scholarly journals “‘You lose your hair, what’s the big deal?’ I was so embarrassed, I was so self-conscious, I was so depressed:” a qualitative interview study to understand the psychosocial burden of alopecia areata

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Natalie V. J. Aldhouse ◽  
Helen Kitchen ◽  
Sarah Knight ◽  
Jake Macey ◽  
Fabio P. Nunes ◽  
...  
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Disease Recurrence ◽  
Structured Interview ◽  
Emotional Impact ◽  
Psychosocial Effects ◽  
Psychosocial Burden ◽  
Qualitative Interview Study ◽  
Interview Guide ◽  
Expert Clinician

Abstract Background Alopecia areata (AA) is characterized by hair loss that can affect the scalp and body. This study describes the psychosocial burden of AA. Methods Participants diagnosed with AA who had experienced ≥50% scalp hair loss according to the Severity of Alopecia Tool (SALT) were identified by clinicians. A semi-structured interview guide, developed with expert clinician input, included open-ended questions to explore patients’ experiences of living with AA. Data were thematically analyzed to identify concepts and relationships. Results Participants (n = 45, 58% female, mean age 33.3 years [range 15–72], mean SALT 67.2 [range 0–100]) described the AA diagnosis as “devastating”. Both males and females reported emotional and psychological impacts of AA including feeling sad/depressed (n = 21), embarrassed/ashamed (n = 10) and angry/frustrated (n = 3). Patients felt helpless (n = 5) due to the unpredictability of disease recurrence, and anxious (n = 19) about judgement from others. Many patients avoided social situations (n = 18), which impaired relationships and increased isolation. Coping strategies included concealment of hair loss through wigs or make-up, although fear of the displacement of these coverings also caused anxiety and the avoidance of activities that could result in scalp exposure (n = 22). Some patients became more accepting of AA over time, which lessened the emotional impact, though efficacious treatment was still desired. A conceptual framework was developed, and a conceptual model was created to depict the relationship between the physical signs/symptoms and the associated psychosocial effects of AA. Conclusion AA impairs patients’ emotional and psychological wellbeing, relationships and lifestyles. Greater disease awareness and effective treatments are needed.

scholarly journals M150. RELATIVES EXPERIENCES OF THE EARLY SIGNS ACTION PLAN

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S192-S192
Author(s):  
Nils Sjöström ◽  
David Berg ◽  
Sofia Johansson ◽  
Eva Andreasson ◽  
Margda Waern
Keyword(s):  
Qualitative Content Analysis ◽  
Action Plan ◽  
Structured Interview ◽  
Warning Signs ◽  
Next Of Kin ◽  
Early Warning Signs ◽  
Early Signs ◽  
Qualitative Interview Study ◽  
Interview Guide ◽  
Persons With Schizophrenia

Abstract Background In the recent years person-centered methods have been developed to involve relatives in the care of their next of kin. The Early Signs Action Plan (ESAP) was developed to facilitate relatives’ participation in the care of their next of kin in psychiatric outpatient units specialized in the treatment of persons with schizophrenia and similar disorders. The aim was to investigate relatives’ experiences regarding the activation of the action plan for their next of kin. Methods The study is a qualitative interview study using a semi-structured interview guide. The interviews were conducted with relatives (N=13) to outpatients whose Early Signs Action Plan had been activated. The interviews were digitally recorded and transcribed verbatim. The material was then analyzed with qualitative content analysis. Results ESAP was positively received by the relatives and most of them experienced that they were participating in the planning of the care of their next of kin’s. Participating in the care also implied a feeling of security and awareness about their next of kin’s early warning signs and what to do in case of a relapse. Relatives also indicated that the ESAP is vulnerable during on call time and during vacation periods. Outdated paths to get in contact with psychiatric services on call time were reported as problematic since this information is crucial for getting in touch with care outside of office hours. Discussion ESAP seems to be a useful tool for the involvement of relatives in the care of their next of kin.

scholarly journals Being active 1½ years after hip fracture: A qualitative interview study of aged adults’ experiences of meaningfulness

2020 ◽  
Author(s):  
Birgit Rasmussen ◽  
Claus Vinther Nielsen ◽  
Lisbeth Uhrenfeldt
Keyword(s):  
Hip Fracture ◽  
Life Experience ◽  
Well Being ◽  
Structured Interview ◽  
Main Theme ◽  
Individual Interviews ◽  
Self Confidence ◽  
Existential Theory ◽  
Qualitative Interview Study ◽  
Interview Guide

