scholarly journals Promise and peril-defining ethical telehealth practice from the clinician and patient perspective: A qualitative study

2022 ◽  
Vol 8 ◽  
pp. 205520762110703
Author(s):  
Amanda Jane Keenan ◽  
George Tsourtos ◽  
Jennifer Tieman
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Biomedical Ethics ◽  
Ethical Principles ◽  
Ethical Framework ◽  
Structured Interviews ◽  
Increased Risk ◽  
Analyse Data ◽  
Global Increase ◽  
Patient Relationships

Objectives We undertook a qualitative study to examine and compare the experience of ethical principles by telehealth practitioners and patients in relation to service delivery theory. The study was conducted prior to and during the recent global increase in the use of telehealth services due to the COVID-19 pandemic, Methods We conducted semi-structured interviews with 20 telehealth practitioners and patients using constructionist grounded theory methods to collect and analyse data. Twenty-five axial coded data categories were then unified and aligned through selective coding with the Beauchamp and Childress (2013) framework of biomedical ethics. The groups were then compared. Results Thirteen categories aligned to the ethical framework were identified for practitioners and 12 for patients. Variance existed between the groups. Practitioner results were non-maleficence 4/13 or (31%), beneficence 4/13 (31%), professional–patient relationships 3/12 (22%), autonomy 1/13 (8%) and justice 1/13 (8%). Patient data results were non-maleficence 4/12 (33%), professional–patient relationships 3/12 (33%), autonomy 2/12 (18%), beneficence 1/12 (8%) and justice 1/12 (8%). Conclusions Ethical principles are experienced differently between telehealth practitioners and patients. These differences can impact the quality and safety of care. Practitioners feel telehealth provides better care overall than patients do. Patients felt telehealth may force a greater share of costs and burdens onto them and reduce equity. Both patients and practitioners felt telehealth can be more harmful than face-to-face service delivery when it creates new or increased risk of harms. Building sufficient trust and mutual understanding are equally important to patients as privacy and confidentiality.

scholarly journals Prescribing for personality disorder: qualitative study of interviews with general and forensic consultant psychiatrists

2014 ◽  
Vol 38 (3) ◽  
pp. 116-121 ◽  
Author(s):  
Lawrence Martean ◽  
Chris Evans
Keyword(s):  
Personality Disorder ◽  
Qualitative Study ◽  
Clinical Implications ◽  
Structured Interviews ◽  
Relational Processes ◽  
Technological Interventions ◽  
Patient Relationships ◽  
And Training ◽  
Pharmaceutical Interventions

Aims and methodTo explore experiences of psychiatrists considering medication for patients with personality disorder by analysis of transcribed, semi-structured interviews with consultants.ResultsThemes show important relational processes in which not prescribing is expected to be experienced as uncaring rejection, and psychiatrists felt helpless and inadequate as doctors when unable to relieve symptoms by prescribing. Discontinuity in doctor–patient relationships compounds these problems.Clinical implicationsProblems arise from: (a) the psychopathology creating powerful relational effects in consultation; (b) the lack of effective treatments, both actual and secondary to under-resourcing and neglect of non-pharmaceutical interventions; and (c) the professionally constructed role of psychiatrists prioritising healing and cure through provision of technological interventions for specific diagnoses. There is a need for more treatments and services for patients with personality disorder; more support and training for psychiatrists in the relational complexities of prescribing; and a rethink of the trend for psychiatrists to be seen primarily as prescribers.

scholarly journals Stabilizing Techniques and Guided Imagery for Traumatized Male Refugees in a German State Registration and Reception Center: A Qualitative Study on a Psychotherapeutic Group Intervention

2019 ◽  
Vol 8 (6) ◽  
pp. 894 ◽  
Author(s):  
Catharina Zehetmair ◽  
Inga Tegeler ◽  
Claudia Kaufmann ◽  
Anne Klippel ◽  
Luise Reddemann ◽  
...  
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Psychosocial Functioning ◽  
Group Intervention ◽  
Guided Imagery ◽  
Mental Health Problems ◽  
Structured Interviews ◽  
German State ◽  
Increased Risk ◽  
State Registration

