scholarly journals Caring for children – ‘24-7’: The experience of WellChild Nurses and the families for whom they are providing care and support

2018 ◽  
Vol 23 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Mark Whiting
Keyword(s):  
Decision Making ◽  
Clinical Care ◽  
Structured Interviews ◽  
Care Needs ◽  
Out Of Hours ◽  
Care And Support ◽  
Study Participants ◽  
Clinical Problems ◽  
Insight Into

There is a growing population of children with complex health needs and disabilities who are being cared for at home by their parents 24 hours per day, 7 days per week. Community Children’s Nursing Teams are a major source of support to these children. In 2006, the charity WellChild introduced the first WellChild Nurse (WCN) post specifically focused upon this group of children. In order to gain insight into how the WCN model was supporting this group of children throughout the 24-hour day, semi-structured interviews were undertaken with 12 WCNs and 10 parents of children with a range of long-term clinical care needs. Analysis of the interviews from both groups of study participants revealed complex patterns of decision-making by parents when seeking support and advice particularly ‘out of hours’. This related to four key questions: ‘Why call?’, ‘When to call?’, ‘Who to call?’ and ‘How to call?’. Parents identified how, as a result of the support provided by the WCNs, they are able to draw upon a range of decision-making skills and algorithms that enhance their ability to troubleshoot both clinical and non-clinical problems throughout the 24-hour day.

A Bird in the Hand Isn’t Good for Long

2018 ◽  
Vol 65 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Stefan Scherbaum ◽  
Simon Frisch ◽  
Maja Dshemuchadse
Keyword(s):  
Decision Making ◽  
Cognitive Control ◽  
The Other ◽  
Decision Task ◽  
Short Term ◽  
Additional Time ◽  
Control Processes ◽  
Folk Wisdom ◽  
Study Participants ◽  
Insight Into

Abstract. Folk wisdom tells us that additional time to make a decision helps us to refrain from the first impulse to take the bird in the hand. However, the question why the time to decide plays an important role is still unanswered. Here we distinguish two explanations, one based on a bias in value accumulation that has to be overcome with time, the other based on cognitive control processes that need time to set in. In an intertemporal decision task, we use mouse tracking to study participants’ responses to options’ values and delays which were presented sequentially. We find that the information about options’ delays does indeed lead to an immediate bias that is controlled afterwards, matching the prediction of control processes needed to counter initial impulses. Hence, by using a dynamic measure, we provide insight into the processes underlying short-term oriented choices in intertemporal decision making.

scholarly journals The rights and duties of post-adolescent daughters: Daughters' and parents' accounts

Sociologija ◽  
2008 ◽  
Vol 50 (4) ◽  
pp. 391-416 ◽  
Author(s):  
Metka Kuhar
Keyword(s):  
Decision Making ◽  
Adolescent Girls ◽  
Balance Of Power ◽  
Parental Home ◽  
Life Situation ◽  
Structured Interviews ◽  
Biological Parents ◽  
Adolescence Period ◽  
University City ◽  
Insight Into

The article deals with the conceptualisation and negotiation of post-adolescent daughters' rights and duties in their families of origin. More and more young Europeans and particularly many young Slovenians are staying with their parents in the post-adolescence period (and even later) or come home from their university city every weekend. This means that two adult generations live together in the same household; so they have to negotiate the rights and duties of the younger generation in different areas, from very personal domains (e.g. appearance) to more far-reaching life decisions (e.g. the post-study life situation, moving out of the parental home). The study provides at least a partial insight into the processes involved in the negotiation of rights and duties in families with post-adolescent daughters. The data stem from semi-structured interviews conducted in autumn 2006 in Slovenia with 70 first-born post-adolescent girls and both of their biological parents. The respondents answered closed- and open-ended questions referring to four vignettes suggesting controversial situations. The answers allow a view of the conceptualisations of post-adolescents' rights and duties, the distribution of decision-making power and the way of dealing with such situations. The results show that post-adolescent daughters are very dependent on their parents in various areas. It turned out that the contemporary Slovenian family with post-adolescent daughters is prepared to negotiate: patterns of intrafamilial communication range from the traditionally grounded commanding pattern where children have to obey unequivocally (but less than 10% of parents resort to the bare use of authority), to an open, active negotiation pattern where the balance of power is more equal and the achievement of consensus is very important.

