scholarly journals Barriers and facilitators to ED physician use of the test and treatment for BPPV

2017 ◽  
Vol 7 (3) ◽  
pp. 214-224 ◽  
Author(s):  
Kevin A. Kerber ◽  
Jane Forman ◽  
Laura Damschroder ◽  
Steven A. Telian ◽  
Angela Fagerlin ◽  
...  
Keyword(s):  
Qualitative Content Analysis ◽  
The United States ◽  
Barriers And Facilitators ◽  
Evidence Based Practices ◽  
Negative Experiences ◽  
Frequent Use ◽  
History Of ◽  
Positive Experiences ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

AbstractBackground:The test and treatment for benign paroxysmal positional vertigo (BPPV) are evidence-based practices supported by clinical guideline statements. Yet these practices are underutilized in the emergency department (ED) and interventions to promote their use are needed. To inform the development of an intervention, we interviewed ED physicians to explore barriers and facilitators to the current use of the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM).Methods:We conducted semi-structured in-person interviews with ED physicians who were recruited at annual ED society meetings in the United States. We analyzed data thematically using qualitative content analysis methods.Results:Based on 50 interviews with ED physicians, barriers that contributed to infrequent use of DHT/CRM that emerged were (1) prior negative experiences or forgetting how to perform them and (2) reliance on the history of present illness to identify BPPV, or using the DHT but misattributing patterns of nystagmus. Based on participants' responses, the principal facilitator of DHT/CRM use was prior positive experiences using these, even if infrequent. When asked which clinical supports would facilitate more frequent use of DHT/CRM, participants agreed supports needed to be brief, readily accessible, and easy to use, and to include well-annotated video examples.Conclusions:Interventions to promote the use of the DHT/CRM in the ED need to overcome prior negative experiences with the DHT/CRM, overreliance on the history of present illness, and the underuse and misattribution of patterns of nystagmus. Future resources need to be sensitive to provider preferences for succinct information and video examples.

scholarly journals The Albanian diaspora : immigration and settlement experiences

2021 ◽  
Author(s):  
Valbona Sulemani
Keyword(s):  
North America ◽  
The United States ◽  
Media Representation ◽  
Anthropological Perspective ◽  
Negative Experiences ◽  
Time Period ◽  
Immigration And Settlement ◽  
History Of ◽  
Positive Experiences ◽  
The Difference

This study attempts to analyze the immigration and settlement experiences of the Albanian diaspora. The paper takes an historical and anthropological perspective in outlining the experiences of Albanian people through a comparative analysis of Europe and North America. This paper examines the difference experiences of migrants in Greece and Italy to those of the United States and Canada in relation to the country of origin (Albania, Kosova, or Macedonia), the time period of migration, and the reason for migration. This study will outline and analyze the more positive experiences of Albanian people in North America, compared to the somewhat more negative experiences in Europe, with a discussion on the effects media representation has had on Albanian migrants in Greece and Italy. The history of a receiving country strongly affects its perspective on immigration and consequently its reception of immigrants.

scholarly journals The Albanian diaspora : immigration and settlement experiences

2021 ◽  
Author(s):  
Valbona Sulemani
Keyword(s):  
North America ◽  
The United States ◽  
Media Representation ◽  
Anthropological Perspective ◽  
Negative Experiences ◽  
Time Period ◽  
Immigration And Settlement ◽  
History Of ◽  
Positive Experiences ◽  
The Difference

This study attempts to analyze the immigration and settlement experiences of the Albanian diaspora. The paper takes an historical and anthropological perspective in outlining the experiences of Albanian people through a comparative analysis of Europe and North America. This paper examines the difference experiences of migrants in Greece and Italy to those of the United States and Canada in relation to the country of origin (Albania, Kosova, or Macedonia), the time period of migration, and the reason for migration. This study will outline and analyze the more positive experiences of Albanian people in North America, compared to the somewhat more negative experiences in Europe, with a discussion on the effects media representation has had on Albanian migrants in Greece and Italy. The history of a receiving country strongly affects its perspective on immigration and consequently its reception of immigrants.

scholarly journals The Knowledge Concealed in Users’ Narratives, Valuing Clients’ Experiences as Coherent Knowledge in Their Own Right

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ragnfrid Kogstad ◽  
Tor-Johan Ekeland ◽  
Jan Kaare Hummelvoll
Keyword(s):  
Narrative Analysis ◽  
Qualitative Content Analysis ◽  
Phenomenological Approach ◽  
Extraction Methods ◽  
History Of Psychiatry ◽  
Negative Experiences ◽  
Hermeneutic Phenomenological ◽  
Open Questions ◽  
History Of ◽  
Year 2000

