scholarly journals Patient-identified early clinical warning signs of nodular melanoma: a qualitative study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adina Coroiu ◽  
Chelsea Moran ◽  
Jessica A. Davine ◽  
Kyla Brophy ◽  
Catherine Bergeron ◽  
...  

Abstract Background Nodular (NM) and superficial spreading melanoma (SSM) show different disease trajectories, with more rapid development in NM and fewer opportunities for early detection often resulting in worse outcomes. Our study described the patient-identified early signs of thin NM via comparisons to thin (≤ 2 mm) SSM and thick (> 2 mm) NM. Methods We conducted semi-structured interviews with NM and SSM patients and analyzed the data using thematic analysis. Results We enrolled 34 NM and 32 SSM patients. Melanoma early signs uniquely identified by patients with thin NM included white, blue or black coloration, “dot-like” size, fast changes in shape and color observed over 2 weeks, elevation and texture or “puffiness” over 6–12 months, and the sensation that the mole “did not feel right”. Early signs reported by both thin NM and thin SSM patients included round or oblong shape, “jagged” border, pink/red, brown/reddish or dark coloration, “elevated like a pimple” or “tiny bump”, fast color darkening, diameter growth, and border irregularity, and mole feeling “really itchy”. Conclusions We found evidence that early signs of NM can be self-identified, which has important implications for the earlier detection of this most aggressive type of melanoma by both health professionals and patients.

2021 ◽  
Author(s):  
Adina Coroiu ◽  
Chelsea Moran ◽  
Jessica A. Davine ◽  
Kyla Brophy ◽  
Catherine Bergeron ◽  
...  

Abstract Background: Nodular (NM) and superficial spreading melanoma (SSM) show different disease trajectories, with more rapid development in NM and fewer opportunities for early detection often resulting in worse outcomes. Our study described the patient-identified early signs of thin NM via comparisons to thin (≤ 2 mm) SSM and thick (>2 mm) NM. Methods: We conducted semi-structured interviews with NM and SSM patients and analyzed the data using thematic analysis. Results: We enrolled 34 NM and 32 SSM patients. Melanoma early signs uniquely identified by patients with thin NM included white, blue or black coloration, “dot-like” size, fast changes in shape and color observed over 2 weeks, elevation and texture or “puffiness” over 6-12 months, and the sensation that the mole “did not feel right”. Early signs reported by both thin NM and thin SSM patients included round or oblong shape, “jagged” border, pink/red, brown/reddish or dark coloration, “elevated like a pimple” or “tiny bump”, fast color darkening, diameter growth, and border irregularity, and mole feeling “really itchy”.Conclusions: We found evidence that early signs of NM can be self-identified, which has important implications for the earlier detection of this most aggressive type of melanoma by both health professionals and patients.


2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. Huglin ◽  
L. Whelan ◽  
S. McLean ◽  
K. Greer ◽  
D. Mitchell ◽  
...  

Abstract Background Allied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. Previous studies have indicated that AHAs may be underutilised in some contexts. This study aims to identify factors contributing to the effective utilisation of AHAs across health, aged care and disability sectors and possible pathway elements that may optimise AHA careers in Victoria. Methods Using an interpretive description approach data collection included a workforce survey and semi structured interviews (individual and group). Data analysis included descriptive statistics, independent t-tests and thematic analysis. Participants included allied health assistants, allied health professionals and allied health leaders in the health, aged care or disability sectors; educators, managers or student of allied health assistance training; and consumers of Victorian health, disability or aged care services. Results The literature scan identified numerous potential barriers to and enablers of AHA workforce utilisation. A total of 727 participants completed the survey consisting of AHAs (n = 284), AHPs & allied health leaders (n = 443). Thirteen group and 25 individual interviews were conducted with a total of 119 participants. Thematic analysis of the interview data identified four interrelated factors (system, training, individual and workplace) in pre-employment training and workplace environments. These factors were reported to contribute to effective utilisation of the AHA workforce across health, aged care and disability sectors. Study findings were also used to create a conceptual diagram of potential AHA career pathway elements. Conclusion This study identified pre-employment and workplace factors which may contribute to the optimal utilisation of the AHA workforce across Victorian health, aged care and disability sectors. Further study is needed to investigate the transferability of these findings to national and global contexts, and testing of the conceptual model.


