Sexuality and Intimacy Needs Within a Hospitalized Palliative Care Population: Results From a Qualitative Study

Author(s):  
Anne Kelemen ◽  
Clara Van Gerven ◽  
Katherine Mullins ◽  
Hunter Groninger

Background: Palliative care (PC) clinicians are well trained to address physical, psychosocial and spiritual needs of patients who have a serious illness. However, one area that is often overlooked is intimacy and sexuality. Objective: To explore patient concerns regarding intimacy as it relates to illness, family reactions, physician conversations, and coping strategies and challenges. Methods: Eligible subjects (at least 18 years old, capacitated, receiving PC consultation at the lead author’s institution) participated in semi-structured interviews between November and December 2017. Transcripts were open-coded and analyzed using Dedoose 3.5.35 software. A constant comparative method was used to identify patterns in the data. Results: 21 interviews were analyzed and several themes emerged. Participants described the effect of physical and mental/emotional changes on their relationships. Family relationships, romantic relationships, and sexuality were prominent in patients’ experiences of intimacy and how it changed as the illness progressed. Relationships were often noted to strengthen during the course of illness, while sexual activity was frequently reported to be negatively impacted. Patients consistently reported little provider communication on the impact of illness on intimacy beyond instructions about what sexual activities they could or could not engage in. Conclusion: This study underlines the significant impact of serious, progressive illness on relationships, sexuality, and physical and emotional intimacy. It highlights that these topics continue to be priorities for patients with serious illness, and that medical teams frequently fail to address them at all. Future research should further explore these issues across diverse patient populations.

2021 ◽  
pp. 1-6
Author(s):  
Alexa Gips ◽  
Bethany-Rose Daubman ◽  
Laura A. Petrillo ◽  
Jason Bowman ◽  
Kei Ouchi ◽  
...  

Abstract Objective To describe the perceived qualities of successful palliative care (PC) providers in the emergency department (ED), barriers and facilitators to ED–PC, and clinicians’ perspectives on the future of ED–PC. Method This qualitative study using semi-structured interviews was conducted in June–August 2020. Interviews were analyzed via a two-phase Rapid Analysis. The study's primary outcomes (innovations in ED–PC during COVID) are published elsewhere. In this secondary analysis, we examine interviewee responses to broader questions about ED–PC currently and in the future. Results PC providers perceived as successful in their work in the ED were described as autonomous, competent, flexible, fast, and fluent in ED language and culture. Barriers to ED–PC integration included the ED environment, lack of access to PC providers at all times, the ED perception of PC, and the lack of a supporting financial model. Facilitators to ED–PC integration included proactive identification of patients who would benefit from PC, ED-focused PC education and tools, PC presence in the ED, and data supporting ED–PC. Increased primary PC education for ED staff, increased automation, and innovative ED–PC models were seen as areas for future growth. Significance of results Our findings provide useful information for PC programs considering expanding their ED presence, particularly as this is the first study to our knowledge that examines traits of successful PC providers in the ED environment. Our findings also suggest that, despite growth in the arena of ED–PC, barriers and facilitators remain similar to those identified previously. Future research is needed to evaluate the impact that ED–PC initiatives may have on patient and system outcomes, to identify a financial model to maintain ED–PC integration, and to examine whether perceptions of successful providers align with objective measures of the same.


2020 ◽  
Vol 13 (1) ◽  
pp. 56
Author(s):  
Tino Herden

Purpose: Analytics research is increasingly divided by the domains Analytics is applied to. Literature offers little understanding whether aspects such as success factors, barriers and management of Analytics must be investigated domain-specific, while the execution of Analytics initiatives is similar across domains and similar issues occur. This article investigates characteristics of the execution of Analytics initiatives that are distinct in domains and can guide future research collaboration and focus. The research was conducted on the example of Logistics and Supply Chain Management and the respective domain-specific Analytics subfield of Supply Chain Analytics. The field of Logistics and Supply Chain Management has been recognized as early adopter of Analytics but has retracted to a midfield position comparing different domains.Design/methodology/approach: This research uses Grounded Theory based on 12 semi-structured Interviews creating a map of domain characteristics based of the paradigm scheme of Strauss and Corbin.Findings: A total of 34 characteristics of Analytics initiatives that distinguish domains in the execution of initiatives were identified, which are mapped and explained. As a blueprint for further research, the domain-specifics of Logistics and Supply Chain Management are presented and discussed.Originality/value: The results of this research stimulates cross domain research on Analytics issues and prompt research on the identified characteristics with broader understanding of the impact on Analytics initiatives. The also describe the status-quo of Analytics. Further, results help managers control the environment of initiatives and design more successful initiatives.


2021 ◽  
pp. 1-21
Author(s):  
Payge Lindow ◽  
Irene H. Yen ◽  
Mingyu Xiao ◽  
Cindy W. Leung

ABSTRACT Objective: Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design: Parents submitted photos around their families’ experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analyzed for thematic content using the constant comparative method. Setting: San Francisco Bay Area, California, USA. Subjects: 17 parents (14 mothers and 3 fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. Results: Four themes were identified from the parents’ photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviors. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt, and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. Conclusions: Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Austad ◽  
Michel Juarez ◽  
Hannah Shryer ◽  
Patricia L. Hibberd ◽  
Mari-Lynn Drainoni ◽  
...  

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.


