scholarly journals Ascribed Meaning of Disease Control

2017 ◽  
Vol 5 (3) ◽  
pp. 160-166
Author(s):  
Laura M Girling ◽  
Sarah E Chard ◽  
J Kevin Eckert
Keyword(s):  
Blood Glucose ◽  
Lived Experience ◽  
Health Care Providers ◽  
Diabetes Control ◽  
Care Providers ◽  
Target Blood Glucose ◽  
Sugar Regulation ◽  
Care Health ◽  
Depth Interviews

Background: Contemporary treatment of type 2 diabetes mellitus (hereafter diabetes) heavily emphasizes “diabetes control,” largely defined by measurable blood glucose parameters. Little is known about how people living with the condition themselves define diabetes control within the lived experience of their disease. Methods: As part of a qualitative study investigating the subjective construction of diabetes, 83 in-depth interviews were conducted with African American and non-Hispanic white older adults. Using content analysis, 4237 pages of narrative data were analyzed to explore how informants conceptualized diabetes control. Findings: Four themes emerged from the data, describing varied understandings of diabetes control: (a) blood sugar regulation, (b) practicable treatment adherence, (c) bodily experience, and (d) degree of pharmaceutical need. Findings demonstrate that among persons with diabetes, the term diabetes control is multifaceted. Conclusion: While clinical guidelines have established target blood glucose parameters as the standard indicator of diabetes control, persons with diabetes conveyed varied and diverse meanings situated within personal experiences. To foster empathetic and collaborative care, health-care providers tending to this population may consider integrating the emergent themes into communicative and treatment approaches.

Doula Support During Childbearing—Aiming for the Best Birthing Experience: A Phenomenological Study

2017 ◽  
Vol 7 (3) ◽  
pp. 139-151 ◽  
Author(s):  
C. Michelle Brisco ◽  
Sandra P. Small
Keyword(s):  
Lived Experience ◽  
Health Care Providers ◽  
Phenomenological Study ◽  
Hermeneutic Phenomenology ◽  
Care Providers ◽  
Peace Of Mind ◽  
Growing Body ◽  
The Right ◽  
Depth Interviews ◽  
Childbirth Experiences

A growing body of evidence indicates that doula support improves childbirth outcomes. The purpose of this study was to examine women’s lived experience of such support. Hermeneutic phenomenology was used to carry out and analyze in-depth interviews with 14 women who had doulas for support during pregnancy, childbirth, and the immediate postpartum period. Six main themes were revealed. The women were aiming for the best birthing experience, and they believed to achieve this they needed extra support and to have a full say in their childbirth experiences. The doulas helped the women to have peace of mind prenatally, and all but one woman had an overall satisfying experience with their doulas. Whether satisfied or dissatisfied with their personal doulas, all the women believed that having a doula is valuable. However, choosing the right doula matters because a comfortable relationship between a woman and her doula is essential to achieving the best birthing experience. Health care providers and policymakers must recognize the importance women place on constant and personalized support during childbirth and endeavor to provide such care.

Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One

2016 ◽  
Vol 27 (7) ◽  
pp. 994-1005 ◽  
Author(s):  
Dolores Angela Castelli Dransart
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Suicide Survivors ◽  
Loved One ◽  
Life Patterns ◽  
Survivors Of Suicide ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.

scholarly journals Acceptability of HPV Vaccine for Males and Preferences for Future Education Programs Among Appalachian Residents

2013 ◽  
Vol 8 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Paul L. Reiter ◽  
Benjamin R. Oldach ◽  
Katherine E. Randle ◽  
Mira L. Katz
Keyword(s):  
Focus Groups ◽  
Health Care Providers ◽  
Hpv Vaccine ◽  
Geographic Region ◽  
Care Providers ◽  
Cultural Issues ◽  
Education Programs ◽  
Potential Barriers ◽  
Depth Interviews ◽  
Appalachian Ohio

Appalachia is a geographic region with several disparities related to human papillomavirus (HPV) infection, yet little is known about acceptability of HPV vaccine for males among Appalachian residents. HPV vaccine acceptability and preferences for future HPV vaccine education programs were examined among residents of Appalachian Ohio. Focus groups and in-depth interviews were conducted with Appalachian Ohio residents between July and October 2011. Participants ( n = 102 from 24 focus groups and 5 in-depth interviews) included four key stakeholder groups: health care providers, community leaders, parents with adolescent sons, and young adult men ages 18 to 26 years. Support for vaccinating males against HPV was high among participants, despite low awareness and knowledge about HPV vaccine for males. Participants reported three categories of potential barriers to vaccinating males against HPV: concerns about vaccine safety and side effects, access to care and vaccination logistics, and gender and cultural issues. Participants reported that HPV vaccine was viewed as being only for females in their communities and that receiving the vaccine may be emasculating or embarrassing to males. Participants suggested that future HPV vaccine education programs mainly target parents, include basic information about HPV-related diseases and HPV vaccine (e.g., number of doses, cost), and present the vaccine as having the potential to prevent cancer (as opposed to preventing genital warts). Acceptability of HPV vaccine for males was high among residents of Appalachian Ohio. Future HPV vaccine education programs in Appalachia should address common potential barriers to vaccination and help destigmatize vaccination among males.

