Veteran families with complex needs: a qualitative study of the veterans’ support system

Abstract Background Families with complex needs face significant challenges accessing and navigating health and social services. For veteran families, these challenges are exacerbated by interactions between military and civilian systems of care, and the density of the veterans’ non-profit sector. This qualitative study was designed to gather rich, detailed information on complex needs in veteran families; and explore service providers’ and families’ experiences of accessing and navigating the veterans’ support system. Methods The study comprised participant background questionnaires (n = 34), focus groups with frontline service providers (n = 18), and one-on-one interviews with veteran families (n = 16) in Australia. The semi-structured focus groups and interviews were designed to gather rich, detailed information on four study topics: (i) health and wellbeing needs in veteran families; (ii) service-access barriers and facilitators; (iii) unmet needs and gaps in service provision; and (iv) practical solutions for improving service delivery. The study recruited participants who could best address the focus on veteran families with complex needs. The questionnaire data was used to describe relevant characteristics of the participant sample. The focus groups and interviews were audio-recorded, transcribed, and a reflexive thematic analysis was conducted to identify patterns of shared meaning in the qualitative data. Results Both service providers and families found the veterans’ support system difficult to access and navigate. System fragmentation was perceived to impede care coordination, and delay access to holistic care for veteran families with complex needs. The medico-legal aspects of compensation and rehabilitation processes were perceived to harm veteran identity, and undermine health and wellbeing outcomes. Recovery-oriented practice was viewed as a way to promote veteran independence and self-management. Participants expressed a strong preference for family-centred care that was informed by an understanding of military lifestyle and culture. Conclusion The health and wellbeing needs of veteran families intensify during the transition from full-time military service to civilian environments, and service- or reintegration-related difficulties may emerge (or persist) for a significant period of time thereafter. Veteran families with complex needs are unduly burdened by care coordination demands. There is a pressing need for high-quality implementation studies that evaluate initiatives for integrating fragmented systems of care.

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Information-seeking to Support Personal and Community Wellbeing: Report of a study of New Zealand Men Using Focus Groups

Proceedings of the Annual Conference of CAIS / Actes du congrès annuel de l'ACSI ◽

10.29173/cais962 ◽

2016 ◽

Author(s):

Peta Wellstead

Keyword(s):

New Zealand ◽

Focus Groups ◽

Support Services ◽

Information Seeking ◽

Service Providers ◽

Structural Constraints ◽

Health And Wellbeing ◽

Study Results ◽

Groupes De Discussion

This paper reports part of an ongoing study exploring the information behaviour of New Zealand men during periods of diminished health and wellbeing. Focus groups were used for this iteration of the study. Results indicate that New Zealand men face both personal and structural constraints to their information-seeking during periods when their health and wellbeing may be compromised. This study highlights that service providers need to develop more effective information delivery mechanisms and support services for men. These services need to be appealing to men and reflect men’s information seeking preferences. The role of LIS professionals in supporting this endeavour is discussed. Cet article présente une étude en cours explorant le comportement informationnel d’ hommes néo-zélandais durant des périodes où leur état de santé et de bien-être est amoindri. Des groupes de discussion ont été utilisés pour cette itération de l'étude. Les résultats indiquent que les hommes en Nouvelle-Zélande font face à des contraintes à la fois personnelles et structurelles dans leur recherche d'information pendant les périodes où leur santé et leur bien-être peuvent être affaiblis. Cette étude met en évidence le besoin pour les fournisseurs de services de développer des mécanismes de diffusion de l'information plus efficaces et des services de soutien pour les hommes. Ces services doivent être attrayants et refléter les préférences des hommes dans leurs recherches d’information. Le rôle des professionnels de l'information dans le soutien à cette entreprise est discuté.