Objective. As the history of psychiatry has been written, users have told their stories and often presented pictures incompatible with the professional or official versions. We ask if such a gap still exists and what the ethical as well as epistemological implications may be. Study Design. The design is based on a hermeneutic-phenomenological approach, with a qualitative content analysis of the narratives. Data Sources. The paper draws on user narratives written after the year 2000, describing positive and negative experiences with the mental health services. Extraction Methods. Among 972 users answering a questionnaire, 492 also answered the open questions and wrote one or two stories. We received 715 stories. 610 contained enough information to be included in this narrative analysis. Principal Findings. The stories are coherent, containing traditional narrative plots, but reports about miscommunication, rejection, lack of responsiveness, and humiliation are numerous. Conclusions. The picture drawn from this material has ethical as well as epistemological implications and motivates reflections upon theoretical and practical consequences when users’ experiences do not influence professional knowledge to a larger degree.

scholarly journals Implementation Science Research Examining the Integration of Evidence-Based Practices Into HIV Prevention and Clinical Care: Protocol for a Mixed-Methods Study Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) Model (Preprint)

2018 ◽  
Author(s):  
April Idalski Carcone ◽  
Karin Coyle ◽  
Sitaji Gurung ◽  
Demetria Cain ◽  
Rafael E Dilones ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hiv Prevention ◽  
Implementation Science ◽  
Real World ◽  
Clinical Care ◽  
The United States ◽  
Barriers And Facilitators ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Ebp Implementation

BACKGROUND The Exploration, Preparation, Implementation, and Sustainment (EPIS) model is an implementation framework for studying the integration of evidence-based practices (EBPs) into real-world settings. The EPIS model conceptualizes implementation as a process starting with the earliest stages of problem recognition (Exploration) through the continued use of an EBP in a given clinical context (Sustainment). This is the first implementation science (IS) study of the integration of EBPs into adolescent HIV prevention and care settings. OBJECTIVE This protocol (ATN 153 EPIS) is part of the Scale It Up program, a research program administered by the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN), described in this issue by Naar et al. The EPIS study is a descriptive study of the uptake of 4 EBPs within the Scale It Up program. The goal of EPIS is to understand the barriers and facilitators associated with the Preparation, Implementation, and Sustainment of EBPs into HIV prevention and clinical care settings. METHODS The EPIS study is a convergent parallel mixed-methods IS study. Key implementation stakeholders, that is, clinical care providers and leaders, located within 13 ATN sites across the United States will complete a qualitative interview conducted by telephone and Web-based surveys at 3 key implementation stages. The Preparation assessment occurs before EBP implementation, Implementation occurs immediately after sites finish implementation activities and prepare for sustainment, and Sustainment occurs 1 year postimplementation. Assessments will examine stakeholders’ perceptions of the barriers and facilitators to EBP implementation within their clinical site as outlined by the EPIS framework. RESULTS The EPIS baseline period began in June 2017 and concluded in May 2018; analysis of the baseline data is underway. To date, 153 stakeholders have completed qualitative interviews, and 91.5% (140/153) completed the quantitative survey. CONCLUSIONS The knowledge gained from the EPIS study will strengthen the implementation and sustainment of EBPs in adolescent prevention and clinical care contexts by offering insights into the barriers and facilitators of successful EBP implementation and sustainment in real-world clinical contexts. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11202

scholarly journals Information Needs and Experiences From Pregnancies Complicated by Hypertensive Disorders: a Qualitative Analysis of Narrative Responses

2021 ◽  
Author(s):  
Raj SHREE ◽  
Kendra HATFIELD-TIMAJCHY ◽  
Alina BREWER ◽  
Eleni TSIGAS ◽  
Marianne VIDLER
Keyword(s):  
Information Needs ◽  
Qualitative Content Analysis ◽  
The United States ◽  
Patient Centered ◽  
Web Searches ◽  
Hypertensive Disorders ◽  
Broad Array ◽  
Centered Care ◽  
History Of ◽  
Patient Provider Communication

