scholarly journals “The talking bit of medicine, that’s the most important bit”: doctors and Aboriginal interpreters collaborate to transform culturally competent hospital care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Vicki Kerrigan ◽  
Stuart Yiwarr McGrath ◽  
Sandawana William Majoni ◽  
Michelle Walker ◽  
Mandy Ahmat ◽  
...  
Keyword(s):  
Scale Up ◽  
Aboriginal Peoples ◽  
Culturally Competent ◽  
Participatory Action ◽  
Work Routines ◽  
Hospital Systems ◽  
Interpreter Service ◽  
Field Notes ◽  
Ward Rounds ◽  
Inductive Thematic Analysis

Abstract Background In hospitals globally, patient centred communication is difficult to practice, and interpreters are underused. Low uptake of interpreters is commonly attributed to limited interpreter availability, time constraints and that interpreter-medicated communication in healthcare is an aberration. In Australia’s Northern Territory at Royal Darwin Hospital, it is estimated around 50% of Aboriginal patients would benefit from an interpreter, yet approximately 17% get access. Recognising this contributes to a culturally unsafe system, Royal Darwin Hospital and the NT Aboriginal Interpreter Service embedded interpreters in a renal team during medical ward rounds for 4 weeks in 2019. This paper explores the attitudinal and behavioural changes that occurred amongst non-Indigenous doctors and Aboriginal language interpreters during the pilot. Methods This pilot was part of a larger Participatory Action Research study examining strategies to achieve culturally safe communication at Royal Darwin Hospital. Two Yolŋu and two Tiwi language interpreters were embedded in a team of renal doctors. Data sources included interviews with doctors, interpreters, and an interpreter trainer; reflective journals by doctors; and researcher field notes. Inductive thematic analysis, guided by critical theory, was conducted. Results Before the pilot, frustrated doctors unable to communicate effectively with Aboriginal language speaking patients acknowledged their personal limitations and criticised hospital systems that prioritized perceived efficiency over interpreter access. During the pilot, knowledge of Aboriginal cultures improved and doctors adapted their work routines including lengthening the duration of bed side consults. Furthermore, attitudes towards culturally safe communication in the hospital changed: doctors recognised the limitations of clinically focussed communication and began prioritising patient needs and interpreters who previously felt unwelcome within the hospital reported feeling valued as skilled professionals. Despite these benefits, resistance to interpreter use remained amongst some members of the multi-disciplinary team. Conclusions Embedding Aboriginal interpreters in a hospital renal team which services predominantly Aboriginal peoples resulted in the delivery of culturally competent care. By working with interpreters, non-Indigenous doctors were prompted to reflect on their attitudes which deepened their critical consciousness resulting in behaviour change. Scale up of learnings from this pilot to broader implementation in the health service is the current focus of ongoing implementation research.

scholarly journals From “stuck” to satisfied: Aboriginal people’s experience of culturally safe care with interpreters in a Northern Territory hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vicki Kerrigan ◽  
Stuart Yiwarr McGrath ◽  
Sandawana William Majoni ◽  
Michelle Walker ◽  
Mandy Ahmat ◽  
...  
Keyword(s):  
Narrative Analysis ◽  
Northern Territory ◽  
Cultural Safety ◽  
Sampled Data ◽  
Health Providers ◽  
Participatory Action ◽  
Discharge Rates ◽  
Field Notes ◽  
Ward Rounds ◽  
Safe Care

Abstract Background Globally, interpreters are underused by health providers in hospitals, despite 40 years of evidence documenting benefits to both patients and providers. At Royal Darwin Hospital, in Australia’s Northern Territory, 60-90% of patients are Aboriginal, and 60% speak an Aboriginal language, but only approximately 17% access an interpreter. Recognising this system failure, the NT Aboriginal Interpreter Service and Royal Darwin Hospital piloted a new model with interpreters embedded in a renal team during medical ward rounds for 4 weeks in 2019. Methods This research was embedded in a larger Participatory Action Research study examining cultural safety and communication at Royal Darwin Hospital. Six Aboriginal language speaking patients (five Yolŋu and one Tiwi), three non-Indigenous doctors and five Aboriginal interpreter staff were purposefully sampled. Data sources included participant interviews conducted in either the patient’s language or English, researcher field notes from shadowing doctors, doctors’ reflective journals, interpreter job logs and patient language lists. Inductive narrative analysis, guided by critical theory and Aboriginal knowledges, was conducted. Results The hospital experience of Yolŋu and Tiwi participants was transformed through consistent access to interpreters who enabled patients to express their clinical and non-clinical needs. Aboriginal language-speaking patients experienced a transformation to culturally safe care. After initially reporting feeling “stuck” and disempowered when forced to communicate in English, participants reported feeling satisfied with their care and empowered by consistent access to the trusted interpreters, who shared their culture and worldviews. Interpreters also enabled providers to listen to concerns and priorities expressed by patients, which resulted in holistic care to address social determinants of health. This improved patient trajectories and reduced self-discharge rates. Conclusions A culturally unsafe system which restricted people’s ability to receive equitable healthcare in their first language was overturned by embedding interpreters in a renal medical team. This research is the first to demonstrate the importance of consistent interpreter use for providing culturally safe care for Aboriginal patients in Australia.

