Beyond Words: Understanding Grit in Survivors of Stroke and Caregivers

Grit is defined as perseverance and long-term focus on goals. Grit may be helpful in surviving stroke for both survivors and caregivers. The purpose of this study was to investigate the level of grit among survivors of stroke and caregivers using health humanities to gain a deeper understanding of the lived experience of stroke survivors. A sample of convenience was used. Phase I (n = 22) utilized the Grit Scale survey. Phase II (n = 6) utilized phenomenological interviews. The Grit Scale survey data were analyzed with SPSS 25. Qualitative data were analyzed with the whole-parts-whole method of Giorgi, Dahlberg, Drew, and Nyström. Grit scores were high for both survivors of stroke (3.77 ± 0.50) and caregivers (3.89 ± 0.51). Themes emerging from the phenomenological interviews included: (a) gritty toughness, (b) challenges, (3) accomplishments, and (4) advice for health-care providers. Survivors of stroke and caregivers embodied high grit levels. Participants articulated the importance of long-term goals despite challenges. Understanding grit among survivors and caregivers may help clinicians develop best practices to better support these individuals.

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Depression: A Long-Term Illness

The British Journal of Psychiatry ◽

10.1192/s0007125000293239 ◽

1994 ◽

Vol 165 (S26) ◽

pp. 9-15 ◽

Cited By ~ 52

Author(s):

Martin B. Keller

Keyword(s):

Health Care ◽

Health Care Providers ◽

Maintenance Treatment ◽

Depressive Disorders ◽

Care Providers ◽

Serious Illness ◽

Antidepressant Treatments ◽

Continued Education ◽

Low Levels

The realisation that major depression is often both chronic and recurrent has slowly begun to change the way that depression is diagnosed and treated. In particular, the need for continuation and maintenance treatment is an issue that now deserves increased attention, especially with the availability of new classes of antidepressant treatments, which have excellent efficacy and more favourable side-effect profiles. Although the serious consequences of depressive disorders clearly indicate the need for effective and prompt intervention on the part of clinicians, the results of several studies indicate that patients with depression consistently receive no or low levels of antidepressant therapy. It is hoped that, through continued education of health care providers and patients about the consequences of depression, the issue of undertreatment of this serious illness will be resolved.

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“Take the treatment and be brave”: Care experiences of pregnant women with rifampicin-resistant tuberculosis

PLoS ONE ◽

10.1371/journal.pone.0242604 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0242604

Author(s):

Marian Loveday ◽

Sindisiwe Hlangu ◽

Jennifer Furin

Keyword(s):

Health Care ◽

Pregnant Women ◽

Health Care System ◽

Health Care Providers ◽

Physical Symptoms ◽

Coding System ◽

Care Providers ◽

Convenience Sample ◽

Care System

Background There are few data on the on the care experiences of pregnant women with rifampicin-resistant TB. Objective To describe the treatment journeys of pregnant women with RR-TB—including how their care experiences shape their identities—and identify areas in which tailored interventions are needed. Methods In this qualitative study in-depth interviews were conducted among a convenience sample from a population of pregnant women receiving treatment for RR-TB. This paper follows COREQ guidelines. A thematic network analysis using an inductive approach was performed to analyze the interview transcripts and notes. The analysis was iterative and a coding system developed which focused on the care experiences of the women and how these experiences affected their perceptions of themselves, their children, and the health care system in which treatment was received. Results Seventeen women were interviewed. The women described multiple challenges in their treatment journeys which required them to demonstrate sustained resilience (i.e. to “be brave”). Care experiences required them to negotiate seemingly contradictory identities as both new mothers—“givers of life”—and RR-TB patients facing a complicated and potentially deadly disease. In terms of their “pregnancy identity” and “RR-TB patient identity” that emerged as part of their care experiences, four key themes were identified that appeared to have elements that were contradictory to one another (contradictory areas). These included: 1) the experience of physical symptoms or changes; 2) the experience of the “mothering” and “patient” roles; 3) the experience of the care they received for their pregnancy and their RR-TB; and 4) the experience of community engagement. There were also three areas that overlapped with both roles and during which identity was negotiated/reinforced and they included: 1) faith; 2) socioeconomic issues; and 3) long-term concerns over the child’s health. At times, the health care system exacerbated these challenges as the women were not given the support they needed by health care providers who were ill-informed or angry and treated the women in a discriminatory fashion. Left to negotiate this confusing time period, the women turned to faith, their own mothers, and the fathers of their unborn children. Conclusion The care experiences of the women who participated in this study highlight several gaps in the current health care system that must be better addressed in both TB and perinatal services in order to improve the therapeutic journeys for pregnant women with RR-TB and their children. Suggestions for optimizing care include the provision of integrated services, including specialized counseling as well as training for health care providers; engagement of peer support networks; provision of socioeconomic support; long-term medical care/follow-up for children born to women who were treated for RR-TB; and inclusion of faith-based services in the provision of care.