Abstract Background: Being active is vital and a source of well-being. However, 18 months after hip fracture (HF), progress seems to have come to a halt. Aged adults may feel vulnerable, experiencing ongoing dependency and limited possibilities for socializing. How they experience the meaningfulness of being active during these circumstances is unknown. The aim of this study was to explore experiences of the meaningfulness of being active for aged adults 18 months after HF. Methods: A phenomenological-hermeneutic methodology based on the philosophies of Heidegger and Gadamer was applied. Data were collected using individual interviews conducted in participants’ homes. The study was part of a longitudinal study, and three former interviews helped build trusting relationships with participants and focus the semi-structured interview guide. An existential theory of well-being and suffering considering health to be a balancing of mobility and dwelling was applied. Participants were nine aged adults 65 years or older with pre-fracture dependency included in the study 18 months earlier while still in hospital after HF. The interpretation was a process of analyzing data by moving between the parts and the whole as a means of gaining a deeper understanding and continuously testing pre-understandings. The analysis followed five steps: a) getting a sense of the whole b) delineating and condensing meaning units, c) interpreting meaning units, d) relating to study purpose, and e) developing themes and sub-themes. Results: Two main themes emerged. The main-theme “Feeling the continuity of life“ had four sub-themes: “Gratitude for present possibilities,“ “Connected with earlier life-experience,“ “Thoughtfully managing vulnerability,“ and “Belonging with other people.“ The main-theme “Feeling vulnerable“ had two sub-themes: “Thwarted“ and “Sad and regretting lost continuity in life.“ Conclusions: Eighteen months after HF, aged adults seem to be struggling on their own to be active in meaningful ways. To maintain hope, relieve the strain in everyday life, and maintain a sense of safety and self-confidence, they may need help. However, to avoid suffering, there is a need to balance additional training and a struggle for progress with well-being experiences in terms of feeling gratitude, restoring a sense of normality, and feeling kinship with other people.

Complex patients’ effect on family physicians: high cognitive load and negative emotional impact

2020 ◽  
Author(s):  
Steven E Roskos ◽  
Laurie Fitzpatrick ◽  
Bengt Arnetz ◽  
Judy Arnetz ◽  
Shiva Shrotriya ◽  
...  
Keyword(s):  
Health Care ◽  
Cognitive Load ◽  
Family Physicians ◽  
Structured Interview ◽  
Emotional Impact ◽  
Physician Burnout ◽  
Medical Problems ◽  
Team Members ◽  
Complex Patients ◽  
Interview Guide

Abstract Background and objectives Complex patients present an increasing challenge to the health care system and family physicians play an important role in their care. As part of a larger project exploring family physicians’ perceptions of complex patients, we sought to understand how complex patients affect family physicians and if these effects might be related to physician burnout. Methods We conducted a qualitative study involving interviews with family physicians from various practice settings. We invited the physicians to choose three of their patients between the ages of 18 and 64 whom they considered to have complex medical problems and to have access to their medical records during a telephone interview using a semi-structured interview guide. Interviews were audio-recorded, professionally transcribed and coded. Using qualitative analytical software, research team members worked together to analyse the interview data and determine emerging themes. Results Eleven family physicians participated in the interviews and described 29 unique complex patients, including challenges and effects on them personally. Analysis of the available 10 family physicians’ interviews revealed two themes related to complexity’s impact on physicians: (i) high cognitive load and (ii) negative emotional impact. Conclusion Although preliminary, this study offers a previously unconsidered understanding of drivers of physician burnout, including high cognitive load and negative emotional impact on family physicians created by caring for complex patients. Interventions to improve health care, including addressing physician wellness and burnout, should include the provision of resources to assist them with decreasing cognitive load and negative emotional impact when caring for complex patients.

scholarly journals The Olympic Games: The Experience of a Lifetime or Simply the Most Important Competition of an Athletic Career?

