki ◽  
Jan Godyń ◽  
Laura Galbusera ◽  
Daria Biechowska ◽  
...  
Keyword(s):  
Psychiatric Care ◽  
Qualitative Interviews ◽  
Hospital Services ◽  
Statistical Parameters ◽  
The Past ◽  
Specific Program ◽  
Welfare Institutions ◽  
Catchment Areas ◽  
Regional Population ◽  
Program Components

Background: The past decade has witnessed the establishment of flexible and integrative treatment (FIT) models in 55 German and Polish psychiatric catchment areas. FIT is based on a global treatment budget (GTB), which integrates funding of all acute psychiatric hospital services for a regional population. Prior research has identified 11 specific program components of FIT in Germany. In this paper we aim at assessing the applicability of these components to the Polish context and at comparatively analysing FIT implementation in Poland and Germany.Methods: Qualitative interviews about the applicability of the 11 FIT-specific components were conducted with the program managers of the Polish FIT models (n = 19). Semi-quantitative data on the FIT-specific components were then collected in 19 Polish and 10 German FIT models. We assessed the grading of each component, their overall degree of implementation and compared them between the two countries. In all study hospitals, structural and statistical parameters of service delivery were collected and compared.Results: The qualitative results showed that the German FIT-specific components are in principle applicable to the polish context. This allowed the comparative assessment of components grading and degree of implementation, which showed only subtle discrepancies between German and Polish FIT models. The little discrepancies point to specific aspects of care such as home treatment, peer support, and cooperation with non-clinical and social welfare institutions that should be further integrated in the components' definition.Conclusions: The specific program components of FIT as first defined from the German experience, serves as a powerful tool to measure, and evaluate implementation of integrated psychiatric care both within and between health systems.

scholarly journals Reflections on the ethical dilemmas involved in promoting self-management

2013 ◽  
Vol 21 (4) ◽  
pp. 402-413 ◽  
Author(s):  
Anne Lise Holm ◽  
Elisabeth Severinsson
Keyword(s):  
Older Persons ◽  
Ethical Dilemmas ◽  
Standard Of Care ◽  
Management Plan ◽  
Self Management ◽  
Healthcare Team ◽  
Main Theme ◽  
Team Members ◽  
Staff Members ◽  
Ethical Stance

Due to their understanding of self-management, healthcare team members responsible for depressed older persons can experience an ethical dilemma. Each team member contributes important knowledge and experience pertaining to the management of depression, which should be reflected in the management plan. The aim of this study was to explore healthcare team members’ reflections on the ethical dilemmas involved in promoting self-management among depressed older persons. A qualitative design was used and data were collected by means of focus group interviews. The results revealed one main theme: ‘Lack of trust in the community health care system’s commitment to bringing about effectiveness and change, based on three themes; ‘Struggling to ensure the reliable transfer of information about depressed older persons to professionals and family members’, ‘Balancing autonomy, care and dignity’ and ‘Differences in the understanding of responsibility’. Lack of engagement on the part of and trust between the various professional categories who work in the community are extremely counterproductive and have serious implications for patient dignity as well as safety. In conclusion, ethical dilemmas occur when staff members are unable to act in accordance with their professional ethical stance and deliver an appropriate standard of care.

scholarly journals Intellectual disability: an Italian perspective

2007 ◽  
Vol 4 (3) ◽  
pp. 73-74
Author(s):  
Giampaolo La Malfa ◽  
Pierluigi Cabras
Keyword(s):  
Intellectual Disability ◽  
Public Sector ◽  
Middle Ages ◽  
Psychiatric Care ◽  
Community Care ◽  
Psychiatric Hospitals ◽  
Before And After ◽  
The Middle Ages

Italy is a country that has a very long tradition, dating back to the Middle Ages, of offering assistance to people with all kinds of disabilities. The approach taken to intellectual disability in recent times can be divided into two periods: before and after the enactment of Law 180 in 1978. That law set in train a profound reform of Italy's public sector psychiatric care, which principally involved the closure of the psychiatric hospitals and the establishment of a system of community care.

