Calling nurses to care for burn victims after color-dust explosion

2021 ◽  
pp. 096973302110032
Author(s):  
Yu-Lun Tsai ◽  
Tin Yi ◽  
Hsien-Hsien Chiang ◽  
Hsiang-Yun Lan ◽  
Hui-Hsun Chiang ◽  
...  
Keyword(s):  
Psychological Health ◽  
Ethical Dilemmas ◽  
Medical Center ◽  
Codes Of Ethics ◽  
Dust Explosion ◽  
Complex Spectrum ◽  
Structured Interviews ◽  
Disaster Victims ◽  
Burn Victims ◽  
Colaizzi's Method

Background: Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse–patient relationships. Aim: This study aimed to understand the experience of nurses who cared for burn victims of the color-dust explosion and the meaning of ethical relationships between nurse and patient. Research design: A qualitative descriptive study using a phenomenological approach. Participants and research context: Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling (N = 12) from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi’s method. Ethical considerations: This study was approved by the institutional review board of the study hospital. All participants provided written informed consent. Findings Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: (1) the calling must be answered, (2) the calling provoked my feelings, and (3) the calling called out my strengths. Conclusions: Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient–nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving.

Life Recovery After Disasters: A Qualitative Study in the Iranian Context

2013 ◽  
Vol 28 (6) ◽  
pp. 573-579 ◽  
Author(s):  
Hamidreza Khankeh ◽  
Maryam Nakhaei ◽  
Gholamreza Masoumi ◽  
Mohammadali Hosseini ◽  
Zohreh Parsa-Yekta ◽  
...  
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Qualitative Study ◽  
Psychological Health ◽  
Qualitative Content Analysis ◽  
Structured Interviews ◽  
Publication Type ◽  
Rehabilitation Process ◽  
Disaster Victims ◽  
Iranian Context

AbstractIntroductionPlanned and organized long-term rehabilitation services should be provided to victims of a disaster for social integration, economic self-sufficiency, and psychological health. There are few studies on recovery and rehabilitation issues in disaster situations. This study explores the disaster-related rehabilitation process.MethodThis study was based on qualitative analysis. Participants included 18 individuals (eight male and ten female) with experience providing or receiving disaster health care or services. Participants were selected using purposeful sampling. Data were collected through in-depth and semi-structured interviews. All interviews were transcribed and content analysis was performed based on qualitative content analysis.ResultsThe study explored three main concepts of recovery and rehabilitation after a disaster: 1) needs for health recovery; 2) intent to delegate responsibility; and 3) desire for a wide scope of social support. The participants of this study indicated that to provide comprehensive recovery services, important basic needs should be considered, including the need for physical rehabilitation, social rehabilitation, and livelihood health; the need for continuity of mental health care; and the need for family re-unification services. Providing social activation can help reintegrate affected people into the community.ConclusionEffective rehabilitation care for disaster victims requires a clear definition of the rehabilitation process at different levels of the community. Involving a wide set of those most likely to be affected by the process provides a comprehensive, continuous, culturally sensitive, and family-centered plan.KhankehH, NakhaeiM, MasoumiG, HosseiniM, Parsa-YektaZ, KurlandL, CastrenM. Life recovery after disasters: a qualitative study in the Iranian context. Prehosp Disaster Med. 2013;28(6):573-579.

Ethical Issues in Private Practice: A Phenomenological Investigation of Music Therapy Business Owners

2021 ◽  
Author(s):  
Kyle Wilhelm ◽  
Lindsey Wilhelm
Keyword(s):  
Music Therapy ◽  
Private Practice ◽  
Phenomenological Study ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
The United States ◽  
Business Owners ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Music Therapists

Abstract As a music therapy private practice is both a business and a healthcare service, it should adhere to ethical standards from both disciplines. However, this topic has rarely been examined in the music therapy literature. The purpose of this phenomenological study was to explore ethical dilemmas experienced by music therapy business owners (MTBOs) in their private practice and how MTBOs avoid or address ethical dilemmas. Utilizing convenience and snowball sampling techniques, 21 MTBOs in the United States were interviewed using semi-structured interviews. To answer the two areas of inquiry, we identified three themes and 12 subthemes: (1) Ethical issues related to client welfare, (2) Ethical issues related to business relationships and operation, and (3) Strategies to address or avoid ethical dilemmas. MTBOs also shared how they ensure ethical behavior in themselves, with their employees or independent contractors, and when interacting with professionals outside the private practice. These findings provide a better understanding of MTBOs’ lived experiences of ethics in their private practice and may benefit other music therapists who are in private practice or are wanting to go into private practice. Limitations and recommendations for further research are provided.