2014 ◽  
Vol 64 (1) ◽  
pp. 41-52
Author(s):  
Rune Dall Jensen ◽  
Ask Vest Christiansen ◽  
Kristoffer Henriksen
Keyword(s):  
Media Coverage ◽  
Olympic Games ◽  
Structured Interview ◽  
Defining Moment ◽  
Sport Event ◽  
Qualitative Interview Study ◽  
Interview Guide ◽  
Sport Organization ◽  
The Individual ◽  
The Olympic Games

AbstractAs a multi-sport event that only takes place every four years and is accompanied by intense media coverage, the Olympic Games are often described by athletes as a defining moment in their careers. The objectives of the present study were: 1) to describe differences in expectations of Olympic debutants towards the Olympics and their actual experiences while they were at the Games; and 2) to describe how the athletes negotiate the balance between performing at and enjoying the experience of the Olympic Games. Further, we will discuss the athletes' stories in light of the differences between the goals and expectations of the elite sport system and those of the individual athletes. Data was collected through a qualitative interview study with a pre- and post-Olympic competition design.Using a semi-structured interview guide, we interviewed 14 Danish Olympic debutants about their Olympic goals and expectations within a month preceding their departure for the Olympic Games and about their actual experiences within a month following their return.Condensed narratives from two Olympic debutants represent the spectrum of the athletes' expectations and experiences: one failed in his performance but had a great experience; the other was successful and won a silver medal but was truly unhappy with her experience. The debutants emphasize balancing their desire to perform with a desire for social experiences. They also discussed the challenges posed during preparation and goal setting.Olympic debutants are caught in a very real dilemma between the Olympics as the “most important competition of their athletic careers” and “the Olympics as the experience of a lifetime.” This dilemma is linked to a wide rift between the perspectives and goals of the sport organization and those of the athletes.

Construction of citizenship in hospitalized children, Peru

2019 ◽  
Vol 1 (1) ◽  
pp. 31
Author(s):  
Fernando Ledesma Perez ◽  
Maria Caycho Avalos ◽  
Juana Cruz Montero ◽  
Andrea Ayala Sandoval
Keyword(s):  
Structured Interview ◽  
Health Condition ◽  
Qualitative Approach ◽  
Fundamental Rights ◽  
Hospitalized Children ◽  
Health Institute ◽  
Interview Guide ◽  
Communication Interaction ◽  
The Individual

Citizenship is the exercise of the fundamental rights of people in spaces of participation, opinion and commitments, which can not be violated by any health condition in which the individual is. This research aims to interpret the process of construction of citizenship in hospitalized children, was developed through the qualitative approach, ethnomethodological method, synchronous design, with a sample of three students hospitalized in a health institute specializing in childhood, was used Observation technique and a semi-structured interview guide were obtained as results that hospitalized children carry out their citizenship construction in an incipient way, through the communication interaction they make with other people in the environment where they grow up.

Patients’ Perceptions of Caring and Uncaring Nursing Encounters in Inpatient Rehabilitation Settings

2019 ◽  
Vol 21 (2) ◽  
Author(s):  
Joan C Cheruiyot ◽  
Petra Brysiewicz
Keyword(s):  
South Africa ◽  
Content Analysis ◽  
Inpatient Rehabilitation ◽  
Structured Interview ◽  
The Self ◽  
Personal Relationships ◽  
Individual Interviews ◽  
Textual Data ◽  
Interview Guide ◽  
Being There

This study explores and describes caring and uncaring nursing encounters from the perspective of the patients admitted to inpatient rehabilitation settings in South Africa. The researchers used an exploratory descriptive design. A semi-structured interview guide was used to collect data through individual interviews with 17 rehabilitation patients. Content analysis allowed for the analysis of textual data. Five categories of nursing encounters emerged from the analysis: noticing and acting, and being there for you emerged as categories of caring nursing encounters, and being ignored, being a burden, and deliberate punishment emerged as categories of uncaring nursing encounters. Caring nursing encounters make patients feel important and that they are not alone in the rehabilitation journey, while uncaring nursing encounters makes the patients feel unimportant and troublesome to the nurses. Caring nursing encounters give nurses an opportunity to notice and acknowledge the existence of vulnerability in the patients and encourage them to be present at that moment, leading to empowerment. Uncaring nursing encounters result in patients feeling devalued and depersonalised, leading to discouragement. It is recommended that nurses strive to develop personal relationships that promote successful nursing encounters. Further, nurses must strive to minimise the patients’ feelings of guilt and suffering, and to make use of tools, for example the self-perceived scale, to measure this. Nurses must also perform role plays on how to handle difficult patients such as confused, demanding and rude patients in the rehabilitation settings.