Author(s):  
Kathleen R. Brazeal ◽  
Tanya L. Brown ◽  
Brian A. Couch

AbstractWhile formative assessments (FAs) can facilitate learning within undergraduate STEM courses, their impact likely depends on many factors, including how instructors implement them, whether students buy-in to them, and how students utilize them. FAs have many different implementation characteristics, including what kinds of questions are asked, whether questions are asked before or after covering the material in class, how feedback is provided, how students are graded, and other logistical considerations. We conducted 38 semi-structured interviews with students from eight undergraduate biology courses to explore how various implementation characteristics of in-class and out-of-class FAs can influence student perceptions and behaviors. We also interviewed course instructors to provide context for understanding student experiences. Using thematic analysis, we outlined various FA implementation characteristics, characterized the range of FA utilization behaviors reported by students, and identified emergent themes regarding the impact of certain implementation characteristics on student buy-in and utilization. Furthermore, we found that implementation characteristics have combined effects on student engagement and that students will tolerate a degree of “acceptable discomfort” with implementation features that contradict their learning preferences. These results can aid instructor reflection and guide future research on the complex connections between activity implementation and student engagement within STEM disciplines.


2020 ◽  
Vol 13 (6) ◽  
pp. 144 ◽  
Author(s):  
Ishaq Salim Al-Naabi

In light of contemporary pedagogical methods, the flipped classroom has been recognised as an effective pedagogy in English as a Foreign Language (EFL). This study employed a quasi-experimental one-group research design to investigate the impact of flipped learning on Omani EFL learners’ grammar and to examine students’ perceptions on the flipped classroom. An intact group of students (n=28) enrolled at the foundation programme in Arab Open University-Oman was randomly selected. Seven videos on English grammar were developed and shared with the students prior to the class. A varaiety of activities were conducted in the class following task-based language teaching. Students met for 8 lessons over the period of 8 weeks. Pre-test, post-test and semi-structured interviews were used in the study. The findings indicated that flipped learning had a positive impact on students’ understanding and usage of English grammar. Students’ perceptions on the flipped approach were positive. The study also provided pedagogical insights for the flipped classroom and recommendations for future research. 


10.28945/3703 ◽  
2017 ◽  
Vol 13 ◽  
pp. 037-057
Author(s):  
Kham Sila Ahmad ◽  
Jocelyn Armarego ◽  
Fay Sudweeks

Aim/Purpose: To develop a framework for utilizing Mobile Assisted Language Learning (MALL) to assist non-native English migrant women to acquire English vocabulary in a non-formal learning setting. Background: The women in this study migrated to Australia with varied backgrounds including voluntary or forced migration, very low to high levels of their first language (L1), low proficiency in English, and isolated fulltime stay-at-home mothers. Methodology: A case study method using semi-structured interviews and observations was used. Six migrant women learners attended a minimum of five non-MALL sessions and three participants continued on and attended a minimum of five MALL sessions. Participants were interviewed pre- and post-sessions. Data were analysed thematically. Contribution: The MALL framework is capable of enriching migrant women’s learning experience and vocabulary acquisition. Findings: Vocabulary acquisition occurred in women from both non-MALL and MALL environment; however, the MALL environment provided significantly enriched vocabulary learning experience. Future Research: A standardised approach to measure the effectiveness of MALL for vocabulary acquisition among migrant women in non-formal setting


The chapter underlines the importance of early involvement of the palliative care team to help patients to live better and longer. Palliative care is a multidisciplinary specialty and the role of community and inpatient nursing staff, physiotherapists, occupational therapists, psychologists, and the bereavement, chaplaincy, and medical teams are discussed. The chapter also covers where palliative care is delivered, which can be at home as well as in a hospice or a hospital. Advice is given on where and when medical students can learn the most from the palliative care team, from listening to one of the palliative care consultants take a history to observing the palliative care team prescribing anticipatory medications for the dying patient. Symptom control, including pain, nausea and vomiting, anorexia, constipation, diarrhoea, and breathlessness are also discussed. The chapter focuses not only on the patient and her/his psychological and spiritual needs but also on family members and carers who might also have their own needs. The chapter underlines the importance of communication skills in palliative care and how medical students should observe carefully in either the hospice or in hospital to learn from interactions that are difficult as well as the ones that go well.


2020 ◽  
Vol 19 ◽  
pp. 160940692094760
Author(s):  
Pablo A. Cantero-Garlito ◽  
Juan Antonio Flores-Martos ◽  
Pedro Moruno-Miralles

The general objective of this study is to describe and analyze the meanings that participants gave to the experience related to maternal caregiving activities of children with disabilities in the rural context and their impact on daily life and health. In order to achieve this general objective, the following specific objectives were established: (1) To describe the meanings given to experiences related to caregiving activities of children with disabilities; (2) To analyze the impact on daily life and health that these mothers attribute to those activities; (3) To describe how they experience the support provided by the social and healthcare system in rural areas. An interpretative paradigm was selected, using a qualitative approach and a phenomenological design. Twelve mothers were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was performed using open, axial, and selective coding processes and the constant comparative method.


2009 ◽  
Vol 18 (2) ◽  
pp. 01 ◽  
Author(s):  
Ping Wong ◽  
Patricia Duff ◽  
Margaret Early

This study is a qualitative exploration of the experiences of immigrants who completed a health care aide training program that combined occupational skills and ESL training. The focus was the employment barriers and personal benefits associated with program completion. Data were collected through structured interviews with nine participants, eight of whom were women, which were then transcribed and analyzed for central themes. The interview data were supplemented with document data consisting of information from application forms and intake assessment tests. The findings revealed that participation in the training program had a major impact on the employment, identities, and settlement of program participants. The skills and language training improved the employment prospects of the individuals, although many had to overcome such employment barriers as the need to work on call, conflicts between domestic responsibilities and work outside the home, and transportation limitations. Many participants also spoke of the importance of learning job-search skills and the personal significance of having an occupational identity. Finally, successful completion of the program increased the self-confidence and autonomy of the individuals, which in turn aided their settlement and integration into Canadian society. The article concludes with recommendations for future research in this area, as well as pedagogical interventions to assist participants with their ongoing language learning, job aspirations, and settlement.


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