Refugees have an increased risk of developing mental health problems. Due to the unstable setting in refugee state registration and reception centers, recommended trauma-focused treatment approaches are often not applicable. For this purpose, we devised a suitable therapeutic approach to treat traumatized refugees in a German state registration and reception center: Group therapy, focusing on stabilizing techniques and guided imagery according to Reddemann (2017). From May 2017 to April 2018, we conducted semi-structured interviews with n = 30 traumatized refugees to assess their experiences with the stabilizing techniques and guided imagery in group sessions and self-practice. Participants mainly reported that they had more pleasant feelings, felt increasingly relaxed, and could better handle recurrent thoughts. Additionally, the participants noticed that their psychosocial functioning had improved. The main difficulties that participants encountered were feeling stressed, having difficulties staying focused, or concentrating on the techniques. During self-practice, the participants found it most challenging that they did not have any verbal guidance, were often distracted by the surroundings in the accommodation, and had recurrent thoughts about post-migratory stressors, such as insecurity concerning the future or the application for asylum. Our results show that stabilizing techniques and guided imagery according to Reddemann (2017) are a suitable approach to treat traumatized refugees living in volatile conditions.

scholarly journals Oncology professionals’ perspectives towards cardiac surveillance in breast cancer patients with high cardiotoxicity risk: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249067
Author(s):  
Yvonne Koop ◽  
Laura Dobbe ◽  
Angela H. E. M. Maas ◽  
Dick Johan van Spronsen ◽  
Femke Atsma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Early Stage ◽  
Prognostic Impact ◽  
Breast Cancer Patients ◽  
Structured Interviews ◽  
Cardiac Damage ◽  
Multidisciplinary Collaboration ◽  
Increased Risk

Breast cancer (BC) patients have an increased risk of developing cancer therapy-related cardiac dysfunction (CTRCD) and cardiovascular morbidity, which seems to have a substantial prognostic impact. Oncologists, in collaboration with dedicated cardiologists, have the opportunity to perform cardiovascular risk stratification. Despite guideline recommendations, strategies to detect cardiac damage at an early stage are not structurally implemented in clinical practice. The perspectives of oncology professionals regarding cardiac surveillance in BC patients have not been qualitatively evaluated. We aim to explore the perceptions of oncology professionals regarding cardiac surveillance in BC patients and, more specifically, the influencing factors of delivering cardiac surveillance. A qualitative study with semi-structured interviews was conducted and thematically analyzed. Twelve oncology professionals participated in this study. Four themes were selected to answer the study objectives: (1) sense of urgency, (2) multidisciplinary collaboration, (3) patient burden, and (4) practical tools for cardiac surveillance. Most professionals did not feel the need to deliver cardiac surveillance as they considered the incidence of CTRCD as rare. Multidisciplinary collaboration was also perceived as unnecessary, and cardiac surveillance was considered disproportionately burdensome with respect to its benefits. Nevertheless, professionals affirmed the need for practical tools to deliver cardiac surveillance. Most professionals are currently unaware of CTRCD incidence and cardiac surveillance benefits. Encouraging multidisciplinary collaboration and improving their knowledge of cardiotoxic effects of treatments and possibility of early detection can lead to structured cardiac surveillance for breast cancer patients.

scholarly journals Veterinary Interventions to Improve Neonatal Survival on British Beef and Sheep Farms: A Qualitative Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Katherine E. Adam ◽  
Ann Bruce ◽  
Alexander Corbishley
Keyword(s):  
Qualitative Study ◽  
Service Delivery ◽  
Population Level ◽  
Realist Evaluation ◽  
Evaluation Framework ◽  
Emotional Impact ◽  
Structured Interviews ◽  
Veterinary Service ◽  
Social And Emotional ◽  
Calf Survival

Neonatal lamb and calf deaths are a major issue in UK agriculture. Consistent mortality rates over several decades, despite scientific advances, indicate that socioeconomic factors must also be understood and addressed for effective veterinary service delivery to improve lamb and calf survival. This qualitative study utilised semi-structured interviews with vets and farmers to explore the on-farm mechanisms and social context, with a particular focus on the role of the vet, to manage and reduce neonatal losses in beef calves and lambs on British farms. Data were analysed using a realist evaluation framework to assess how the mechanisms and context for veterinary service delivery influence survival as the outcome of interest. A lack of a clear outcome definition of neonatal mortality, and the financial, social and emotional impact of losses on both vets and farmers, are barriers to recording of losses and standardisation of acceptable mortality levels at a population level. Despite this, there appears to be an individual threshold on each farm at which losses become perceived as problematic, and veterinary involvement shifts from preventive to reactive mechanisms for service delivery. The veterinarian-farmer relationship is central to efforts to maximise survival, but the social and economic capital available to farmers influences the quality of this relationship. Health inequalities are well-recognised as an issue in human healthcare and the findings indicate that similar inequalities exist in livestock health systems.

