scholarly journals Thoughts, beliefs and concepts concerning infectious childhood diseases of physicians practicing homeopathic, anthroposophic and conventional medicine – a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
N. Mittring-Junghans ◽  
C. Holmberg ◽  
C. M. Witt ◽  
M. Teut
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Scarlet Fever ◽  
Conventional Medicine ◽  
Vaccination Schedule ◽  
Anthroposophic Medicine ◽  
Theory Approach ◽  
Parent Child Relationship ◽  
Childhood Diseases ◽  
Child Relationship

Abstract Background Physicians who include complementary medicine in their practice are thought to have an understanding of health and disease different from that of colleagues practicing conventional medicine. The aim of this study was to identify and compare the thoughts and concepts concerning infectious childhood diseases (measles, mumps, rubella, chickenpox, pertussis and scarlet fever) of physicians practicing homeopathic, anthroposophic and conventional medicine. Methods This qualitative study used semistructured interviews. Participating physicians were either general practitioners or pediatricians. Data collection and analysis were guided by a grounded theory approach. Results Eighteen physicians were interviewed (6 homeopathic, 6 anthroposophic and 6 conventional). All physicians agreed that while many classic infectious childhood diseases such as measles, mumps and rubella are rarely observed today, other diseases, such as chickenpox and scarlet fever, are still commonly diagnosed. All interviewed physicians vaccinated against childhood diseases. A core concern for physicians practicing conventional medicine was the risk of complications of the diseases. Therefore, it was considered essential for them to advise their patients to strictly follow the vaccination schedule. Homeopathic-oriented physicians viewed acute disease as a biological process necessary to strengthen health, fortify the immune system and increase resistance to chronic disease. They tended to treat infectious childhood diseases with homeopathic remedies and administered available vaccines as part of individual decision-making approaches with parents. For anthroposophic-oriented physicians, infectious childhood diseases were considered a crucial factor in the psychosocial growth of children. They tended to treat these diseases with anthroposophic medicine and underlined the importance of the family’s resources. Informing parents about the potential benefits and risks of vaccination was considered important. All physicians agreed that parent-delivered loving care of a sick child could benefit the parent-child relationship. Additionally, all recognized that existing working conditions hindered parents from providing such care for longer durations of time. Conclusions The interviewed physicians agreed that vaccines are an important aspect of modern pediatrics. They differed in their approach regarding when and what to vaccinate against. The different conceptual understandings of infectious childhood diseases influenced this decision-making. A survey with a larger sample would be needed to verify these observations.

Adoption: Lesbian and Gay Adoptive Parents

2014 ◽  
Author(s):  
Abbie E. Goldberg ◽  
April Moyer
Keyword(s):  
Decision Making ◽  
Adoptive Parents ◽  
Adoptive Parent ◽  
Future Research ◽  
Decision Making Process ◽  
Parent Child Relationship ◽  
Gay Parents ◽  
Lesbian And Gay ◽  
Child Relationship ◽  
Adoptive Parenthood

Adoption by lesbian and gay parents is becomingly increasingly common. This entry presents an overview of the limited research that has focused on lesbian and gay adoptive parents. Specifically, this entry addresses the experience of adoptive parenthood for lesbian and gay parents, with emphasis on the decision-making process (that is, choosing adoption, choosing an agency, choosing an adoption type, and specifying child characteristics), the transition to adoptive parenthood, the psychological adjustment of the adoptive parents and their children, and the adoptive parent–child relationship. We end with recommendations for future research and implications for practitioners and policymakers.

scholarly journals Understanding Barriers to Adoption of Facility Assisted Delivery in a Maasai Community in Ngorongoro District, Tanzania: A qualitative study to document psychosocial preferences, agency for decision-making, access barriers, and other factors that influence where a woman in Nainokanoka Ward will deliver