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Underage Rural Drinking: Survey Data and Implications for Educators

The Rural Educator ◽

10.35608/ruraled.v31i3.959 ◽

2019 ◽

Vol 31 (3) ◽

Author(s):

Jon Lasser ◽

Eric Schmidt ◽

James Diep ◽

Amy Huebel

Keyword(s):

Health Care ◽

Alcohol Use ◽

Survey Data ◽

Health Care Providers ◽

Health Risks ◽

Underage Drinking ◽

Care Providers ◽

Prevention Strategies ◽

Texas County ◽

Significant Health

This article reports data collected in a rural Texas county that explores the beliefs and perceptions of youth about alcohol use. Results from the study suggest high rates of underage drinking and present significant health risks. The data also shed some light on how yuth perceive parents, responsibilities, access, and prevention strategies with regard to alcohol usage. Implications for rural educators and health care providers are discussed in light of the findings, with an emphasis on both prevention and intervention.

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Influence of Health Care Providers on the Development of Diabetes Complications: Long-term follow-up from the Pittsburgh Epidemiology of Diabetes Complications Study

Diabetes Care ◽

10.2337/diacare.25.9.1584 ◽

2002 ◽

Vol 25 (9) ◽

pp. 1584-1590 ◽

Cited By ~ 37

Author(s):

J. C. Zgibor ◽

T. J. Songer ◽

S. F. Kelsey ◽

A. L. Drash ◽

T. J. Orchard

Keyword(s):

Health Care ◽

Health Care Providers ◽

Diabetes Complications ◽

Care Providers ◽

Long Term Follow Up

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Abstract WP408: Tacls: Taking Action for Optimal Community and Long Term Stroke Care

Stroke ◽

10.1161/str.48.suppl_1.wp408 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Theresa L Green ◽

Patrice Lindsay

Keyword(s):

Health Care ◽

Acute Stroke ◽

Health Care Providers ◽

Stroke Care ◽

Residential Aged Care ◽

Stroke Survivors ◽

Care Providers ◽

Community Based ◽

Taking Action

Introduction: In Canada, approximately 12% of acute stroke patients are admitted to long-term care (LTC; or residential aged care) facilities following an acute stroke event. An additional 20-30% of patients are discharged home from hospital with referral for community-based homecare. Training programs for health care providers in these settings is variable and at times inconsistent with best practices. Internationally, focus is now shifting from a predominant inpatient acute care focus, to one encompassing ongoing care and support in the community for people living with stroke. In 2015, an educational resource called Taking Action for Optimal Community & Long Term Stroke Care (TACLS) was launched across Canada to ensure the appropriate knowledge and skills of front line care providers for stroke survivors in community and LTC facilities; the focus of this resource is on rehabilitation and recovery. Methods: The purpose of this interactive session is to introduce the TACLS resource and to engage health professionals in an examination of current international community based rehabilitation and recovery programs. The discussion/workshop will allow participants to examine, compare and contrast components of the TACLS program with programs being developed or offered elsewhere. Results: As health care providers helping stroke survivors live well and longer means investing in the use of best practice tools and resources that fit the local context and organizational practices. Bringing together international opinions and observations around post-stroke community care will allow cross-collaboration and inter-professional networking opportunities that ultimately will benefit patients living with stroke in community based settings. Discussion: As care shifts from hospital to community based settings, the importance of tools available to support stroke survivors in this area of the care continuum is essential. In Canada, utilizing the HSF education resource (TACLS) provides information to support community based health care providers working with people who have had a stroke in helping them achieve optimal outcomes, regain their best level of functioning, and live meaningful lives.