scholarly journals Blood transfusion prescribing in the ACT: an insight into clinical decision making

2005 ◽  
Vol 29 (2) ◽  
pp. 240 ◽  
Author(s):  
Philip J Crispin ◽  
Bethany J Crowe ◽  
Anne M McDonald
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Early Discharge ◽  
Organisation Of Care ◽  
Metropolitan Hospital ◽  
Loss Of Appetite ◽  
Insight Into ◽  
Structured Questionnaire

This study aimed to determine the perspectives of a group of patients categorised as ?long-stay outliers? at a large South Australian metropolitan hospital about aspects of organisation of care and the perceived impact of long-term hospitalisation. Nineteen patients were interviewed using a semi-structured questionnaire. Eighty-nine percent of participants stated that they had no knowledge of how long they were to be in hospital. Forty-two percent indicated that they did not know when they would be discharged from hospital. This was of concern, especially considering the vulnerability of this patient group and the known benefits of patient involvement in decision making and the improvements this can make to health outcomes and early discharge. Participants indicated concern about sleep deprivation, diet, ability to return to paid employment, and missing their family as the main areas of impact of their long hospitalisation. Concerns about being discharged from hospital included: apprehension as to whether they were well enough to leave; the recurrence of infection; whether they would be able to sleep well when they got home; their recent loss of appetite and associated weight loss; mobility concerns; and what supports they would have when they were discharged home. All these issues require staff to be more patient and family-centred in their approach to preparing for discharge.

Sudden violent death: social workers’ strategies for coping with a traumatic event in a Bedouin community

2021 ◽  
Author(s):  
Nuzha Allassad Alhuzail ◽  
Merav Moshe Grodofsky
Keyword(s):  
Social Workers ◽  
Cultural Values ◽  
Traumatic Event ◽  
Violent Death ◽  
Structured Interviews ◽  
Negative Effects ◽  
Traumatic Death ◽  
And Coping ◽  
Study Participants

Abstract This qualitative study used semi-structured interviews to explore challenges and coping strategies of social workers following the traumatic death of eight women from a Bedouin village in southern Israel. The data highlight how religion and indigenous Bedouin knowledge and customs both assisted and impeded the study participants’ strategies. The findings suggest that familiarity with religion and indigenous knowledge and customs may be useful to social workers in helping to manage traumatic events. However, the findings also suggest that religious and cultural values that encourage suppression of emotion may have long-term negative effects on social workers.

scholarly journals Exploring the effects of long-term anti-social behaviour victimisation

2020 ◽  
pp. 026975802096197
Author(s):  
Vicky Heap
Keyword(s):  
Qualitative Research ◽  
Social Behaviour ◽  
Empirical Work ◽  
Criminal Behaviour ◽  
Structured Interviews ◽  
Different Types ◽  
The Impact ◽  
Mental And Physical Health ◽  
Insight Into

Despite victimological interest in the impacts of different types of criminal victimisation, there is little empirical work that examines the effects of sub-criminal behaviour on victims. This article begins to redress the balance by reporting the findings from a qualitative research project in England that investigated the effects of long-term anti-social behaviour victimisation. Semi-structured interviews explored victims’ accounts of the long-term anti-social behaviour they experienced and the resultant effects it had on their lives. The research uncovered that victims experience a range of mental and physical health effects as well as behavioural changes and has provided the first in-depth insight into the impact of this type of victimisation. The findings suggest the cumulative harms associated with anti-social behaviour need to be better acknowledged, understood and addressed, with greater support made available to victims.

scholarly journals Clinical and economic strategies in outpatient medical care during the COVID-19 pandemic