2016 ◽  
Vol 15 (1) ◽  
pp. 35
Author(s):  
Thomas Joseph Parayil ◽  
Tony Sam George

This paper explores the therapists’ views and experience on spiritual components in counselling. Qualitative data were collected through semi-structured interviews, and thematic analysis used. The participants were nine mental health professionals from different backgrounds with 15 to 30 years of experience in the field. The four main themes that emerged are faith in God, the power of prayer, forgiveness and wholesome treatment process  


2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Devi Nereida Puerto Jimenez ◽  
Luis Fernando Fontibón Vanegas ◽  
María Lourdes Calderón ◽  
Ximena Pedraza

Los programas de educación continua en detección temprana del cáncer son una herramienta útil y necesaria en la adquisición de conocimientos, competencias y habilidades requeridas por los profesionales de la salud. En Colombia existen falencias en la formación de profesionales en estas áreas, derivando en la falta de estandarización de técnicas y procedimientos, e inadecuada unificación de criterios de abordaje diagnóstico y terapéutico de los pacientes. El estudio buscó evaluar el programa de educación continua en detección temprana del cáncer de mama implementado por el Instituto Nacional de Cancerología entre 2016-2018. Se realizó un estudio con metodología mixta concurrente, con diseño analítico descriptivo, a partir de un análisis documental, entrevistas semiestructuradas, análisis de las encuestas de satisfacción, y de los exámenes pre y pos de las capacitaciones realizadas. Se realizó un muestreo no probabilístico y a conveniencia, la población seleccionada fueron los sujetos involucrados (profesionales capacitados, capacitadores, creadores), entre los años 2016 a 2018. Dentro de los resultados se encontró, que el nivel de satisfacción con el curso fue del 97.5%; resaltando la metodología basada en el aprendizaje activo, la educación por competencias, la pertinencia de los temas abordados, la utilización de modelos anatómicos en silicona y la experticia de los capacitadores. Se encontraron diferencias estadísticamente significativas posterior a la intervención educativa (V=439; p=0.001). Quedaron en evidencia barreras de tipo económico, administrativo y de divulgación; además, se sugiere implementar el curso de manera sistemática, aumentando la cobertura, divulgación y tiempo de capacitación, ofreciendo prácticas con pacientes. Concluyendo que, la implementación de programas de educación continua en profesionales de la salud son una herramienta útil y necesaria en la adquisición de competencias básicas en detección temprana del cáncer y debe contar con una estructura definida, organizada y en concordancia con los programas y políticas públicas del país. Continuing education programs in early detection of cancer are a useful and necessary tool for the acquisition of knowledge, competencies, and skills required by health professionals. In Colombia, there are shortcomings in the training of professionals in these areas, resulting in a lack of standardization of techniques and procedures, and inadequate unification of criteria for diagnosis and therapeutic patient management. This study sought to evaluate the continuing education program in early detection of breast cancer implemented by the National Cancer Institute of Colombia between 2016 and 2018. A concurrent mixed methodology study was conducted, with descriptive analytical design, based on a documentary analysis, semi-structured interviews, analysis of satisfaction surveys, and pretest and posttest exams. A non-probability convenience sampling was performed; the selected population consisted of subjects involved in the program (trained professionals, trainers, creators) between 2016 and 2018. Among the results, the level of satisfaction with the course was found to be 97.5%, highlighting the methodology based on active learning, competency-based education, the relevance of the topics addressed, the use of anatomical silicone models, and the expertise of trainers. Statistically significant differences were found after the educational intervention (V=439; p=0.001). Economic, administrative, and dissemination barriers were evidenced. In addition, it was suggested to implement the course in a systematic way, increasing its coverage, dissemination, and training time, as well as to offer internships with patients. The study concludes that the implementation of continuing education programs among health professionals are a useful and necessary tool for the acquisition of basic skills in early cancer detection and must have a defined and organized structure in accordance with existing programs and public policies in the country.


2017 ◽  
Vol 28 (2) ◽  
pp. 212-230 ◽  
Author(s):  
Chloe Parton ◽  
Jane M Ussher ◽  
Simone Natoli ◽  
Janette Perz

Multiple sclerosis can impact affected women’s experiences of motherhood through physical and cognitive impairment. This study examined how women construct and experience motherhood while living with multiple sclerosis. Twenty mothers diagnosed with multiple sclerosis took part in semi-structured interviews. Transcripts were analysed using theoretical thematic analysis, drawing on feminist poststructuralist theory to organise and interpret themes. Two main themes were identified: “Performing motherhood in the context of MS” and “Bringing up a ‘good’ child”. “Performing motherhood in the context of MS” comprises the subthemes, “The self-sacrificing mother: Negating women’s needs”, “The unreliable mother: Adjusting day-to-day mothering practices”, and “Resisting discourses of idealised motherhood”. “Bringing up a ‘good’ child”, comprises the subthemes, “The damaging mother: Fear of harming the child” and “The good mother: Caring and building resilience in the child”. Women positioned themselves as failing to be good mothers, because of limitations to their mothering, and fear of damaging children. Focusing on building children’s emotional resilience functioned to restore constructions of “good” mothering. Acknowledging how Western cultural ideals influence women’s experience of mothering when living with chronic illness is important. Health professionals can provide support by addressing women’s feelings of failure as mothers and supporting communication with children.