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Best Practices to Promote Patient and Donor Engagement to Care in Living Donor Transplant

Health Literacy ◽

10.4018/978-1-5225-1928-7.ch015 ◽

2017 ◽

pp. 306-327

Author(s):

Emanuela Saita ◽

Susanna Zanini ◽

Enrico Minetti ◽

Chiara Acquati

Keyword(s):

Health Care ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Best Practices ◽

Health Care Providers ◽

Living Donor ◽

Care Providers ◽

Health Care Outcomes ◽

Care Outcomes ◽

Donor Kidney Transplantation

Increasing evidence has demonstrated that patients' involvement promotes better health care outcomes and cost-effectiveness of services. However, limited literature is available about the experience of living donor kidney transplantation and best practices to promote patients and donors' engagement. Aim of the present chapter is to review the literature about patient engagement in the context of chronic kidney disease, and to introduce an innovative protocol developed to promote potential donors and recipients' participation and adherence to care at the Niguarda Ca' Granda Hospital in Milan (Italy). Results are critical to reflect on the identification of best practices for patients' engagement in the context of chronic kidney disease. Through a better understanding of the emotional and affective dynamics and the relational implications that may influence the elaboration of the information given by health care providers, it will be possible to develop evidence-informed interventions.

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Best Practices to Promote Patient and Donor Engagement to Care in Living Donor Transplant

Transformative Healthcare Practice through Patient Engagement - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-5225-0663-8.ch001 ◽

2017 ◽

pp. 1-28

Author(s):

Emanuela Saita ◽

Susanna Zanini ◽

Enrico Minetti ◽

Chiara Acquati

Keyword(s):

Health Care ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Best Practices ◽

Health Care Providers ◽

Living Donor ◽

Care Providers ◽

Health Care Outcomes ◽

Care Outcomes ◽

Donor Kidney Transplantation

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The state of the science on trauma inquiry

Women s Health ◽

10.1177/1745506519861234 ◽

2019 ◽

Vol 15 ◽

pp. 174550651986123

Author(s):

Annie Lewis-O’Connor ◽

Abi Warren ◽

Jeannie V Lee ◽

Nomi Levy-Carrick ◽

Samara Grossman ◽

...

Keyword(s):

Health Care ◽

Best Practices ◽

Health Care Providers ◽

Partner Violence ◽

Life Experiences ◽

Traumatic Experiences ◽

Care Providers ◽

Adverse Health Outcomes ◽

Trauma Informed Care ◽

State Of The Science

Within the context of longitudinal medical care for adults, health care providers have a unique opportunity to inquire and respond to the traumatic life experiences affecting the health of their patients, as well as a responsibility to minimize retraumatizing these patients during medical encounters. While there is literature on screening women for intimate partner violence, and there is emerging data on pediatric screening for adverse life experiences, there is sparse literature on inquiry of broader trauma histories in adult medical settings. This lack of research on trauma inquiry results in an absence of guidelines for best practices, in turn making it challenging for policy makers, health care providers, and researchers to mitigate the adverse health outcomes caused by traumatic experiences and to provide equitable care to populations that experience a disproportionate burden of trauma. This state of the science summarizes current inquiry practices for patients who have experienced trauma, violence, and abuse. It places trauma inquiry within an anchoring framework of trauma-informed care principles, and emphasizes a focus on resilience. It then proposes best practices for trauma inquiry, which include tiered screening starting with broad trauma inquiry, proceeding to risk and safety assessment as indicated, and ending with connection to interventions.

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“Beyond Personal Beliefs”

SAGE Open ◽

10.1177/2158244016672714 ◽

2016 ◽

Vol 6 (4) ◽

pp. 215824401667271 ◽

Cited By ~ 3

Author(s):

Maria Giulia Olivari ◽

Gaia Cuccì ◽

Emanuela Confalonieri

Keyword(s):

Health Care ◽

Health Care Providers ◽

Family Health ◽

Job Attitudes ◽

Main Theme ◽

Care Providers ◽

Personal Beliefs ◽

Structured Interviews ◽

Adolescent Patients

Using a qualitative method, our study aims to explore, identify, and describe Italian health care providers’ reflections on the contraceptive behaviors of adolescents attending family health centers, and health care providers’ self-perception of their own job attitudes toward these adolescent patients. Semi-structured interviews with 46 Italian health care providers were conducted and analyzed using thematic analysis. Two main themes emerged from the thematic data analysis regarding Italian health care providers’ self-perceptions and reflections. The first main theme was labeled “adolescents’ contraceptive behavior” and included two subthemes: “adolescents are confused and unprepared” and “contraception is a girls’ responsibility.” The second theme was labeled “job attitudes with adolescents,” and included three subthemes: “to inform and to educate,” “to build trustful relationships,” and “to go beyond personal beliefs.” The findings of this study showed that Italian health care providers perceive themselves as nonjudgmental and they interpret their own behavior as an attempt to answer adolescents’ sexual and reproductive health (SRH) needs in an open-minded way. Their work with adolescent patients with relation to contraceptive behaviors is led by the desire to educate through building a significant and long-term relationship that could sustain these patients.

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