Abstract BackgroundIncorporation of the patient voice is urgently needed in a broad array of health care settings, but it is particularly lacking in the obstetrical literature. Systematically derived information about patients’ experience with hypertensive disorders of pregnancy (HDP), most notably preeclampsia, is necessary to improve patient-provider communication and ultimately inform patient-centered care and research. We sought to examine the information needs and experiences of individuals with pregnancies complicated by hypertensive disorders. MethodsWe conducted a qualitative content analysis of narrative-responses to an open-ended question from an online registry hosted by the Preeclampsia Foundation. Individuals were invited to enroll in The Preeclampsia Registry via social media, web searches, and newsletters. We restricted our analysis to participants who self-reported a history of HDP and responded to the open-ended question, “Is there any information that you could have had at the time of this pregnancy that would have been helpful?”. Available responses from July 2013 to March 2017 were included. Narrative responses were coded, reconciled, and thematically analyzed by multiple coders using an inductive approach. Our main outcome measures included participants’ expressed needs and additional concerns with respect to their HDP pregnancy.ResultsOf 3202 enrolled participants, 1850 completed the survey and self-reported having at least one pregnancy complicated by HDP, of which 895 (48.4%) responded to the open-ended question. Participants delivered in the United States (83%) and 27 other countries. Compared to non-responders, responders reported more severe HDP phenotypes and adverse offspring outcomes. We identified three principal themes from responses: patient-identified needs, management and counseling, and potential action. Responses revealed that participants’ baseline understanding of HDP, including symptoms, management, therapeutic strategies, and postpartum complications, was demonstrably lacking. Responders strongly desired improved counseling so that both they and their providers could collaboratively diagnose, appropriately manage, and robustly and continuously communicate to facilitate a partnership to address any HDP complications.Conclusions Participants’ responses regarding their HDP experience provide indispensable insight into the patient’s perspectives. Our study suggests that improved education regarding possible HDP complications and enriched provider counseling when considering an HDP diagnosis are needed and efforts to implement these strategies should be sought. Trial registrationThe Preeclampsia Registry: https://clinicaltrials.gov/ct2/show/NCT02020174

scholarly journals Patients' and Nurses’ Experiences and Perceptions of Remote Monitoring of Implantable Cardiac Defibrillators in Heart Failure: Cross-Sectional, Descriptive, Mixed Methods Study

10.2196/19550 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e19550
Author(s):  
Maria Liljeroos ◽  
Ingela Thylén ◽  
Anna Strömberg
Keyword(s):  
Heart Failure ◽  
Mixed Methods ◽  
Response Rate ◽  
Qualitative Content Analysis ◽  
Implantable Cardioverter Defibrillators ◽  
Cross Sectional ◽  
Negative Experiences ◽  
Positive Experiences ◽  
The Mean ◽  
Score Range

Background The new generation of implantable cardioverter-defibrillators (ICDs) supports wireless technology, which enables remote patient monitoring (RPM) of the device. In Sweden, it is mainly registered nurses with advanced education and training in ICD devices who handle the arrhythmias and technical issues of the remote transmissions. Previous studies have largely focused on the perceptions of physicians, and it has not been explored how the patients’ and nurses’ experiences of RPM correspond to each other. Objective Our objective is to describe, explore, and compare the experiences and perceptions, concerning RPM of ICD, of patients with heart failure (HF) and nurses performing ICD follow-up. Methods This study has a cross-sectional, descriptive, mixed methods design. All patients with HF and an ICD with RPM from one region in Sweden, who had transitioned from office-based visits to implementing RPM, and ICD nurses from all ICD clinics in Sweden were invited to complete a purpose-designed, 8-item questionnaire to assess experiences of RPM. The questionnaire started with a neutral question: “What are your experiences of RPM in general?” This was followed by one positive subscale with three questions (score range 3-12), with higher scores reflecting more positive experiences, and one negative subscale with three questions (score range 3-12), with lower scores reflecting more negative experiences. One open-ended question was analyzed with qualitative content analysis. Results The sample consisted of 175 patients (response rate 98.9%) and 30 ICD nurses (response rate 60%). The majority of patients (154/175, 88.0%) and nurses (23/30, 77%) experienced RPM as very good; however, the nurses noted more downsides than did the patients. The mean scores of the negative experiences subscale were 11.5 (SD 1.1) for the patients and 10.7 (SD 0.9) for the nurses (P=.08). The mean scores of the positive experiences subscale were 11.1 (SD 1.6) for the patients and 8.5 (SD 1.9) for the nurses (P=.04). A total of 11 out of 175 patients (6.3%) were worried or anxious about what the RPM entailed, while 15 out of 30 nurses (50%) felt distressed by the responsibility that accompanied their work with RPM (P=.04). Patients found that RPM increased their own (173/175, 98.9%) and their relatives’ (169/175, 96.6%) security, and all nurses (30/30, 100%) answered that they found RPM to be necessary from a safety perspective. Most patients found it to be an advantage with fewer office-based visits. Nurses found it difficult to handle different systems with different platforms, especially for smaller clinics with few patients. Another difficulty was to set the correct number of alarms for the individual patient. This caused a high number of transmissions and a risk to miss important information. Conclusions Both patients and nurses found that RPM increased assurance, reliance, and safety. Few patients were anxious about what the RPM entailed, while about half of the nurses felt distressed by the responsibility that accompanied their work with RPM. To increase nurses’ sense of security, it seems important to adjust organizational routines and reimbursement systems and to balance the workload.

scholarly journals Barriers and Facilitators to Telemedicine: Can You Hear Me Now?