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Syrian Crisis in Jordan: Case Study of Hosting Community Psycho-social in Low Income areas in Amman

Journal of Social Sciences (COES&RJ-JSS) ◽

10.25255/jss.2020.9.1.171.184 ◽

2020 ◽

Vol 9 (1) ◽

pp. 171

Author(s):

Manal Fathi Anabtawi

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Low Income ◽

Service Providers ◽

Self Esteem ◽

Policy Makers ◽

Syrian Crisis ◽

Syrian Refugee

This paper explores the influence that the Syrian crisis has on hosting community psycho-social in low income areas in Amman, Capital of Jordan. Case study was chosen as a design that would support a wider and in-depth exploration because it would be able to address the sensitivity of the issue; based on data from a qualitative study involving ten focus groups conducted from July to October 2017. Available reports and researches have investigated Syrian refugee needs and experiences, while few studies have explored the experiences of Jordanians in a hosting community, especially their psycho-social. In this paper, researcher argues that policy makers and service providers have to pay attention to hosting community experiences; especially their psycho-social. Paper concludes that Jordanians living in low income areas in Amman have been influenced by the Syrian crisis; suffering from frustration and despair, fears, anger, low self-esteem and hopelessness.

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Acceptability of Serious Games in Pediatric Asthma Education and Self-Management: Qualitative study with a consensual qualitative design (Preprint)

10.2196/preprints.33389 ◽

2021 ◽

Author(s):

Nicole Silva-Lavigne ◽

Alena Valderrama ◽

Sandra Pelaez ◽

Myriam Bransi ◽

Fabio Balli ◽

...

Keyword(s):

Qualitative Study ◽

Focus Groups ◽

Support System ◽

Serious Games ◽

Self Management ◽

Asthma Education ◽

Asthma Knowledge ◽

Children With Asthma ◽

The Impact

BACKGROUND Asthma is the most common chronic pediatric disease. Despite existing tools to manage asthma, 40-55% of children with asthma suffer from uncontrolled asthma. Serious games (SGs) represent a novel approach in promoting asthma education and self-management for children. OBJECTIVE In this qualitative study with an embedded quantitative design, we used focus groups and questionnaires to describe the perceived role of SGs in different aspects of asthma self-management by children and their parents. These aspects include asthma perception and knowledge, the impact of asthma and barriers to asthma self-management, and the support system for asthma self-management. METHODS Five children with asthma and their parents were invited to participate during an organized gaming session. Children and their parents filled out a pre-gaming questionnaire on their medical history and asthma knowledge. They were then invited to test four original SGs prototypes, after which the children answered a post-gaming questionnaire on their asthma knowledge and perception of the SGs. Children and their parents subsequently participated in parallel focus groups which were video- and/or audio-recorded, transcribed verbatim, and analyzed by reaching consensus among members of the research team. RESULTS The mean age of the children was 10.3 year, with 20% being male. Qualitative data from the transcripts were coded into three separate domains: 1) asthma self-management perception and knowledge, 2) impact of asthma and barriers to asthma self-management, and 3) support system for asthma self-management. We specifically explored the perceived roles of SGs within each of these domains. A key takeaway message was identified for each of these three domains: 1) Heterogeneity of asthma knowledge and the ability of SGs to encourage knowledge transfer through games, 2) Consequences and limitations of asthma and the ability of SGs to allow for identification and management of real-life situations through games, and 3) Insufficient support system and the ability of SGs to encourage playing with others for support and shared knowledge. CONCLUSIONS Our study explored the role of SGs in the self-management of asthma as perceived by children and their parents. Our findings support the acceptability of SGs in asthma education and self-management in pediatrics and the necessity for future development in this field.

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Social Inclusion as Freedom for Persons Living with Mental Illness

Canadian Journal of Community Mental Health ◽

10.7870/cjcmh-2018-023 ◽

2019 ◽

Vol 38 (1) ◽

pp. 23-35

Author(s):

Phyllis Montgomery ◽

Amy Wuest ◽

Cheryl Forchuk ◽

Tracy Smith-Carrier ◽

Momodou S. Jeng (Mo) ◽

...