scholarly journals Evaluating interventions with victims of intimate partner violence: a community psychology approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cinzia Albanesi ◽  
Carlo Tomasetto ◽  
Veronica Guardabassi
Keyword(s):  
Intimate Partner Violence ◽  
Social Services ◽  
Psychological Health ◽  
Partner Violence ◽  
Process Model ◽  
Professional Training ◽  
Phenomenological Approach ◽  
Intimate Partner ◽  
Structured Interviews ◽  
The Impact

Abstract Purpose Intimate Partner Violence (IPV) is one of the most common forms of domestic violence, with profound implication for women's physical and psychological health. In this text we adopted the Empowerment Process Model (EPM) by Cattaneo and Goodman (Psychol Violence 5(1):84–94) to analyse interventions provided to victims of IPV by a Support Centre for Women (SCW) in Italy, and understand its contribution to women’s empowerment. Method We conducted semi-structured interviews with ten women who had been enrolled in a program for IPV survivors at a SCW in the past three years. The interviews focused on the programs’ aims, actions undertaken to reach them, and the impact on the women’s lives, and were analysed using an interpretative phenomenological approach. Results Results showed that the interventions provided by the SWC were adapted according to women's needs. In the early phases, women’s primary aim was ending violence, and the intervention by the SCW was deemed as helpful to the extent it provided psychological support, protection and safe housing. Women’s aims subsequently moved to self-actualisation and economic and personal independence which required professional training, internships, and social support. Although satisfying the majority of the women’s expectations, other important needs (e.g., economic support or legal services) were poorly addressed, and cooperation with other services (e.g., police or social services) was sometimes deemed as critical. Conclusions By evaluating a program offered by a SCW to IPV survivors through the lens of the EPM model, we found that women deemed the program as effective when both individual resources and empowerment processes were promoted. Strengths, limitations and implications are discussed.

scholarly journals Couples’ experiences with expanded carrier screening: evaluation of a university hospital screening offer

2021 ◽  
Author(s):  
Ivy van Dijke ◽  
Phillis Lakeman ◽  
Naoual Sabiri ◽  
Hanna Rusticus ◽  
Cecile P. E. Ottenheim ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Center ◽  
Informed Choice ◽  
Carrier Screening ◽  
University Hospital ◽  
Structured Interviews ◽  
Expanded Carrier Screening ◽  
Post Test ◽  
Future Child ◽  
Clinically Significant

AbstractPreconception carrier screening offers couples the possibility to receive information about the risk of having a child with a recessive disorder. Since 2016, an expanded carrier screening (ECS) test for 50 severe autosomal recessive disorders has been available at Amsterdam Medical Center, a Dutch university hospital. This mixed-methods study evaluated the experiences of couples that participated in the carrier screening offer, including high-risk participants, as well as participants with a general population risk. All participants received genetic counselling, and pre- (n = 132) and post-test (n = 86) questionnaires and semi-structured interviews (n = 16) were administered. The most important reason to have ECS was to spare a future child a life with a severe disorder (47%). The majority of survey respondents made an informed decision (86%), as assessed by the Multidimensional Measure of Informed Choice. Among the 86 respondents, 27 individual carriers and no new carrier couples were identified. Turn-around time of the test results was considered too long and costs were perceived as too high. Overall, mean levels of anxiety were not clinically elevated. High-risk respondents (n = 89) and pregnant respondents (n = 13) experienced higher levels of anxiety before testing, which decreased after receiving the test result. Although not clinically significant, distress was on average higher for carriers compared to non-carriers (p < 0.0001). All respondents would opt for the test again, and 80.2% would recommend it to others. The results suggest that ECS should ideally be offered before pregnancy, to minimise anxiety. This study could inform current and future implementation initiatives of preconception ECS.