scholarly journals The lived experience of people with obesity: study protocol for a systematic review and synthesis of qualitative studies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Emma Farrell ◽  
Marta Bustillo ◽  
Carel W. le Roux ◽  
Joe Nadglowski ◽  
Eva Hollmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lived Experience ◽  
Health Care Providers ◽  
Evidence Synthesis ◽  
Qualitative Studies ◽  
Qualitative Evidence Synthesis ◽  
Care Providers ◽  
Critical Appraisal Skills ◽  
Health Complications

Abstract Background Obesity is a prevalent, complex, progressive and relapsing chronic disease characterised by abnormal or excessive body fat that impairs health and quality of life. It affects more than 650 million adults worldwide and is associated with a range of health complications. Qualitative research plays a key role in understanding patient experiences and the factors that facilitate or hinder the effectiveness of health interventions. This review aims to systematically locate, assess and synthesise qualitative studies in order to develop a more comprehensive understanding of the lived experience of people with obesity. Methods This is a protocol for a qualitative evidence synthesis of the lived experience of people with obesity. A defined search strategy will be employed in conducting a comprehensive literature search of the following databases: PubMed, Embase, PsycInfo, PsycArticles and Dimensions (from 2011 onwards). Qualitative studies focusing on the lived experience of adults with obesity (BMI >30) will be included. Two reviewers will independently screen all citations, abstracts and full-text articles and abstract data. The quality of included studies will be appraised using the critical appraisal skills programme (CASP) criteria. Thematic synthesis will be conducted on all of the included studies. Confidence in the review findings will be assessed using GRADE CERQual. Discussion The findings from this synthesis will be used to inform the EU Innovative Medicines Initiative (IMI)-funded SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) study. The objective of SOPHIA is to optimise future obesity treatment and stimulate a new narrative, understanding and vocabulary around obesity as a set of complex and chronic diseases. The findings will also be useful to health care providers and policy makers who seek to understand the experience of those with obesity. Systematic review registration PROSPERO CRD42020214560.

Payment Accuracy in Value-Based Care Contracts

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Mackenzie A ◽  
◽  
Wang J ◽  
Teppema S ◽  
Duncan I ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Model Risk ◽  
Care Services ◽  
Value Based Care ◽  
Stochastic Risk

Reimbursement for health care services is transferring more risk away from payers and toward health care providers in the form of Alternative Payment Models (APMs), also known as Value-Based Care (VBC) models. VBC models cover a wide variety of forms but all include guarantees by providers of services to improve quality of care and/or reduce cost. Types of risk include performance risk, contract design risk or stochastic risk (because of the random variation in health care services and costs). A form of contract risk that can be a significant driver of cost is model risk, defined as the probability that the savings calculated at contract reconciliation will deviate from the actual savings generated. To estimate the degree of risk we quantify the potential variance in outcomes in a naïve population prior to intervention and the components that could affect outcomes, using examples of maternity and type 2 diabetes. This analysis has implications for both participants in, and designers of value-based contracts.

The Experience of Occupational Disruption among Student Musicians

2007 ◽  
Vol 22 (4) ◽  
pp. 140-146 ◽  
Author(s):  
Shannon McCready ◽  
Denise Reid
Keyword(s):  
Health Care Providers ◽  
Sense Of Belonging ◽  
Qualitative Data ◽  
Comparative Method ◽  
Theory Approach ◽  
Care Providers ◽  
Constant Comparative Method ◽  
Grounded Theory Approach ◽  
Depth Interviews ◽  
Major Occupation

Student musicians frequently need to take breaks from playing their instruments because of physical playing-related injuries, yet little is known about their experiences with these occupational disruptions. We conducted a qualitative study that explored student musicians' lived experiences with unplanned disruptions stemming from engagement in their major occupation of playing an instrument. In-depth interviews with seven student musicians who attended either a special arts high school or a university were conducted. Consistent with a grounded theory approach to qualitative research, the constant comparative method of qualitative data analysis was implemented. A major finding related to the theme of “being and becoming,” where student musicians expressed a strong sense of belonging to a group of other like musicians who they learned from, relied on for support, and created music with. Another theme was motivation to excel, where students expressed a strong desire and motivation to improve and master their instrument. Occupational tensions and pressures emerged as another theme. Students were aware of the need to practice and the need to care for their bodies. A constant negotiation was required in which students struggled to find a good balance between the need to practice and to respect their bodies while maintaining an identity of a musician. These findings are discussed in relation to how health care providers and educators need to understand the demands and stresses associated with playing an instrument so that they can better support these young musicians.

scholarly journals Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider and Staff Perspectives

2021 ◽  
Author(s):  
Hannah R. Lucas ◽  
Roxann C. Williams ◽  
Laura N. Hollar ◽  
Bethany Johnson-Javois ◽  
Heidi B. Miller ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Health Care Providers ◽  
Diabetes Prevention ◽  
Diabetes Risk ◽  
Care Providers ◽  
Diabetes Screening ◽  
Structured Interviews ◽  
Future Diabetes