Keyword(s):

Social Capital ◽

Mental Illness ◽

Focus Groups ◽

Social Services ◽

Thematic Analysis ◽

Social Inclusion ◽

Community Integration ◽

Complex Needs ◽

Health And Social Services

This study describes the meaning of social inclusion to persons living with mental illness and poverty. Participants were recruited from health and social services where they completed the Community Integration Questionnaire (CIQ). From this sample, 46 participants attended one of three focus groups that corresponded with their self-reported CIQ scores. Thematic analysis showed that regardless of their CIQ scores, participants described freedom as both a liberating process for, and outcome of, social inclusion; freedom allows for the accumulation of health and social capital commensurate with one’s complex needs, and freedom represents success in the construction life surrounded by affirming others.

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A qualitative exploratory study of UK first-time fathers’ experiences, mental health and wellbeing needs during their transition to fatherhood

BMJ Open ◽

10.1136/bmjopen-2019-030792 ◽

2019 ◽

Vol 9 (9) ◽

pp. e030792 ◽

Cited By ~ 6

Author(s):

Sharin Baldwin ◽

Mary Malone ◽

Jane Sandall ◽

Debra Bick

Keyword(s):

Mental Health ◽

Service Providers ◽

Early Years ◽

Mental Illnesses ◽

Current Evidence ◽

Full Time ◽

Perceived Needs ◽

Health And Wellbeing ◽

First Time ◽

Transition To Fatherhood

ObjectivesTo develop an understanding of men’s experiences of first-time fatherhood, their mental health and wellbeing needs.DesignA qualitative study using semi-structured interviews. Data were analysed using framework analysis.SettingTwo large National Health Service integrated care trusts covering four London (UK) local authority boroughs.ParticipantsFirst-time fathers with children under 12 months of age were included. Maximum variation sampling was used, with 21 fathers recruited. Ten of these men described their ethnic background as Indian, seven as White British, one as Spanish, one as Black African, one as Black Caribbean and one as Pakistani. Participants’ ages ranged from 20 to over 60 years; completion of full-time education ranged from high school certificate to doctorate level; and annual income ranged from £15 000 to over £61 000. Non-English speaking fathers, those experiencing bereavement following neonatal death, stillbirth, pregnancy loss, sudden infant death, and fathers with existing severe mental illnesses were excluded.ResultsNine major categories were identified: ‘preparation for fatherhood’, ‘rollercoaster of feelings’, ‘new identity’, ‘challenges and impact’, ‘changed relationship: we’re in a different place’, ‘coping and support’, ‘health professionals and services: experience, provision and support’, ‘barriers to accessing support’, and ‘men’s perceived needs: what fathers want’. Resident (residing with their partner and baby) and non-resident fathers in this study highlighted broadly similar needs, as did fathers for whom English was their first language and those for whom it was not. A key finding of this study relates to men’s own perceived needs and how they would like to be supported during the perinatal period, contributing to the current evidence.ConclusionsThis study provides insight into first-time fathers’ experiences during their transition to fatherhood, with important implications for healthcare policy makers, service providers and professionals for how perinatal and early years services are planned and provided for both new parents.

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Influence of past trauma and health interactions on homeless women’s views of perinatal care: a qualitative study

British Journal of General Practice ◽

10.3399/bjgp19x705557 ◽

2019 ◽

Vol 69 (688) ◽

pp. e760-e767 ◽

Cited By ~ 1

Author(s):

Anna CT Gordon ◽

David Lehane ◽

Jennifer Burr ◽

Caroline Mitchell

Keyword(s):