Problems and Practice of Management on Menstruation by Adolescents Girls of Basic Schools of Chitwan, Nepal

2020 ◽  
Vol 8 ◽  
pp. 85-94
Author(s):  
Sudha Ghimire
Keyword(s):  
Current Practice ◽  
Quantitative Information ◽  
Community Schools ◽  
Mixed Method Research ◽  
Participatory Action ◽  
Group Discussions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Field Notes ◽  
Sanitary Pads

Managing menstruation in a hygienic way is a challenge in most of the low and middle-income countries (LMIC) including Nepal, where normal and natural physiological process of menstruation is considered as girls’ problem which is viewed as sinful, unholy and matter of shame. This paper explores the current practice and existing difficulties that adolescents girls encounter hygienic management of menstruation (MHM) especially during school days. The study was conducted on five purposively selected community schools of Chitwan district. The study adopted Participatory Action Research (PAR) as an approach, that is encapsulated with mixed method research design. For qualitative information observation, focus group discussions (FGD) and field notes were used, whereas for quantitative data self-administrative questionnaires were used. Quantitative information was collected from 205 girls students who were present at schools on the day of data collection. The finding shows that majority of the girls (93.7%) who encounter hygienic management of menstruation were of 10-14 years old age, whereas nearly one third of them were (29%) from grade eight. Similarly, among the total 205 girls, only 79 girls have already started their menstruation; among those who have started menstruation majority (78%) had heard about menstruation form their mothers. Likewise, 35% girls used homemade cotton pads and 40.5% of them changed pad three times a day. During FGD, adolescents girls shared that lack of water and soap in toilets, stress and lack of concentration during menstruation are the major difficulties which they encounter during days of menstruation. They suggested the concerned authorities to manage pad bank, make soap and water available, and develop skills for proper disposing of used sanitary pads for MHM at schools. 

scholarly journals Exploring the ‘active mechanisms’ for engaging rural-dwelling older men with dementia in a community technological initiative

2019 ◽  
Vol 40 (9) ◽  
pp. 1906-1938 ◽  
Author(s):  
Ben Hicks ◽  
Anthea Innes ◽  
Samuel R. Nyman
Keyword(s):  
Computer Game ◽  
Older Men ◽  
Community Dwelling ◽  
Microsoft Kinect ◽  
Participatory Action ◽  
Nintendo Wii ◽  
Traditional Health ◽  
People With Dementia ◽  
Health And Social Care ◽  
Field Notes

AbstractResearch has suggested ecopsychosocial initiatives can promote a sense of wellbeing and inclusion in people with dementia. However, few studies have elucidated the ‘active mechanisms’ whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the ‘active mechanisms’ of a technological initiative for older men (65+ years) with dementia in rural England. An individually tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine-week period. Multiple qualitative methods were employed, including: focus groups, open interviews and extensive reflective field notes, to gather data from the perspective of 22 men, 15 care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative's success: the use of the technology, the male-only environment and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery.

scholarly journals What was Research for the Peasants of Córdoba? Participation in the Early Years of Participatory Action Research

2021 ◽  
Vol 18 ◽  
Author(s):  
Joanne Rappaport
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Collaborative Research ◽  
National Association ◽  
Early Years ◽  
Participatory Action ◽  
Field Notes ◽  
The Caribbean

Abstract Reflections on participatory and collaborative research commonly neglect to pay attention to the fact that for community researchers, investigation into their own realities frequently takes forms very different from those of academic scholars. They may use methods that are more explicitly intuitive and may depart from approaches that involve the rigorous collection and systematization of data. This paper explores what research might have meant to the Caribbean peasants of the early 1970s with whom Colombian sociologist Orlando Fals Borda developed his approach to what is today called participatory action research. In particular, it focuses on the field notes of Alfonso Salgado Martínez, a leader of the National Association of Peasant Users-Sincelejo Line (ANUC, Asociación Nacional de Usuarios Campesinos-Línea Sincelejo), juxtaposing them to his published work, both read in comparison to Fals Borda's own notes and writings.