Risky business: Reflections on critical performativity in practice

Organization ◽  
2018 ◽  
Vol 25 (3) ◽  
pp. 428-445 ◽  
Author(s):  
Nick Butler ◽  
Helen Delaney ◽  
Sverre Spoelstra
Keyword(s):  
Leadership Development ◽  
Business School ◽  
Ethical Dilemmas ◽  
Radical Change ◽  
Institutional Pressures ◽  
Structured Interviews ◽  
Academic Values ◽  
Critical Leadership ◽  
The Impact ◽  
Risky Business

Critical scholars in the business school are becoming increasingly concerned about the impact of their research beyond the confines of academia. This has been articulated most prominently around the concept of ‘critical performativity’. Drawing on semi-structured interviews with critical leadership scholars, this article explores how academics engage with practitioners at the same time as they seek to maintain a critical ethos in relation to their external activities. While proponents of critical performativity tend to paint a frictionless picture of practitioner engagement—which can take the form of consulting, coaching, and leadership development—we show how critical scholars may end up compromising their academic values in corporate settings due to practitioner demands and other institutional pressures. Taken together, these pressures mean that critical scholars often need to negotiate a series of (sometimes insoluble) dilemmas in practitioner contexts. We argue that the concept of critical performativity is unable to contend meaningfully with these tensions because it replicates the myth of the ‘heroic-transformational academic’ who is single-handedly able to stimulate critical reflection among practitioners and provoke radical change in organizations. We conclude with a call for further reflection on the range of ethical dilemmas that can arise during academic–practitioner engagement.

Patient Involvement in Anesthesia Decision-making: A Qualitative Study of Knee Arthroplasty

2021 ◽  
Author(s):  
Veena Graff ◽  
Justin T. Clapp ◽  
Sarah J. Heins ◽  
Jamison J. Chung ◽  
Madhavi Muralidharan ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Knee Arthroplasty ◽  
Patient Involvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
Shared Decision ◽  
Structured Interviews ◽  
Primary Knee Arthroplasty

Background Calls to better involve patients in decisions about anesthesia—e.g., through shared decision-making—are intensifying. However, several features of anesthesia consultation make it unclear how patients should participate in decisions. Evaluating the feasibility and desirability of carrying out shared decision-making in anesthesia requires better understanding of preoperative conversations. The objective of this qualitative study was to characterize how preoperative consultations for primary knee arthroplasty arrived at decisions about primary anesthesia. Methods This focused ethnography was performed at a U.S. academic medical center. The authors audio-recorded consultations of 36 primary knee arthroplasty patients with eight anesthesiologists. Patients and anesthesiologists also participated in semi-structured interviews. Consultation and interview transcripts were coded in an iterative process to develop an explanation of how anesthesiologists and patients made decisions about primary anesthesia. Results The authors found variation across accounts of anesthesiologists and patients as to whether the consultation was a collaborative decision-making scenario or simply meant to inform patients. Consultations displayed a number of decision-making patterns, from the anesthesiologist not disclosing options to the anesthesiologist strictly adhering to a position of equipoise; however, most consultations fell between these poles, with the anesthesiologist presenting options, recommending one, and persuading hesitant patients to accept it. Anesthesiologists made patients feel more comfortable with their proposed approach through extensive comparisons to more familiar experiences. Conclusions Anesthesia consultations are multifaceted encounters that serve several functions. In some cases, the involvement of patients in determining the anesthetic approach might not be the most important of these functions. Broad consideration should be given to both the applicability and feasibility of shared decision-making in anesthesia consultation. The potential benefits of interventions designed to enhance patient involvement in decision-making should be weighed against their potential to pull anesthesiologists’ attention away from important humanistic aspects of communication such as decreasing patients’ anxiety. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Women's perception of choice and support in making decisions regarding management of breech presentation

2021 ◽  
Vol 29 (7) ◽  
pp. 392-400
Author(s):  
Antonio Sierra
Keyword(s):  
Breech Presentation ◽  
Study Data ◽  
External Cephalic Version ◽  
Structured Interviews ◽  
Management Options ◽  
Lower Segment Caesarean Section ◽  
Postnatal Women ◽  
Phenomenological Research Design ◽  
Colaizzi's Method ◽  
Professional Guidelines