Author(s):  
Mariana de Miranda Seize ◽  
Juliane Callegaro Borsa

Screening for early signs of autism spectrum disorder (ASD) (before 36 months of age) allows an early diagnosis and early intervention programs that provide better developmental opportunities for the child. The objective of this chapter is to increase the knowledge about early signs of ASD enabling their early detection. The method used was a literature review of the early warning signs of autism spectrum disorder in children between 24 and 36 months of age in the domains that characterize this disorder.


2018 ◽  
Vol 71 (suppl 1) ◽  
pp. 660-667 ◽  
Author(s):  
Marcela Gonçalves ◽  
Michely Aline Rodrigues do Prado ◽  
Simone Santana da Silva ◽  
Karen da Silva Santos ◽  
Priscila Norié de Araujo ◽  
...  

ABSTRACT Objective: To analyze the interference of leprosy in women’s life regarding work and daily life activities. Method: Exploratory qualitative study developed from semi-structured interviews and with the use of field diaries. The strategy of the organization of data was a thematic analysis of content and referential of the work process in health and gender. Results: The themes presented are: “The leprosy pains”, “Changes with the disease and adaptation at work and activities” and “Being a woman with leprosy”. On them, we present the aspects that changed in women’s life from the leprosy, especially regarding work and daily activities. Beyond physical limitation, there are impacts on social relations and above all on formal work, there may even be dismission. Final considerations: In women affected by leprosy, work and daily activities are directly affected; this deepens the social difficulties and requires attention of health professionals.


2021 ◽  
Author(s):  
Philippa K Bird ◽  
Zoe Hindson ◽  
Abigail Dunn ◽  
Anna Cronin de Chavez ◽  
Josie Dickerson ◽  
...  

A secure parent-infant relationship lays the foundations for childrens development, however there are currently no measurement tools recommended for clinical practice. We evaluate the clinical utility of a structured assessment of the parent-infant relationship (the Maternal Postnatal Attachment Scale, MPAS) in a deprived, multi-ethnic urban community in England. This paper answers the question: what are health visitors views on the parent-infant relationship, and experiences of piloting the MPAS? It explores the barriers and facilitators to implementation, and complements the paper on psychometric properties and representativeness reported in Dunn et al (submitted). Semi-structured interviews were conducted with 11 health visitors and data were analysed using thematic analysis. Health visitors stressed the importance of the parent-infant relationship and reported benefits of the MPAS, including opening conversation, and identifying and reporting concerns. Challenges included timing, workload, the appropriateness and understanding of the questions and the length of the tool. Suggestions for improvements to the tool were identified. Our findings help to explain results in Dunn et al, and challenges identified would hinder routine assessment of the parent-infant relationship. Further work with health professionals and parents has been undertaken to co-produce an acceptable, feasible and reliable tool for clinical practice.


2018 ◽  
Vol 9 (1) ◽  
pp. 123-131 ◽  
Author(s):  
Denis Frederic ◽  
Rat Corinne ◽  
Reynaud Matthieu ◽  
Siu-Paredes Francesca ◽  
Tubert-Jeannin Stephanie ◽  
...  

Abstract Background The aim of this study was to present the different stages of development of the Schizophrenia Oral Health Profile (SOHP) questionnaire, aimed at assessing oral disorders and their impacts on functioning and psychosocial wellbeing for patients with schizophrenia (PWS) and to give the results of a feasibility study conducted in France Materials and methods The first step of this qualitative study was semi-structured interviews were conducted with 20 PWS and 6 health professionals (HP). A focus group integrating 4 PWS and 4 HP was also organised to identify the items of the SOHP. The data were analysed using a thematic analysis. Second, a feasibility study was conducted in a sample of 30 PWS who answered the SOHP questionnaire. The acceptability and understanding of the SOHP were evaluated, using a specific questionnaire. Results The semi-structured interviews and focus groups included 34 individuals in total. Items’ selection was done with several stages and led to a SOHP scale with 53 final items related to oral disorders and their impacts on functioning and psychosocial well-being. These items were classified in 13 preselected dimensions including one additional module related to the side effects of medications (11 items). The feasibility study showed good acceptability and understanding of the items of the SOHP scale. Conclusions The psychometric validation of the SOHP scale, involving a large sample of PWS, is currently in progress. The SOHP is important to evaluate PWS oral health needs and to offer appropriate strategies to improve oral health of this persons. Trial registration Clinical Trials Gov NCT02730832. Date registered: 21 March, 2016.


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