‘It is not entirely healthy.’ A qualitative study into public appraisals of uncertain risks of chemical substances in food

2020 ◽  
Vol 29 (2) ◽  
pp. 139-156 ◽  
Author(s):  
Tom Jansen ◽  
Liesbeth Claassen ◽  
Irene van Kamp ◽  
Daniëlle RM Timmermans
Keyword(s):  
Qualitative Study ◽  
Prior Knowledge ◽  
Food Additive ◽  
Scientific Uncertainty ◽  
Food Contaminants ◽  
Structured Interviews ◽  
Risk Appraisal ◽  
Chemical Substances ◽  
The Public ◽  
Increased Risk

For some chemical substances in food, scientific uncertainty prevents definitive statements about the presence of risk for human health. In this qualitative study, we explored the public’s understanding and risk appraisal of these substances. During semi-structured interviews, participants from the public were presented with inconclusive risk information about either a food additive or one of two food contaminants. Findings show that interviewees had no prior knowledge and constructed their risk appraisal on the spot. Results suggest that generic and case specific beliefs and inferences affect understanding and appraisal. Respondents’ interpretations of the risk messages used in this study were often not in line with what the message intended to convey. In addition, specific use of scientific jargon was associated with increased risk. In general, respondents were more apprehensive about the presence of the chemical in food than that they were worried about the chance of experiencing health effects.

scholarly journals Māori lived experience of osteoarthritis: a qualitative study guided by Kaupapa Māori principles

2019 ◽  
Vol 11 (2) ◽  
pp. 128 ◽  
Author(s):  
Nikita McGruer ◽  
Jennifer N. Baldwin ◽  
Brian T. Ruakere ◽  
Peter J. Larmer
Keyword(s):  
Qualitative Study ◽  
Lived Experience ◽  
Hip Osteoarthritis ◽  
Structured Interviews ◽  
Four Dimensions ◽  
Kaupapa Māori ◽  
Analyse Data ◽  
Primary Care Practitioners ◽  
Maori Health ◽  
Family Wellbeing

ABSTRACT INTRODUCTIONOsteoarthritis adversely affects people’s quality of life; however, the effects of osteoarthritis on Māori in New Zealand remain unknown. AIMTo explore the Māori lived experience of osteoarthritis. METHODSA qualitative study guided by Kaupapa Māori principles. Māori adults (≥30 years) with clinical knee or hip osteoarthritis took part in semi-structured interviews that were recorded and transcribed. Thematic analysis and a model of Māori health (Te Whare Tapa Whā, outlining four dimensions of wellbeing (taha tinana- physical; taha hinengaro- mental; taha wairua- spiritual; and taha whānau- family)) were used to analyse data. RESULTSSeven Māori females aged 44–71 years participated. Physical manifestations of osteoarthritis, namely pain and limited daily activities, affected mental, spiritual and family wellbeing. Participants experienced whakamā (shame) and frustration. Cultural duties such as attending the marae were impeded, affecting spiritual wellbeing and cultural identity. Participants described drawing on the strength of their ancestors to cope with their impairments. Western medicine was commonly used, although side-effects were prominent and few participants had received information about the condition from health professionals. Both positive and negative experiences of health-care and treatments were reported. DISCUSSIONOsteoarthritis inflicts a substantial burden on the physical, mental, spiritual and family wellbeing of Māori women. Primary care practitioners must consider spiritual and family wellbeing when providing care for Māori with osteoarthritis. Culturally sensitive education for patients and their whānau is needed.