Gestational diabetes mellitus (GDM) increases type 2 diabetes risk; however, postpartum diabetes screening rates are low. Using semi-structured interviews and focus groups, this study investigates the understanding of GDM and its relationship to future diabetes risk and diabetes prevention among patients with public or no insurance (<i>n </i>= 36), health care providers (<i>n </i>= 21), and clinic staff (<i>n </i>= 9) from Federally Qualified Health Centers. Five main themes emerged: <i>1</i>) general understanding of GDM diagnosis with focus on neonatal complications; <i>2</i>) variable recall of diet, exercise, and weight recommendations; <i>3</i>) overwhelming medication and self-monitoring routines; <i>4</i>) short-term focus of type 2 diabetes risk and screening; and <i>5</i>) limited understanding of all options for diabetes prevention. The results may inform diabetes screening and prevention interventions in primary care settings.

scholarly journals Awareness of Oral Complications and Oral Hygiene Habits of Subjects with Diagnosed Diabetes Mellitus

2018 ◽  
Vol 22 (3) ◽  
pp. 138-145
Author(s):  
Hülya Çankaya ◽  
Pelin Güneri ◽  
Joel B. Epstein ◽  
Hayal Boyacıoğlu
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Oral Health ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Oral Health Status ◽  
Care Providers ◽  
Oral Complications ◽  
Type 2 Dm

SummaryBackground/Aim: The aim was to evaluate Diabetes Mellitus (DM) patients’ awareness of their risk for oral and dental complications, to evaluate their oral health behaviors, assess their sources of related information, and to detect the influence of their awareness on oral health and dental management.Material and Methods: Total of 240 DM patients presenting to a university outpatient dental facility for routine care completed a self-administered questionnaire about demographic-socioeconomic characteristics, oral health care and awareness on oral complications of DM. Dental status of each patient was recorded. Data were analyzed with Chi- square test; p was set as 0.05.Results: The patients’ mean age was 52.85 years; the majority had Type 2 DM (72.1%) and 61.7% were females. Two thirds of the patients had tooth loss; 65% brushed daily and used toothpick for interproximal cleaning (35%). Only 12.9% had regular dental visits and 37.5% reported their oral health as “poor”. DM patients rarely received guidance from their health care professionals regarding their oral health (28.3%). Even though 62.5% were aware of oral complications of DM, only 46.3% knew that oral health may affect DM. The patients with Type 1 and Type 2 DM had similar perceptions about their oral health status (p=0.15>0.05). However, insulin users were more aware of the interaction between oral health and DM (p>0.05), and were more likely to consider their oral health as “poor” (p>0.05).Conclusions: DM patients’ awareness of the effect of DM on oral health was higher than that of the effect of oral health on DM management. Medical health care providers were failing to provide the necessary information regarding these issues when compared to dentists.

scholarly journals Sociocultural Influences on African Americans’ Representations of Type 2 Diabetes: A Qualitative Study

2018 ◽  
Vol 28 (1) ◽  
pp. 25 ◽  
Author(s):  
Olayinka O. Shiyanbola ◽  
Earlise Ward ◽  
Carolyn Brown
Keyword(s):  
Type 2 Diabetes ◽  
African Americans ◽  
Racial Discrimination ◽  
Health Care Providers ◽  
Eating Habits ◽  
Cultural Beliefs ◽  
Sociocultural Factors ◽  
Diabetes Diagnosis ◽  
Care Providers

<p class="Pa7"><strong>Objective: </strong>Illness representations, known as patients’ beliefs and expectations about an illness, may be influenced by cultural beliefs and personal experiences. This study explored African Americans’ perceptions of the sociocultural factors that influence their representations of diabetes.</p><p class="Pa7"><strong>Design: </strong>Six semi-structured focus groups.</p><p class="Pa7"><strong>Setting: </strong>Private space at a convenient site.</p><p class="Pa7"><strong>Participants: </strong>Forty African Americans, aged 45-60 years with type 2 diabetes for at least one year prior.</p><p class="Pa7"><strong>Results: </strong>Participants perceived that there was a race-mediated effect of how they developed diabetes because of poverty due to past slavery, racial discrimination by health care providers, and the stigma associated with diabetes within the African American community. Participants perceived that pov­erty influenced African Americans’ unhealthy eating habits, which led to diabetes diagnosis among their ancestors and their develop­ment of the disease since it was hereditary. Participants also perceived that there was provider ill intention, ie, providers were pur­posefully making people sick, and their lack of education on diabetes from providers was done on purpose, as information on diabetes was withheld and not shared due to racial discrimination. Perceived stigma by the com­munity led to African Americans’ avoidance and denial of the disease, and subsequently the development of diabetes.</p><p class="Pa7"><strong>Conclusions: </strong>To enhance disease manage­ment for African Americans with diabetes, it is important to focus on the sociocultural context of how African Americans view their world that may be influenced by their knowl­edge of negative historical circumstances and their current provider relationship, which, in turn, may be reflected in their perceptions of diabetes.</p><p class="Pa7"><em>Ethn Dis. </em>2018;28(1):25-32; doi:10.18865/ed.28.1.25.</p>

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