Background Professional guidelines recommend midwives and obstetricians actively involve women in making decisions about their care. To date, breech research has focused mainly on assessing the effectiveness of different management options. Aim This research explores women's experience of breech presentation and their perception of choice and support in making decisions with regards to breech management. Methods This study uses a phenomenological research design. Semi-structured interviews took place in hospital or women's homes. A total of six postnatal women who were diagnosed with breech presentation after 36 weeks' gestation took part in the study. Data was analysed using Colaizzi's method. Findings A total of 84 significant statements were clustered into four main emerging themes. These include women's feelings, their healthcare expectations, their preferences and their values. Results Breech discussions mostly occurred between obstetricians and women. These primarily focused on external cephalic version, Elective Lower Segment Caesarean Section and Breech Vaginal Birth. These options did not always become choices available to women.

scholarly journals Physicians as Advisors Not Leaders of Multidisciplinary Teams: A Qualitative Study of an Innovative Practice

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
Eliezer Mendelev ◽  
Madhu Mazumdar ◽  
Laurie Keefer ◽  
Ksenia Gorbenko
Keyword(s):  
Medical Home ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cost Savings ◽  
Leadership Role ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Home Team ◽  
Team Meetings ◽  
Physician Role

Abstract Background and Aims As various models of team-based chronic disease management have proliferated, physicians have assumed the leadership role in most of them. However, physician time is costly, and regular attendance of team meetings adds another task to a long list of responsibilities. This is the first study to explore the role of physicians as advisors rather than leaders of a multidisciplinary team. Methods We conducted an exploratory qualitative research study of a subspecialty medical home located within a tertiary academic medical center that cares for highly complex pediatric and adult patients with inflammatory bowel diseases. The medical home team consists of a psychologist, dieticians, social workers, a clinical pharmacist, and nurses. No physicians regularly attend team meetings. We conducted semi-structured interviews with nonphysician team members (N = 11) and gastroenterologists (N = 6). Two authors coded interview transcripts in NVivo 11 for themes related to “physician role” using an inductive qualitative analysis approach. Results Nonphysician participant believed gastroenterologists did not need to attend weekly meetings. Having only nonphysician personnel in the room made them feel more empowered to openly express their views. Gastroenterologists expressed interest in attending one or more, but not all meetings, in order to better understand the process of the team and desired a more formal feedback loop for staying informed about their patients’ progress. Conclusions Our findings suggest that gastroenterologist participation may not require regular attendance of team meetings. Team meeting consisting of nonphysician providers would result in cost savings and may empower nonphysician providers.

scholarly journals The Self-Management Experiences of Adolescents with Type 1 Diabetes: A Descriptive Phenomenology Study

2020 ◽  
Vol 17 (14) ◽  
pp. 5132
Author(s):  
Li-Chen Hung ◽  
Chu-Yu Huang ◽  
Fu-Sung Lo ◽  
Su-Fen Cheng
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Phenomenological Study ◽  
Medical Center ◽  
Self Management ◽  
Good Glycemic Control ◽  
Descriptive Phenomenology ◽  
Parental Assistance ◽  
Colaizzi's Method

Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi’s method. Four themes were identified: (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents’ misconceptions regarding self-management of diabetes.

Are you a spy? On the inconveniences of conventional methodology in terror wrap ethnography

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Asif Iqbal Dawar
Keyword(s):  
Design Methodology ◽  
Qualitative Data ◽  
Ethical Dilemmas ◽  
Codes Of Ethics ◽  
Process Approach ◽  
Research Experience ◽  
Content Type ◽  
Interview Method ◽  
Starting Point ◽  
Practical Implications

PurposeThe purpose of this paper is to explain the significance of contextually localized strategies and to engage researchers in critical reflection about the ethical dilemmas of researching in volatile situations.Design/methodology/approachBased on 14 months of research experience, the paper reflects on the challenges and difficulties in qualitative data collection through conventional methodology in dangerous fields.FindingsThe paper argues that conventional methodology and the established codes of ethics and their guidelines certainly provide a useful starting point but each dangerous setting requires different localized approaches whereas ethics need to be considered as a process approach.Practical implicationsThis paper not only suggests the significance of “intermittent interview method” and its effectivity but also the importance of “respondent pyramiding” and “mutual confidentiality” in a dangerous field.Originality/valueThe paper reflects on the original 14 months of ethnographic accounts which will add value to the existing literature on qualitative research in dangerously hazardous fields.

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