scholarly journals Does midwifery-led care demonstrate care ethics: A template analysis

2021 ◽  
pp. 096973302110086
Author(s):  
Kate Buchanan ◽  
Elizabeth Newnham ◽  
Deborah Ireson ◽  
Clare Davison ◽  
Sara Bayes

Background: Ethical care in maternity is fundamental to providing care that both prevents harm and does good, and yet, there is growing acknowledgement that disrespect and abuse routinely occur in this context, which indicates that current ethical frameworks are not adequate. Care ethics offers an alternative to the traditional biomedical ethical principles. Research aim: The aim of the study was to determine whether a correlation exists between midwifery-led care and care ethics as an important first step in an action research project. Research design: Template analysis was chosen for this part of the action research. Template analysis is a design that tests theory against empirical data, which requires pre-set codes. Participants and context: A priori codes that represent midwifery-led care were generated by a stakeholder consultative group of nine childbearing women using nominal group technique, collected in Perth, Western Australia. The a priori codes were applied to a predesigned template with four domains of care ethics. Ethical considerations: Ethics approval was granted by the Edith Cowan University research ethics committee REMS no. 2019-00296-Buchanan. Findings: The participants generated eight a priori codes representing ethical midwifery care, such as: 1.1 Relationship with Midwife; 1.2 Woman-centred care; 2.1 Trust women’s bodies and abilities; 2.2. Protect normal physiological birth; 3.1. Information provision; 3.2. Respect autonomy; 4.1. Birth culture of fear (midwifery-led care counter-cultural) and 4.2. Recognition of rite of passage. The a priori codes were mapped to the care ethics template. The template analysis found that midwifery-led care does indeed demonstrate care ethics. Discussion: Care ethics takes into consideration what principle-based bioethics have previously overlooked: relationship, context and power. Conclusion: Midwifery-led care has been determined in this study to demonstrate care ethics, which suggest that further research is defensible with the view that it could be incorporated into the ethical codes and conduct for the midwifery profession.

Author(s):  
Muhammad Imran Yousuf ◽  
Muhammad Sarwar ◽  
Gareth Dart ◽  
Muhmmad Naseer-ud-Din

Peace has been recognized as a matter of education and to be promoted at the initial level.  The present study attempts to generate a profile of activities toward peace education among prospective teachers.  The Nominal Group Technique (NGT) was used by selecting fifteen prospective teachers as a Nominal Group (NG). NGT was applied under a sequence of stages (idea generating, selection, listing, clarification, ranking and consensus stages). Results generated from the NGT were organized into three categories of student-related activities, teacher-focused activities, and administration and community- related activities. Participants’ preferences were higher for activities that included individual practical participation. Participation in the Action Research process was ranked at the  bottom. Tentative conclusions are drawn with regard to teacher education and peace studies.


Author(s):  
Barend KLITSIE ◽  
Rebecca PRICE ◽  
Christine DE LILLE

Companies are organised to fulfil two distinctive functions: efficient and resilient exploitation of current business and parallel exploration of new possibilities. For the latter, companies require strong organisational infrastructure such as team compositions and functional structures to ensure exploration remains effective. This paper explores the potential for designing organisational infrastructure to be part of fourth order subject matter. In particular, it explores how organisational infrastructure could be designed in the context of an exploratory unit, operating in a large heritage airline. This paper leverages insights from a long-term action research project and finds that building trust and shared frames are crucial to designing infrastructure that affords the greater explorative agenda of an organisation.


2021 ◽  
Vol 2 ◽  
pp. 263348952110184
Author(s):  
Melissa R Hatch ◽  
Kristine Carandang ◽  
Joanna C Moullin ◽  
Mark G Ehrhart ◽  
Gregory A Aarons

Background: The successful implementation of evidence-based practices (EBPs) in real-world settings requires an adaptive approach and ongoing process evaluation and tailoring. Although conducting a needs assessment during the preparation phase of implementation is beneficial, it is challenging to predict all barriers to EBP implementation that may arise over the course of implementation and sustainment. This article describes a process evaluation that identified emergent and persistent barriers that impacted the implementation of an EBP across multiple behavioral health organizations and clinics. Methods: This study was conducted during the first cohort of a cluster randomized controlled trial testing the effectiveness of the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI) in substance use disorder treatment agencies and clinics. We used a modified nominal group technique (NGT) in which clinic leaders identified barriers faced during the implementation process. Barriers were categorized, then ranked and rated according to leaders’ perceptions of each barrier’s influence on implementation. The barriers were then contextualized through individual qualitative interviews. Results: Fifteen barriers were identified, grouped into staff-level barriers, management-level barriers, and implementation program barriers. Time and resistance to MI were rated as the most influential staff-level barriers. Among management-level barriers, time was also rated highest, followed by turnover and external contractual constraints. The most influential implementation barrier was client apprehension of recording for fidelity assessment and feedback. Individual interviews supported these findings and provided suggested adaptations for future implementation efforts. Conclusion: EBP implementation is an ongoing process whereby implementation strategies must be proactively and strategically tailored to address emergent barriers. This research described a process evaluation that was used to identify 15 emergent and/or persistent barriers related to staff, management, and the implementation program. Using implementation strategies that can be tailored and/or adapted to such emergent barriers is critical to implementation effectiveness. Plain Language Summary Unforeseen barriers often arise during the course of implementation. Conducting evaluations during implementation allows for tailoring the implementation strategy. As part of a larger study using the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI), we collected data from the first cohort of LOCI clinic leaders to identify barriers to MI implementation that persisted despite advanced planning and to understand unanticipated barriers that arose during implementation. Leaders identified 15 barriers faced during the implementation process that fell into three categories: staff-level barriers, management-level barriers, and implementation program barriers. The leaders ranked time as the most influential barrier at both the staff and management levels. Staff apprehension, resistance to MI implementation, and staff turnover were also of significant concern to leaders. Future implementation efforts may benefit from conducting a similar process evaluation during the implementation phase.


Foods ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1102
Author(s):  
Purificación García-Segovia ◽  
Mª Jesús Pagán-Moreno ◽  
Amparo Tárrega ◽  
Javier Martínez-Monzó

Sandwiches are the most common “casual-food” consumed by all age groups in Spain. Due to the importance of visual appearance to promote unplanned or impulse buying, foodservice and hospitality companies focus on improving the visual impression of their food menus to create an expectation that satisfies both sensory and hedonic consumer experiences. To provide a list of attributes about the visual appearance of sandwiches, 25 students were recruited from a university and were invited to participate in two nominal group technique (NGT) sessions. To understand whether a sandwiches’ appearance can influence the expectation of consumers, 259 participants completed an online survey specially designed from the results of the NGT sessions. Data were analyzed using conjoint, internal preference mapping and cluster analysis; the interaction effect by gender was also studied. The conjoint results indicate that visual perception about the filling (vegetal or pork based) plays the most key role overall in consumer expectation. When consumers choose vegetables as the filling, the consumers’ perceived sandwiches as healthier, but the pork filling was perceived as more attractive and satiating. Interaction effect by gender was observed in filling when females perceived pork filling as less healthy than vegetable. By acceptance, consumers were segmented into three groups. The first cluster (n = 80) selected the pork filling. The smaller group (cluster 3, n = 36) prioritized the vegetal filling, and the most numerous cluster 2 (n = 140) liked sandwiches with multigrain bread. These results may help companies to build tailor-made marketing strategies to satisfy consumer segments.


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