2019 ◽  
Author(s):  
Paul D Mosley ◽  
Kisiaya Saruni ◽  
Bernadetha Lenga
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health Sector ◽  
Facility Delivery ◽  
Care Group ◽  
Group Model ◽  
Theory Approach ◽  
Access Barriers ◽  
Study Results ◽  
Assisted Delivery

Abstract BACKGROUND Tanzania’s One Plan II health sector program aims to increase facility deliveries from 50% to 80% from 2015-2020. Success is uneven among certain Maasai pastoralist women in Northern Tanzania who resist going to a facility for birth even after completing 4+ ANC visits. EbOO is a program in Nainokanoka ward to promote facility-births through a care-group model using traditional birth attendants (TBAs) as facilitators. Results to date are promising but show a consistent gap between women completing ANC and those going to a facility for birth. METHODS A qualitative study was conducted in Nainokanoka ward to understand psychosocial preferences, agency for decision-making, and access barriers that influence where a woman in the ward will deliver. Interviews were conducted with twenty-three pregnant and/or parous women, along with 3 men’s and 2 TBA’s focus groups, and finally 3 key-informants from ward health facilities. Interviews were coded and analyzed thematically using a grounded theory approach. RESULTS Most women interviewed expressed preference for a home delivery with a TBA and even those who expressed agency and preference for a facility delivery usually had their last delivery at home attributed to unexpected labor. TBAs are engaged by husbands and play a significant influential role in deciding place of delivery as husbands defer to their judgment. TBAs claim to support facility deliveries but in practice use them as a last resort and reported a significant trust gap based on a bad experience at a facility where women in labor were turned away. CONCLUSIONS EbOO project data and study results show a slow but steady change in norms in Nainokanoka ward. Gaps between expressed intention and practice, especially around ‘unexpected labor’ present opportunities to accelerate this process by more intentionally promoting birth plans, and perhaps constructing a maternity waiting house near the ward health center. Rebuilding trust between facility midwives, TBAs, and the community on the availability of health facility services and assurance that women in labor will not be denied service, could also close the gap between the number of women who are currently using facilities for ANC and those returning for a facility delivery.

scholarly journals Gesinspolitiek en die ouer-kind verhouding

2017 ◽  
Vol 1 (1) ◽  
pp. 223
Author(s):  
C Maré
Keyword(s):  
Decision Making ◽  
Common Law ◽  
The State ◽  
Fundamental Rights ◽  
Customary Law ◽  
Decision Making Process ◽  
Parent Child Relationship ◽  
Child Relationship ◽  
The Family ◽  
Parent Child