scholarly journals ‘I always live in a quebrada [favela] and today I am here. So, you can be also here one day’: Exploring pre-service teachers’ perceptions of love for youth from socially vulnerable backgrounds

2020 ◽  
Vol 26 (4) ◽  
pp. 1006-1022 ◽  
Author(s):  
Carla Luguetti ◽  
Brent McDonald
Keyword(s):  
Data Analysis ◽  
Physical Education ◽  
Participatory Action Research ◽  
Sociocultural Context ◽  
Participatory Action ◽  
Teachers Perceptions ◽  
Embodied Experiences ◽  
Field Notes ◽  
Project Participants ◽  
Democratic Spaces

In recent years, socially critical scholars have argued that love, as a moral basis for socio-critical work, should not be colorblind or power blind and that marginalized populations may understand caring within their sociocultural context, creating spaces for youth and teachers to challenge the racism, sexism, class exploitation and linguicism imposed on their communities. While there is advocacy of love in education and physical education, there is little research that aims to explore how pre-service teachers’ (PSTs’) conceptions change across time. The aim of this study was to explore PSTs’ changing perceptions of love as they worked in an activist sport project with youth from socially vulnerable backgrounds. Participatory action research framed this four-semester research project. Participants included the lead researcher, four PSTs and 110 youth. Data collected included the following: (a) the lead researcher’s field notes; (b) collaborative PSTs’ group meetings; (c) PSTs’ generated artifacts; and (d) PSTs’ focus groups and interviews. Data analysis involved induction and constant comparison. The PSTs understood that love was represented by the following: (a) creating democratic spaces for students to care for each other and their community; (b) trusting and understanding the students, and dreaming possible futures with them; (c) being the best teacher in order to facilitate students’ learning; and (d) making sure all students are included. We concluded that the PSTs’ embodied experiences of oppression and the reflexive experience lived in the activist approach created a space for the PSTs to see themselves in the youth, reconnect with their own identity and develop empathy and love for the diverse youth.

scholarly journals Using Technology to Scale up Youth-Led Participatory Action Research: A Systematic Review

2020 ◽  
Vol 67 (2) ◽  
pp. S14-S23 ◽  
Author(s):  
Lisa Gibbs ◽  
Mariah Kornbluh ◽  
Katitza Marinkovic ◽  
Sherry Bell ◽  
Emily J. Ozer
Keyword(s):  
Systematic Review ◽  
Action Research ◽  
Participatory Action Research ◽  
Scale Up ◽  
Participatory Action

scholarly journals “Now, I’m Magazine Detective the Whole Time”: Listening and Responding to Young People’s Complex Experiences of Popular Physical Culture

2013 ◽  
Vol 32 (4) ◽  
pp. 394-418 ◽  
Author(s):  
Eimear Enright ◽  
Mary O’Sullivan
Keyword(s):  
Physical Activity ◽  
Physical Education ◽  
Physical Culture ◽  
Participatory Action ◽  
Action Research Project ◽  
Making Meaning ◽  
Audio Recordings ◽  
Methodological Tool ◽  
Field Notes ◽  
A Site

Popular physical culture serves as a site, subject and medium for young people’s learning (Sandford & Rich, 2006) and impacts their relationship with physical education, physical activity and the construction of their embodied identities. This paper addresses the potential of scrapbooking as a pedagogical and methodological tool to facilitate physical education researchers and teachers to listen to, and better understand and respond to extend students’ existing knowledge of, and critical engagement with popular physical culture. The data draws from a three year Participatory Action Research project that was undertaken in an urban, secondary school and was designed to engage 41 girls (aged 15–19) in understanding, critiquing and transforming aspects of their lives that influenced their perspectives of their bodies and their physical activity and physical education engagement. In this paper the focus is on the engagement of eleven of these girls in a five week popular physical culture unit. The students’ scrapbooks, audio-recordings of classes, a guided conversation, and field notes constitute the data sources. Findings suggest scrapbooking has the potential to allow researchers access, understand and respond to students’ perspectives on popular physical culture and their lives in a way that other methods may not. Pedagogically, scrapbooking supported students in critically appraising and making meaning of “scraps” of popular physical culture.