Mental Illness ◽

Substance Use ◽

Qualitative Study ◽

Social Services ◽

Perinatal Care ◽

Homeless Women ◽

Structured Interviews ◽

Child Loss ◽

Complex Needs ◽

Data Saturation

BackgroundHomeless women are twice as likely to become pregnant and are less likely to receive antenatal care than women who are not homeless. Prevalent biopsychosocial complexity and comorbidities, including substance use and mental illness, increase the risk of obstetric complications, postnatal depression, and child loss to social services.AimTo explore the perspectives of women who have experienced pregnancy and homelessness to ascertain how to improve perinatal care.Design and settingA qualitative study with a purposive sample of women who had experienced pregnancy and homelessness, recruited from three community settings.MethodSemi-structured interviews continued to data saturation and were recorded, transcribed, and analysed thematically using a self-conscious approach, with independent verification of emergent themes.ResultsEleven women, diverse in age (18–40 years) and parity (one to five children), participated. Most women had experienced childhood trauma, grief, mental illness, and substance use. Overarching themes of ‘mistrust‘ and ‘fear of child loss to social services’ (CLSS) influenced their interactions with practitioners. The women experienced stigma from practitioners, and lacked effective support networks. Women who mistrusted practitioners attended appointments but concealed their needs, preventing necessary care. Further themes were being seen to do ‘the best for the baby’; pregnancy-enabled access to necessary holistic biopsychosocial care; and lack of postnatal support for CLSS or parenting.ConclusionPregnancy offered a pivotal opportunity for homeless women to engage with care for their complex needs and improve self-care, despite mistrust of practitioners. Poor postnatal support and the distress of CLSS reinforced an ongoing cycle of grief, mental health crises, substance use relapse, and homelessness.

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How congenital Zika virus impacted my child’s functioning and disability: a Brazilian qualitative study guided by the ICF

BMJ Open ◽

10.1136/bmjopen-2020-038228 ◽

2020 ◽

Vol 10 (12) ◽

pp. e038228

Author(s):

Taynah Neri Correia Campos ◽

Veronica Schiariti ◽

Melissa Gladstone ◽

Adriana Melo ◽

Jousilene Sales Tavares ◽

...

Keyword(s):

Environmental Factors ◽

Qualitative Study ◽

Focus Groups ◽

Social Services ◽

Outcome Measures ◽

Zika Virus ◽

Extended Family ◽

Northeastern Brazil ◽

International Classification Of Functioning ◽

The Impact

IntroductionThe Zika virus outbreak in Brazil has had devasting social, medical and financial consequences for families. Both researchers and clinicians are measuring longer-term outcomes to understand the impact of the Zika on child development, functioning and disability. Outcomes and tools used to measure them are very varied and we are unclear how meaningful they are to families and children. This study aimed to identify the parents’ perspectives on relevant areas of functioning and disability that should be included as outcome measures for children with congenital Zika syndrome (CZS), as guided by the International Classification of Functioning, Disability and Health (ICF).MethodsThis qualitative study included parents or caregivers of children aged 0–5 years with confirmed CZS from two states in northeastern Brazil. Interviews were conducted using focus groups. Content mapping followed the WHO’s ICF linking rules. Three raters analysed the content using NVivo V.11.ResultsThirty-two caregivers participated in six focus groups, 88% were mothers with an average age of 30 years. Most children were male (59%) and all were level V (severe) to on the Gross Motor Function Classification System (GMFCS). Overall, 825 themes were mapped to 36 ICF categories. Although parents mentioned areas across all ICF domains, they reported that areas of mobility, eating and recreation were most relevant for them. In addition, environmental factors were highly identified as barriers, specifically services, policies and access to assistive devices. The most predominant facilitators within the environment were; immediate family support, kind relationships with therapists and support from the extended family.ConclusionsAlthough parents emphasised issues related to mobility, their greatest concerns involved environmental factors, such as access and quality of health and social services, systems and policies. These results reinforce the importance of including parents’ perspectives when selecting or developing outcome measures for CZS.

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Work Hard, Party Hard: Harm Reduction in a Postsecondary Setting

Canadian Journal of Higher Education ◽

10.47678/cjhe.vi0.188745 ◽

2021 ◽

pp. 1-14

Author(s):

Victoria Ford ◽

Alyssa Wooster ◽

Mary Bartram

Keyword(s):

Mental Health ◽

Qualitative Study ◽

Focus Groups ◽

Harm Reduction ◽

Service Providers ◽

Psychological Safety ◽

Student Leaders ◽

Academic Context ◽

Post Secondary ◽

Challenges And Opportunities

In the context of the increasing focus on harms, psychological safety, and mental health in post-secondary settings, this qualitative study explores the challenges and opportunities for harm reduction through focus groups with student leaders, service providers, and administrators in one large Canadian university. Key themes explored by participants include a pervasive work hard, party culture, clashes regarding how to define and operationalize harm reduction, broad approaches to harm reduction in tension with the risk of becoming a band-aid solution, and knowledge transfer and privilege in an academic context. These findings suggest possible avenues for harm reduction that could be implemented as part of the new post-secondary standard, as well as in society as a whole.