Topik-Topik Komunikasi Dakwah Dalam Mesej Akidah Kepada Masyarakat Orang Asli di Selangor

Sains Insani ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. 15-21
Author(s):  
Zulkefli Aini ◽  
Abdul Ghafar Don ◽  
Ahmad Irdha Mokhtar ◽  
Nur Uswah Ahmad Fauzi
Keyword(s):  
Qualitative Study ◽  
Study Design ◽  
Verbal Feedback ◽  
Structured Interviews ◽  
Orang Asli ◽  
Case Study Design ◽  
Beliefs And Practice ◽  
Islamic Faith ◽  
Selection Of

One of the factors that can affect a person's behavior is a communication message. In the context of the da`wah, preachers who involved actively in da`wah communication with the Orang Asli should be able to ensure that the message conveyed can be understood by the target group. In addition, the selection of the correct messages of da`wah based on the foremost priority simplify the process of sharing information between the preachers and the Orang Asli. Accordingly, this article aims to identify specific topics of Islamic faith (akidah) submitted by the Orang Asli in the process of da`wah communication and to identify verbal feedback given by the preachers to the Orang Asli of the topics. This qualitative study using case study design and data was collected through semi-structured interviews. Interviews involving nine preachers were active in da`wah activity to the Orang Asli community in Selangor. Data were analyzed thematically according to the specified objectives. The study found that the topics frequently raised by the Orang Asli is concerned about belief in Allah, belief in Malaikat, and belief in Qada' and Qadar. The topics may be found within the framework of worldview in their beliefs and practice of ancient traditions. Therefore, the preachers gave verbal feedback on these topics is based on a clear and precise sample corresponding to the level of their thinking. The emphasis on these topics is very important to strengthen and purify the faith of the community.Keywords: Communication; Message; Preacher; Indigenous community Abstrak: Elemen mesej dalam komunikasi merupakan salah satu faktor yang dapat memberi kesan terhadap perubahan tingkah laku seseorang. Dalam konteks dakwah, pendakwah yang terlibat dalam proses komunikasi dakwah dengan Orang Asli seharusnya berkebolehan memastikan kandungan mesej yang disampaikan boleh difahami oleh sasaran dakwahnya. Di samping itu, pemilihan mesej dakwah yang betul mengikut keutamaan memudahkan proses perkongsian maklumat antara pendakwah dengan Orang Asli. Sehubungan dengan itu, artikel ini bertujuan untuk mengenalpasti topik-topik tertentu dalam mesej akidah yang dikemukakan oleh masyarakat Orang Asli kepada pendakwah dan mengenalpasti maklum balas lisan yang diberikan oleh pendakwah kepada Orang Asli terhadap topik tersebut. Kajian kualitatif ini menggunakan reka bentuk kajian kes dengan pengumpulan data melalui temu bual separa struktur. Temu bual melibatkan sembilan orang pendakwah yang aktif dalam aktiviti dakwah masyarakat Orang Asli di Selangor. Data kajian dianalisis secara tematik mengikut objektif yang ditentukan. Kajian ini mendapati bahawa topik-topik yang sering dikemukan oleh Orang Asli kepada pendakwah dalam penyampaian mesej akidah ialah berkenaan tentang keimanan kepada Allah SWT, keimanan kepada malaikat, dan keimanan kepada qada’ dan qadar. Topik-topik berkenaan didapati berada dalam kerangka worldview kepercayaan dan amalan tradisi mereka. Sehubungan dengan itu, pendakwah memberikan maklum balas lisan terhadap topik-topik tersebut adalah berdasarkan keterangan yang jelas dan contoh yang tepat bersesuaian dengan tahap pemikiran mereka. Penekanan terhadap topik-topik tersebut merupakan perkara yang penting dalam rangka mengukuhkan dan memurnikan akidah masyarakat Orang Asli.Kata kunci: Komunikasi; Mesej; Pendakwah; Komuniti Orang Asli

Diversity in teachers’ approaches to movement integration: A qualitative study of lower secondary school teachers’ perceptions of a state school reform involving daily physical activity

2019 ◽  
Vol 26 (2) ◽  
pp. 429-447
Author(s):  
Henrik Taarsted Jørgensen ◽  
Sine Agergaard ◽  
Michalis Stylianou ◽  
Jens Troelsen
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
School Reform ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Teachers Perceptions ◽  
Physical Activity Policy ◽  
Danish School ◽  
Group Interviews ◽  
Movement Integration