Virtual world global collaboration: an educational quest

2017 ◽  
Vol 118 (9/10) ◽  
pp. 547-565 ◽  
Author(s):  
Valerie Hill ◽  
K. Brant Knutzen
Keyword(s):  
Experiential Learning ◽  
Virtual Worlds ◽  
Digital Literacy ◽  
Virtual World ◽  
Mediated Learning ◽  
Participatory Action ◽  
Skill Levels ◽  
Content Type ◽  
Field Notes

Purpose This research case study shares the partnership between librarians and educators to create a live digital literacy experience at The Quest (Camelot Project), a virtual world medieval simulation. The purpose of the partnership was to gain understanding of the learning elements addressed with a group of participants from across the globe, working at various skill levels and interacting with an immersive virtual world simulation. Design/methodology/approach Using field notes, machinima and interviews (participatory action research), the study identifies learning elements within three contexts: technological, pedagogical and content. Learners cycle toward intended learning outcomes in a virtual-world treasure hunt game from the perspective of both designers and participants. Findings Findings of the case study illustrate the value of collaboration in a digital game-based learning (DGBL) environment through scaffolding of knowledge and skills in a virtual world. Findings exemplify the experiential learning cycle within a virtual world for constructing learning, and support a proposed new theoretical framework of technology-mediated learning which may help educators in both design and implementation. Originality/value As virtual worlds and immersive learning opportunities continue to expand for learners and educators, this study shares the value of experiential learning from the perspective of both the teacher and the learner. Socially constructing knowledge and acquiring skills across distance with a team of librarians and educators are innovative examples of DGBL in an alternative reality setting.

Reorienting Public Health Nurses’ Practice With a Professional Practice Model

2017 ◽  
Vol 49 (1) ◽  
pp. 16-27 ◽  
Author(s):  
Cheryl Cusack ◽  
Benita Cohen ◽  
Javier Mignone ◽  
Mariette J. Chartier ◽  
Zana Lutfiyya
Keyword(s):  
Public Health ◽  
Professional Practice ◽  
Public Health Nurses ◽  
Significant Feature ◽  
Research Approach ◽  
Semistructured Interview ◽  
Participatory Action ◽  
Practice Model ◽  
Action Research Approach ◽  
Field Notes

Purpose Documents articulating public health nurses’ (PHNs’) roles, including Canadian standards and competencies, depict a broad focus working at multiple levels to improve population outcomes through the promotion of health equity. Conversely, Canadian experts depict a looming crisis, based on the rising disconnect between daily activities and ideal practice. While perfectly positioned, PHNs’ skills and abilities are under-utilized and largely invisible. The intention of this study was to develop a model to support the full scope of equity-focused PHN practice. Method A participatory action research approach was used. Qualitative data were gathered using semistructured interview guides during audio-recorded meetings. The data were coded into central themes using content analysis and constant comparison. A researcher reflexive journal and field notes were kept. A significant feature was full participant involvement. Results The outcome was a professional practice model to reframe the PHN role to focus on population health and equity. The model was imperative in promoting full scope of practice, dealing with workload pressures, and describing PHNs’ value within the organization and broader health system. Conclusion Professional practice models hold promise as frameworks to depict autonomous practice activities, situated within organizations and healthcare systems, and underpinned by nursing knowledge.

scholarly journals Putting the social back into sociotechnical: Case studies of co-design in digital health

2020 ◽  
Author(s):  
Chrysanthi Papoutsi ◽  
Joseph Wherton ◽  
Sara Shaw ◽  
Clare Morrison ◽  
Trisha Greenhalgh
Keyword(s):  
Heart Failure ◽  
Case Studies ◽  
Digital Health ◽  
Scale Up ◽  
Patient Portal ◽  
Healthcare Staff ◽  
Clinical Practices ◽  
Field Notes ◽  
Technology Users ◽  
Cross Case Analysis

Abstract Objective We sought to examine co-design in 3 contrasting case studies of technology-supported change in health care and explain its role in influencing project success. Materials and Methods Longitudinal case studies of a seizure detection and reporting technology for epilepsy (Southern England, 2018-2019), a telehealth service for heart failure (7 UK sites, 2016-2018), and a remote video consultation service (Scotland-wide, 2019-2020). We carried out interviews with 158 participants and collected more than 200 pages of field notes from observations. Within- and cross-case analysis was informed by sociotechnical theory. Results In the epilepsy case, co-design prioritized patient-facing features and focused closely around a specific clinic, which led to challenges with sustainability and mainstreaming. In the heart failure case, patient-focused co-design produced an accessible and usable patient portal but resulted in variation in uptake between clinical sites. Successful scale-up of video consultations was explained by a co-design process involving not only the technical interface, but also careful reshaping of work practices. Discussion A shift is needed from co-designing with technology users to co-designing with patients as service users, and with healthcare staff as professionals. Good co-design needs to involve users, including those who engage with the technology-supported service bothdirectly and indirectly. It requires sensitivity to emergence and unpredictability in complex systems. Healthcare staff need to be supported to accommodate iterative change in the service. Adequate resourcing and infrastructures for systems-focused co-design are essential. Conclusions If co-design focuses narrowly on the technology, opportunities will be missed to coevolve technologies alongside clinical practices and organizational routines.

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