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Keeping one step ahead: A qualitative study among Norwegian health-care providers in hospitals involved in care coordination for patients with complex needs

International Journal of Care Coordination ◽

10.1177/2053434518764643 ◽

2018 ◽

Vol 21 (1-2) ◽

pp. 15-25 ◽

Cited By ~ 1

Author(s):

Audhild Høyem ◽

Deede Gammon ◽

Gro Berntsen ◽

Aslak Steinsbekk

Keyword(s):

Health Care ◽

Qualitative Study ◽

Health Care Providers ◽

Care Coordination ◽

Care Pathway ◽

Clinical Pathways ◽

Care Providers ◽

Complex Needs ◽

One Step

Introduction Various efforts aim to enhance continuity of care for patients with long-term health-care needs. Since 2012, Norwegian hospitals are mandated to appoint individual care coordinators for patients with complex needs to ensure continuity in the care pathway. New roles must meld with current practice. Implementation has been slow. This study investigates current care coordination across hospital contexts, from the perspective of health-care providers, a scarcely researched area. Methods A qualitative study using semi-structured individual, duo, and group interviews with 16 purposefully selected Norwegian health-care providers from different hospitals, departments, professions and with various roles. A thematic cross-case analysis using systematic text condensation was performed. Results Common for the interviewees’ care coordination experiences was to “keep one step ahead.” The scope of their coordination activities varied from diagnostics and treatment to orchestrating long-term, cross-sectional multidisciplinary care. This work was often performed without designated resources. The interviewees applied experience, knowledge, and sensitivity when defining the patients’ needs and searching for resources to orchestrate coordination work. They strived to balance the needs of patients with the resources available and adjusted the continuity ambitions on behalf of their patients to what they considered doable in the relevant contexts. However, many told of negotiating special solutions for selected patients with particularly complex needs. Discussion Care coordination for patients with complex needs emerged as diverse and context-sensitive. Acknowledgement of coordination activities that go beyond established workflow routines and clinical pathways, together with flexible leadership support and accessible infrastructural resources are needed.

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Understanding the Needs of People With Rare Dementias and Recommendations for Improving Post-diagnostic Care: ‘There Is No Such Thing as One Size Fits All’

10.21203/rs.3.rs-820704/v1 ◽

2021 ◽

Author(s):

Clarissa Giebel ◽

Jacqueline Cannon ◽

Sandra Smith ◽

Anna Pearson

Keyword(s):

Focus Groups ◽

Thematic Analysis ◽

Service Providers ◽

Lewy Body Dementia ◽

Alzheimer’S Dementia ◽

Active Member ◽

Alzheimer's Dementia ◽

North West ◽

Complex Needs ◽

The North

Abstract People with rare dementias such as Lewy Body dementia show different symptoms to those with Alzheimer’s dementia. Due to the large proportion of people with Alzheimer’s dementia, most services are designed to support their needs and often neglect those of people with rarer dementias. The aim of this study was to understand the needs of people with rare dementias and their families to develop targeted support. Two care professional focus groups were held in the North West of England. Focus groups lasted up to 60 minutes and were subsequently transcribed and analysed via thematic analysis. One former carer for her husband with a rare dementia was an active member of the project team and helped design the interview schedule, interpret and disseminate the findings. 18 dementia care professionals took part. Thematic analysis generated six themes: (1) Complex needs unsupported; (2) Reluctance to approach services; (3) Lack of service adaptation to both people living with dementia and carers; (4) Lack of communication between service providers; (5) Environment of service provision; (6) Funding issues. As opposed to suggesting new types of social activities, focus groups identified significant barriers in approaching and using post-diagnostic for those affected by a rare dementia, as well as inequalities in access to care services. There are various personal and service barriers for people with rarer dementias and unpaid carers to accessing and using post-diagnostic services. Future implementation work needs to adapt services and identify ways in which to overcome barriers in approaching services.

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