2020 ◽  
Vol 45 (8) ◽  
pp. 579-585 ◽  
Author(s):  
David Anthony Provenzano ◽  
B Todd Sitzman ◽  
Samuel Ambrose Florentino ◽  
Glenn A Buterbaugh
Keyword(s):  
Medical Care ◽  
Clinical Care ◽  
Economic Consequences ◽  
Financial Indicators ◽  
Medical Practices ◽  
Strategic Plans ◽  
Economic Strategies ◽  
The Us ◽  
Insight Into

The COVID-19 pandemic has resulted in significant clinical and economic consequences for medical practices of all specialties across the nation. Although the clinical implications are of the utmost importance, the economic consequences have also been serious and resulted in substantial damage to the US healthcare system, including pain practices. Outpatient pain practices have had to significantly change their clinical care pathways, including the incorporation of telemedicine. Elective medical and interventional care has been postponed. For the most part, ambulatory surgical centers have had to cease operations. As patient volumes have decreased for non-emergent elective care, the financial indicators have deteriorated. This review article will provide insight into solutions to mitigate the clinical and economic challenges induced by COVID-19. Undoubtedly, the COVID-19 pandemic will have short-term and long-term implications for all medical practices and facilities. In order to survive, medical practices will need dynamic, operational, and creative strategic plans to mitigate the disruption in medical care and pathways for successful reintegration of clinical and surgical practice.

scholarly journals The patient experience of hemodialysis vascular access decision-making

2020 ◽  
pp. 112972982096840
Author(s):  
Karen Woo ◽  
Huibrie Pieters
Keyword(s):  
Decision Making ◽  
Vascular Access ◽  
Information Seeking ◽  
Medical Decision ◽  
Clear Understanding ◽  
Structured Interviews ◽  
Systematic Analysis ◽  
Physician Characteristics ◽  
End Stage ◽  
Study Participants

Background: To describe vascular access (VA)-related decision-making from the patient perspective, in patients who have already chosen hemodialysis as their renal replacement modality, and identify areas where physicians can improve this experience. Methods: In-person, semi-structured interviews with 15 patients with end-stage kidney disease were systematically analyzed by two independent researchers using thematic analysis. Interviews were conducted until systematic analysis revealed no new themes. Results: Patients had mean age 57 (range 22–85), with seven males and diverse racial/ethnic/marital status. All (15/15) patients viewed VA as “intertwined and interrelated” with dialysis, prioritized the dialysis, described the VA merely as the “hookup” to life-preserving dialysis and gave it minimal consideration. Three themes were identified: consolidation of dialysis and VA, reliance on supportive advisors and communication with physicians. Although 14/15 patients described processes common to medical decision-making, including information seeking, learning from the experiences of others, and weighing risks and benefits, they did not apply these processes specifically to VA. While all participants took ownership of the VA decision, they lacked clear understanding about the different types of VA and their consequences. Most patients (14/15) depended on family and friends for reinforcement, motivation and advice. Patients all described physician characteristics they associated with trustworthiness, the most common being listening and explaining, demonstrating empathy and making an effort to meet the patient’s individual needs. Perceived arrogance, unavailability and lack of expertise represented untrustworthiness. The majority (14/15) accepted VA recommendations from physicians they found trustworthy and authoritative. Conclusions: The study participants were minimally engaged in VA decision-making. Educational aids and shared decision-making tools are needed to empower patients to make better-informed, self-efficacious VA decisions.

The utility of relationships in the creation and maintenance of an event portfolio

2018 ◽  
Vol 36 (2) ◽  
pp. 260-275 ◽  
Author(s):  
Donna M. Kelly ◽  
Sheranne Fairley
Keyword(s):  
Process Model ◽  
Structured Interviews ◽  
Content Type ◽  
Key Stakeholders ◽  
Strategic Goals ◽  
The Creation ◽  
Practical Implications ◽  
Insight Into