scholarly journals INFORMATION MODEL OF THE ECOTOURISM TERRITORY OF THE CENTRAL PART IN THE EASTERN SAYAN

2021 ◽  
Vol 6 (3) ◽  
pp. 74-86
Author(s):  
D. Astanin
Keyword(s):  
Environmental Education ◽  
Social Space ◽  
Methodological Approach ◽  
Information Modeling ◽  
Main Theme ◽  
Information Flows ◽  
The Social ◽  
Responsible Attitude ◽  
Visitor Center ◽  
Eastern Sayan

In information modeling, it is important to determine the content, direction and form of information flows. Information flows of environmental education are formed in the visitor center, distributed across the territory of ecotourism and are aimed at forming an ecological mentality among various groups of visitors to the territory of ecotourism. The information system of environmental education and enlightenment, which forms a responsible attitude of tourists to their natural environment, is integrated into the tourist framework of the territory. The decomposition of the network of tourist routes in the Central part of Eastern Sayan made it possible to determine the field of influence of information centers and to identify the main characteristics: the general theme of expositions, environmental routes, a set of functions and architectural style. The territory of ecotourism is considered as a social space. The power of influence of information objects depends on their position in the social space, which is determined by the size of their social capital. The methodological approach to modeling the information content of the ecological and educational visit center is the concept of the social field of P. Bourdieu, where the ecological field seeks to maximize its influence. The institution that exerts this influence is the educational system. As a result, the author proposed a conceptual model of the environmental education system, the essence of which is that the content of the main theme of the visit center should correspond to its field of influence.

scholarly journals The Collective Agency of Language Teachers under the Scheme of Research Excellence: Using a social network approach

2020 ◽  
Vol 84 ◽  
pp. 13-25
Author(s):  
Jian Tao ◽  
Ke Zhao ◽  
Xiuwen Chen
Keyword(s):  
Social Network ◽  
Social Interactions ◽  
Methodological Approach ◽  
Qualitative Interviews ◽  
Language Teachers ◽  
Collective Agency ◽  
Chinese University ◽  
Complementary Resources ◽  
Social Network Approach ◽  
Development Of Language

This study adopted social network analysis (SNA) as a theoretical framework and methodological approach to understand the collective agency of a multilingual team of eight language teachers during their research practice in a Chinese university. As being guided by SNA that focuses on identifying social relationships and their impact, we used questionnaires and qualitative interviews to collect data and examine the emergence of collective agency. The data analysis revealed that the participants broke linguistic boundaries and engaged in cross-linguistic interactions. The findings further suggest that they offered complementary resources and emotional support for each other at individual, subgroup and group level. Based on the findings, this paper proposes a multi-layered understanding of collective agency to advance our knowledge of how to sustain collective agency. The findings point to the importance of addressing social interactions and relations in the emergence and enhancement of collective agency, so as to facilitate the professional development of language teachers.

scholarly journals How Do the Support Networks of Older People Influence Their Experiences of Social Isolation in Care Homes?

2021 ◽  
Vol 9 (4) ◽  
pp. 315-326
Author(s):  
Jennifer M. Ferguson
Keyword(s):  
Older People ◽  
Social Isolation ◽  
Qualitative Interviews ◽  
Care Home ◽  
Support Networks ◽  
Care Homes ◽  
Support Network ◽  
Staff Members ◽  
Egocentric Network

Understanding how to better support older people living in care homes is imperative for improving their wellbeing and quality of life. Despite this, little research has explored how support networks are structured and composed for individual residents. This study aimed to explore how, and by whom, residents felt they were supported, and how this support influenced their experiences of social isolation within the care home. The study included 36 residents from seven care homes located in the Scottish central belt in 2018. This article uses egocentric network analysis to analyse the structure and composition of the support networks, while a thematic analysis of qualitative interviews resulted in themes exploring how a resident’s support network impacts their social isolation within the care home. Findings indicated that residents’ most supportive alters were adult children, while staff members were only nominated as providing support in one third of support networks, despite most residents needing specialised care every day. Ambiguous relationships within residents’ support networks lead to feelings of social isolation, as well as adding to residents’ isolating behaviour. This suggests that national care frameworks, such as person‐centred care frameworks, which advocate for coordinated support between residents, relatives, and staff are not being implemented effectively and that more needs to be done to break down barriers to inclusion for care home residents.

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