In the context of implementing a physical activity policy as part of a national school reform in Denmark, the purpose of this study was to explore lower secondary teachers’ interpretations and perceptions of the physical activity policy with a focus on movement integration. In total, 14 teachers from four different schools were selected to take part in this qualitative study, which involved semi-structured interviews, focus group interviews, go-along observations and informal interviews. A thematic analysis framework was employed to identify and describe patterns of meaning within data. The findings showed substantial diversity among teachers’ interpretations and perceptions of movement integration, and consequently a lack of definitional clarity regarding movement integration and a possible misalignment between policy and practice. Teachers’ perceptions and interpretations of movement integration were influenced by other and more prioritised policies and discourses regarding academic achievement, as well as by intrapersonal, interpersonal and institutional factors. The findings also suggested a lack of support and collaboration within the school and provided insights into the strengths and weaknesses associated with the autonomy afforded in the Danish school reform.

Transition from Childcare Institutions to Adulthood for Youth: Through the Lens of Identity and Gender

2020 ◽  
pp. 234930032098055
Author(s):  
Garima Sharma
Keyword(s):  
Young Adults ◽  
Qualitative Study ◽  
Social Factor ◽  
Smooth Transition ◽  
Structured Interviews ◽  
Male And Female ◽  
Female Youth ◽  
Youth Identity ◽  
The Social ◽  
And Gender

This article explores the transition of youth from childcare institutions as young adults through the lens of youth identity and gender. The research revolves around rethinking the delicate boundaries of adolescence and adulthood for the ‘institutionalised’ youth that is already on the edge of the society. This research tries to understand and decode the experiences of youth, who have lived in the childcare institutions. The childcare institutions reinforce the gender roles through its practices and structure, enabling gaps and challenges for both male and female youth outside the childcare institutions. There is an absence of a strong mechanism, enabling the smooth transition of youth from childcare institutions to adulthood. This results in unprepared young adults for an unplanned transition, fostering several challenges on them as they exit the childcare system. This is a qualitative study. The research includes both male and female youth who have lived in childcare institutions situated in Delhi. The data was collected using semi-structured interviews with the youth. This study finds that youth leaving the childcare institutions are at higher risks of having negative adult outcomes in life. While there is an absolute absence of any body or mechanism to help the youth transit smoothly, childcare institutions reinforce the inferiority and exclusion on a child during the stay period, creating a foundation for youth to perceive the social factor outside the institutions.

scholarly journals NICU and postpartum nurse perspectives on involving fathers in newborn care: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katharine W. Buek ◽  
Dagoberto Cortez ◽  
Dorothy J. Mandell
Keyword(s):  
Qualitative Study ◽  
Father Involvement ◽  
Perinatal Care ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Small Scale ◽  
Structured Interviews ◽  
Provider Attitudes ◽  
Attitudes And Practices ◽  
Sense Of Efficacy

Abstract Background Perinatal care nurses are well positioned to provide the education and support new fathers need to navigate the transition to fatherhood and to encourage positive father involvement from the earliest hours of a child’s life. To effectively serve fathers in perinatal settings, it is important to understand the attitudes, beliefs, and behaviors of healthcare providers that may encourage and engage them, or alternatively alienate and discourage them. Methods This qualitative study involved structured interviews with ten NICU and postpartum nurses from hospitals in two large Texas cities. The interview protocol was designed to elicit descriptive information about nurses’ attitudes and beliefs, sense of efficacy and intention for working with fathers, as well as their father-directed behaviors. Nurses were recruited for the study using a purposive sampling approach. Interviews were conducted by telephone and lasted approximately 25 to 35 min. Data were analyzed using a qualitative descriptive approach. Results Overall, study participants held very positive subjective attitudes toward fathers and father involvement. Nevertheless, many of the nurses signaled normative beliefs based on race/ethnicity, gender, and culture that may moderate their intention to engage with fathers. Participants also indicated that their education as well as the culture of perinatal healthcare are focused almost entirely on the mother-baby dyad. In line with this focus on mothers, participants comments reflected a normative belief that fathers are secondary caregivers to their newborns, there to help when the mother is unavailable. Conclusions Nurse attitudes and practices that place mothers in the role of primary caregiver may be interpreted by fathers as excluding or disregarding them. Further research is needed to validate the results of this small-scale study, and to assess whether and how provider attitudes impact their practices in educating and engaging fathers in newborn care.

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