Purpose Event portfolios promote synergies among events and stakeholders within a destination in order to maximise resources. The purpose of this paper is to examine the role of relationships in the creation and maintenance of an event portfolio using the four stages of Parvatiyar and Sheth’s (2000) process model of relationship marketing: formation, management and governance, performance evaluation, and evolution. Design/methodology/approach Nine semi-structured interviews were conducted with tourism and government stakeholders involved in the creation and maintenance of an event portfolio within a single destination. Findings The destination outlined clear strategic goals through an event strategy. An Events Board was established to bring together key stakeholders from tourism, events, and government to oversee the development of an event portfolio. The Events Board gave advice to relevant tourism and government stakeholders on which events they should provide funding. Developing relationships was not a stated objective, but the Events Board realised the importance of relationships to create and maintain the destination’s event portfolio. Long-term funding contracts were used as a mechanism to establish relationships and were an impetus for interaction. Relationships were also maintained through dedicated staff who managed the relationships between the destination stakeholders and the events. Practical implications Understanding factors that contribute to the successful creation and maintenance of event portfolios can inform destination stakeholders who are responsible for generating tourism through events. Originality/value Limited research has examined the creation and maintenance of event portfolios. This study provides insight into the central importance of relationships in creating and maintaining an event portfolio.

scholarly journals Information and choice of residential care provider for older people: a comparative study in England, the Netherlands and Spain

2017 ◽  
Vol 38 (6) ◽  
pp. 1121-1147 ◽  
Author(s):  
LISA TRIGG ◽  
STEPHANIE KUMPUNEN ◽  
JACQUETTA HOLDER ◽  
HANS MAARSE ◽  
MERITXELL SOLÉ JUVÉS ◽  
...  
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Older People ◽  
Residential Care ◽  
Clinical Care ◽  
Quality Information ◽  
Care Providers ◽  
Subjective Experiences ◽  
Structured Interviews ◽  
Decision Making Processes

ABSTRACTThis study compared how older people use quality information to choose residential care providers in England, the Netherlands and Spain (Catalonia). The availability of information varies between each country, from detailed inspection and survey information in the Netherlands, through to a lack of publicly available information in Catalonia. We used semi-structured interviews and group workshops with older people, families and professionals to compare experiences of the decision-making process and quality information, and also to explore what quality information might be used in the future. We found that most aspects of the decision-making experience and preferences for future indicators were similar across the three countries. The use of quality information was minimal across all three, even in England and the Netherlands where information was widely available. Differences arose mainly from factors with the supply of care. Older people were most interested in the subjective experiences of other residents and relatives, rather than ‘hard’ objective indicators of aspects such as clinical care. We find that the amount of publicly available quality information does not in itself influence the decisions or the decision-making processes of older people and their carers. To improve the quality of decisions, more effort needs to be taken to increase awareness and to communicate quality in more accessible ways, including significant support from professionals and better design of quality information.

Participation in decision-making when starting long-term medication - patients´ experiences

2014 ◽  
Vol 2 (3) ◽  
pp. 282
Author(s):  
Birgitta Semark ◽  
G Petersson ◽  
S Engstrom ◽  
E Arvidsson ◽  
G Nilsson
Keyword(s):  
Decision Making ◽  
Drug Treatment ◽  
Healthcare Costs ◽  
Clinical Care ◽  
Medication Use ◽  
Patient Experiences ◽  
Patient Needs ◽  
Shared Decision ◽  
Participation In Decision Making

Rationale, aim and objective: To achieve the beneficial effect of drug treatment and reduce unnecessary healthcare costs, patients must be involved in shared decision-making. The aim of this study was to describe patient experiences of participation in decision-making when commencing long-term medication.Method: Nine patients at 2 healthcare centers were semi-structured interviewed about their experiences, beliefs and feelings about their participation in the decision to commence long-term medication. Data were analyzed by a qualitative content method. Results: Respondents stated that participating in decision-making in drug treatment requires knowledge of the relevant area and requires trust in the physician. The respondent’s responsibility and motivation were found to facilitate adherence to drug treatment. Conclusion: Patients sought participation in the decision-making of long-term medication use and expressed a needed for adequate time as part of this dialogue. If they lacked sufficient knowledge, patients wanted relevant and useful information from the physician. To experience trust in the physician through a ‘good’ encounter increases the possibility for participation and enhancement of medication adherence. In order to participate in decision-making, the patient needs the physician’s encouragement. It is contended that direct attempts to involve the patient in decision-making on long-term drug use directly increases the person-centeredness of clinical care.

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