Hair Growth in a Patient with Alopecia Areata on Tocilizumab

2021 ◽  
pp. 1-5
Author(s):  
Chloe J. Walker ◽  
Kelly E. Flanagan ◽  
James T. Pathoulas ◽  
Isabel Pupo Wiss ◽  
Maryanne M. Senna
Keyword(s):  
Monoclonal Antibody ◽  
Autoimmune Disease ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Interleukin 6 ◽  
Hair Growth ◽  
Posterior Uveitis ◽  
Case Presentation ◽  
Antibody Targeting ◽  
Growth Changes

<b><i>Introduction:</i></b> Tocilizumab (TCZ), a recombinant humanized antihuman monoclonal antibody targeting interleukin-6 (IL-6) signaling, is often utilized in the management of autoimmune disease. Few reports have demonstrated hair growth changes in patients on TCZ. <b><i>Case Presentation:</i></b> Herein, we review the literature and report a 21-year-old woman with progressive alopecia areata (AA) presenting with AA improvement while on TCZ for concomitant posterior uveitis. <b><i>Discussion:</i></b> Our case demonstrates the potential ability of TCZ to disrupt IL-6 signaling involved in AA, leading to hair loss and regrowth.

scholarly journals Barriers and facilitators to the adoption of electronic clinical decision support systems: a qualitative interview study with UK general practitioners

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Ford ◽  
Natalie Edelman ◽  
Laura Somers ◽  
Duncan Shrewsbury ◽  
Marcela Lopez Levy ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Support Systems ◽  
General Practitioners ◽  
Clinical Decision Support ◽  
Support Systems ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Structured Interview ◽  
Qualitative Interview Study ◽  
High Level

Abstract Background Well-established electronic data capture in UK general practice means that algorithms, developed on patient data, can be used for automated clinical decision support systems (CDSSs). These can predict patient risk, help with prescribing safety, improve diagnosis and prompt clinicians to record extra data. However, there is persistent evidence of low uptake of CDSSs in the clinic. We interviewed UK General Practitioners (GPs) to understand what features of CDSSs, and the contexts of their use, facilitate or present barriers to their use. Methods We interviewed 11 practicing GPs in London and South England using a semi-structured interview schedule and discussed a hypothetical CDSS that could detect early signs of dementia. We applied thematic analysis to the anonymised interview transcripts. Results We identified three overarching themes: trust in individual CDSSs; usability of individual CDSSs; and usability of CDSSs in the broader practice context, to which nine subthemes contributed. Trust was affected by CDSS provenance, perceived threat to autonomy and clear management guidance. Usability was influenced by sensitivity to the patient context, CDSS flexibility, ease of control, and non-intrusiveness. CDSSs were more likely to be used by GPs if they did not contribute to alert proliferation and subsequent fatigue, or if GPs were provided with training in their use. Conclusions Building on these findings we make a number of recommendations for CDSS developers to consider when bringing a new CDSS into GP patient records systems. These include co-producing CDSS with GPs to improve fit within clinic workflow and wider practice systems, ensuring a high level of accuracy and a clear clinical pathway, and providing CDSS training for practice staff. These recommendations may reduce the proliferation of unhelpful alerts that can result in important decision-support being ignored.

Perspectives of community members on homeless people with mental illness in Nsawam, Ghana

2020 ◽  
pp. 002076402098419
Author(s):  
Kwamina Abekah-Carter ◽  
George Ofosu Oti
Keyword(s):  
Mental Illness ◽  
Homeless People ◽  
Structured Interview ◽  
Homeless Persons ◽  
Community Members ◽  
Qualitative Research Design ◽  
People With Mental Illness ◽  
Interview Guide ◽  
Audio Data ◽  
Good Food

Background: Homelessness among people with mental illness has grown to become a common phenomenon in many developed and developing countries. Just like in any other country, the living conditions of homeless people with mental illness in Ghana are unwholesome. Despite the increased population of these vulnerable individuals on the streets, not much is known about the perspectives of the general public towards this phenomenon in Ghana. Aim: This research was conducted to explore the perspectives of community members on homeless people with mental illness. The main study objectives were (a) to find out the impacts of the presence of persons with mental illness on the streets and (b) to ascertain the reasons accounting for homelessness among persons with mental illness. Method: Utilizing a qualitative research design, twenty community members were sampled from selected suburbs in Nsawam and interviewed with the use of a semi-structured interview guide. The audio data gathered from the interviews were transcribed verbatim and analysed thematically. Results: Majority of the participants asserted that homeless people with mental illness had no access to good food, shelter, and health care. They further stated that some homeless people with mental illness perpetrated physical and sexual violence against the residents. Moreover, the participants believed that persons with mental illness remained on the streets due to neglect by their family members, and limited access to psychiatric services. Conclusion: This paper concludes by recommending to government to make mental health services accessible and affordable to homeless persons with mental illness nationwide.

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