The family-unit did, in one form or another occur since the beginning of man’s existence. The aim of the unit was to sire children and to provide for them until they reached maturity. To realise this provisional aim, a decision making process was required. The child and her parents’ individual interests can generate conflict where decisions have to be made regarding various questions, for example: which church the child should attend and or whether she should attend any church; which school a child should be enrolled in; with whom the child may associate and with whom not; if the child may use contraceptives, and whether an adolescent female may of her free will request or reject an abortion. Henceforth it must be kept in mind that the decision making process, i.e. family politics, is unique for each parent-child relationship. Various social, economic and cultural factors can influence the handling of conflict in the decision making process. Furthermore, fundamental rights can influence the decision making process differently in respectively the common law parent-child relationship and the customary law parent-child relationship. Central to the latter situation is the fact that fundamental rights recognise individual rights, while customary law is founded in communalism. It is furthermore important to note that the nature of the parent-child relationship is not neutral, but is determined by historical and social elements within the community. There are various statutory provisions in terms of which courts can intervene in the exercise of parental authority and can even terminate it, over and above the fact that the courts possess a common law competence as upper guardian. However, no law expressly grants the court the power to intervene in the parent-child relationship where conflict arises within the decision making process. The courts only have the authority to intervene in the parent-child relationship in the event of physical maltreatment or molestation of a child, in divorce proceedings, and where consent must be granted for a minor’s marriage. Even the family advocate is employed as mediator only in divorce matters. The court as common law upper guardian of minors, will only intervene in the parent-child relationship if it is of the opinion that such a step is in the interests of the child and it will therefor not be done lightly. The current constitutional provisions regarding children in a multi-cultural society has brought about changes in the parent-child relationship. Reading together sections 9 and 28 of the 1996-constitution puts it beyond doubt that any child under the age of 18 years is a person possessing fundamental rights. The state is drawn in as a third party in the parent-child relationship and must ensure that the interests of the child, that is fundamental rights, are guaranteed. Section 28 of the 1996-constitution goes further than section 30 of the 1993-constitution and provides a description for the meaning of parental care. The reference to family care, parental care and appropriate alternative care in the 1996-constitution can be indicative of the fact that the changed relationships wherein children find themselves within the community (other than the nuclear family) are recognised. The constitutional provisions also causes a change of emphasis in the parent-child relationship. The emphasis changes from the parent’s rights and responsibilities to the rights that a child may claim. The child can enforce her rights against the state and her parents. The yardstick which determines whether the child is entitled to its constitutional rights, is in whether such a claim would be in the best interests of the child. If the child approaches the High Court as the common law upper guardian to enforce her rights, or to strike a balance in the decision making process, the state must supply the child with the necessary legal representation. Due to the relevant constitutional provisions, the parent-child relationship can no longer be considered to be regulated merely by rules of authority, but the emphasis has shifted to the promotion of the child’s interests. The best interest of the child must thus be the guiding principle in all legal proceedings. It implies further that the South African family law approach to balancing the decision making process within the parent-child relationship has also changed 

Clinical Decision-Making in Parent–Child Contact Problem Cases

2016 ◽  
pp. 13-62 ◽  
Author(s):  
Barbara J. Fidler ◽  
Peggie Ward
Keyword(s):  
Decision Making ◽  
Contact Problem ◽  
Clinical Decision Making ◽  
Contact Problems ◽  
Clinical Decision ◽  
Parent Child Relationship ◽  
Preliminary Screening ◽  
Clinical Interventions ◽  
Child Relationship ◽  
Parent Child

This chapter summarizes the continuum along which parent–child contact problems may be conceptualized and differentiated and addresses how legal and clinical interventions may be tailored to the nature and severity of the problem in a particular family. Parent–child contact problems include affinity, alignment, justified rejection, and alienation as well as hybrid cases, each of which can range from mild to severe. Which of these problems is observed in a given family and parent–child relationship depends on numerous factors, including the child’s developmental stage, whether a parent has engaged in parental alienating behaviors, whether and when there was violence between the parents, and whether a parent was abusive or neglectful of the child. The chapter provides an overview of psychoeducational and clinical interventions for mild, moderate, and severe cases. It also explicates protocols for managing initial queries, preliminary screening, clinical intake, and contracting for such interventions.

scholarly journals A Qualitative Exploration of Emerging Adults’ and Parents’ Perspectives on Communicating Adulthood Status

2015 ◽  
Author(s):  
Jessica Jablonski ◽  
Sara Martino
Keyword(s):  
College Students ◽  
Decision Making ◽  
Emerging Adulthood ◽  
Emerging Adults ◽  
Parent Child Relationship ◽  
Parent Child Communication ◽  
Child Relationship ◽  
The Family ◽  
Qualitative Exploration ◽  
Parent Child

In this study the authors examine parent - child communication in Emerging Adulthood. Thirty - seven college students and one or both of their parents completed written questionnaires assessing whether the parent had verbally communicated or did some action to acknowledge the Emerging Adult’s maturity. Communication about changes in the parent - child relationship, as well as the Emerging Adult’s decision - making abilities, obligations to the family, and financial responsibilities were also assessed. The responses to the open ended questions were qualitatively analyzed using grounded theory. The findings indicated that the Emerging Adults’ and parents’ responses were very similar, and the overwhelming majority reported that there had indeed been an acknowledgment from the parents to indicate Emerging Adulthood status, although this was not always verbally communicated; sometimes it was indicated through the parents’ behavior. K

How Psychosocial Factors Contribute to Japanese Older Adults’ Initiation of Advance Care Planning Discussions: A Qualitative Study

2020 ◽  
pp. 073346482091153 ◽  
Author(s):  
Jun Miyashita ◽  
Ayako Kohno ◽  
Yosuke Yamamoto ◽  
Sayaka Shimizu ◽  
Teruhisa Azuma ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Qualitative Study ◽  
Psychosocial Factors ◽  
Advance Care Planning ◽  
Family Caregiving ◽  
Care Planning ◽  
Theory Approach ◽  
Advance Care ◽  
Family Centered

Objectives: This study aimed to reveal the features of older adults’ advance care planning (ACP) discussions by identifying psychosocial factors related to their discussions in Japan, where people value family-centered decision making. Methods: A qualitative study using in-depth interviews was conducted with 39 participants (aged ≥65 years) recruited from the outpatient department of a community hospital in Fukushima, Japan. Data were analyzed using the grounded theory approach. Results: Through experiences of family caregiving, participants became aware of their own feelings about the end of life. Equal relationship with family members was important for lowering the threshold for having discussions. Some participants and their families in the same generation reached agreements on ACP; however, they were willing to yield to children’s decision making despite these discussions. Discussions: These findings provide insights into the psychosocial factors in relation to ACP discussions and support for the role of ACP discussions in the family-centered decision-making culture.

scholarly journals Beyond the “information deficit model” - understanding vaccine-hesitant attitudes of midwives in Austria: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Lehner ◽  
Janna Gribi ◽  
Kathryn Hoffmann ◽  
Katharina T. Paul ◽  
Ruth Kutalek
Keyword(s):  
Decision Making ◽  
Early Childhood ◽  
Qualitative Study ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Scientific Information ◽  
Vaccine Hesitancy ◽  
Theory Approach ◽  
Deficit Model ◽  
The Right

Abstract Background Healthcare workers are considered key stakeholders in efforts to address vaccine hesitancy. Midwives’ influence in advising expectant parents on early-childhood vaccinations is unquestioned, yet they remain an understudied group. The literature on midwives’ attitudes towards vaccinations is also inconclusive. We therefore conducted an explorative qualitative study on midwives’ vaccine-hesitant attitudes towards MMR (measles-mumps-rubella) vaccinations in Austria. Methods We conducted 12 in-depth interviews on their knowledge, concerns, and beliefs with midwives who self-identified as hesitant or resistant towards early-childhood MMR vaccinations. We analyzed the data using a grounded theory approach to distill common themes and meanings. Results Healthcare workers’ stewardship to address vaccine hesitancy is commonly framed in terms of the “information deficit model”: disseminate the right information and remedy publics’ information deficits. Our findings suggest that this approach is too simplistic: Midwives’ professional self-understanding, their notions of “good care” and “good parenthood” inflect how they engage with vaccine information and how they address it to their clients. Midwives’ model of care prioritized good counseling rather than sharing scientific information in a “right the wrong”-manner. They saw themselves as critical consumers of that information and as promoting “empowered patients” who were free, and affluent enough, to make their own choices about vaccinations. In so doing, they also often promoted traditional notions of motherhood. Conclusions Research shows that, for parents, vaccine decision-making builds on trust and dialogue with healthcare professionals and is more than a technical issue. In order to foster these interactions, understanding healthcare professionals’ means of engaging with information is key to understanding how they engage with their constituents. Healthcare workers are more than neutral resources; their daily praxis influenced by their professional standing in the healthcare system. Similarly, healthcare professionals’ views on vaccinations cannot be remedied with more information either. Building better and more diverse curricula for different groups of healthcare workers must attend to their respective roles, ethics of care, and professional beliefs. Taken together, better models for addressing vaccine hesitancy can only be developed by espousing a multi-faceted view of decision-making processes and interactions of healthcare workers with constituents.

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