2021 ◽  
pp. 25-36
Author(s):  
Ana Maria Lopez ◽  
Kenneth Lam ◽  
Ramya Thota
Keyword(s):  
Health Care ◽  
Rural Communities ◽  
Health Care Professionals ◽  
Scaling Up ◽  
The United States ◽  
Barriers And Facilitators ◽  
Patients With Cancer ◽  
Barriers To Access ◽  
Direct Interpretation ◽  
History Of

In its most direct interpretation, telemedicine is medical care provided at a distance. Although telemedicine’s use had been steadily increasing, the COVID-19 pandemic prompted an unprecedented interest and urgency among patients, health care professionals, and policymakers to facilitate health care devoid of the need for in-person contact. The growth in personal access to telecommunications technology meant an unprecedented number of people in the United States and around the world had access to the equipment and technology that would make virtual care possible from the home. As the mass implementation of telemedicine unfolded, it became quickly apparent that scaling up the use of telemedicine presented considerable new challenges, some of which worsened disparities. This article describes those challenges by examining the history of telemedicine, its role in both supporting access and creating new barriers to access in trying to get everyone connected, frameworks for thinking about those barriers, and facilitators that may help overcome them, with a particular focus on older adults and patients with cancer in rural communities.

scholarly journals THE HISTORY OF THE FORMATION OF THE CONCEPT OF MULTICULTURALISM

2021 ◽  
Vol 69 (2) ◽  
Author(s):  
Akmaral Uteshova ◽  
◽  
◽  
Keyword(s):  
United States ◽  
Western Europe ◽  
Modern Society ◽  
Cultural Orientation ◽  
The United States ◽  
European Culture ◽  
Frequent Use ◽  
Cultural Movements ◽  
Social Difficulties ◽  
History Of

The article examines the emergence and formation of the concept of" multiculturalism", as well as its frequent use in scientific and public texts. In connection with the concept of" Multiculturalism", the definitions and views presented in the works of Russian and foreign scientists are presented. Various definitions of this concept analyze its uncertain political and cultural orientation. In this regard, the concept of "Multiculturalism" is interpreted in different media and in different audiences, which, in turn, requires a detailed study of this issue. In addition, it is characteristic that the concept of "multiculturalism" was formed in the classical immigration countries of the United States, Canada, and Australia, which is associated with the development of ethno-cultural movements, and as the main form of multiculturalism in European countries. The emergence of multiculturalism in Western Europe is associated with the historical era of colonial countries compared to countries of cultural immigration. The ideology of multiculturalism in the countries of Western Europe is supported by the spread of liberal values, which make us think about the ineffectiveness of modern Western European culture. The reason for this is that multiculturalism in Europe has a debt and coercive policy. This term appears and is discussed in many discussions when it comes to immigration and social difficulties, the lack of disagreement and cooperation in modern society, the crisis of the modern model of the state.

scholarly journals “You gotta respect”: Mexican-origin Adolescents’ Perspectives on Respect in Organized Activities

2016 ◽  
Vol 10 (3) ◽  
pp. 74-88 ◽  
Author(s):  
Andrea Vest Ettekal ◽  
Erin R. Gaskin ◽  
Alex R. Lin ◽  
Sandra D. Simpkins
Keyword(s):  
Qualitative Content Analysis ◽  
Ethnically Diverse ◽  
Future Research ◽  
Mexican Origin ◽  
Organized Activities ◽  
Moral Virtues ◽  
Shared Experiences ◽  
Different Types ◽  
History Of ◽  
Positive Experiences

Respect is crucial for promoting participation and positive experiences in organized activities, especially among ethnically diverse youth. However, little is known regarding how Mexican-origin adolescents conceptualize respect and specifically how to promote respect in activities. Guided by theory and previous research, we used qualitative content analysis to elucidate perspectives on respect and features involved in the development of respect in activities. Our sample consisted of 18 Mexican-origin 7th graders who resided in the Southwest of the U.S., an area with a history of inter-ethnic group tensions. The adolescents in this study described three different types of respect:  humanity respect, respect for culture, and linguistic respect. Potential features involved in the development of respect were identified, including individual- (e.g., moral virtues), contextual (e.g., welcoming atmosphere), and inter-personal (e.g., shared experiences) features. This study increases out depth of understanding of respect in activities, identifies areas for researchers to pursue in future research, and unveils potential implications for designing activities that promote positive, respectful relationships.

Hispanic Caregiver Experiences Supporting Positive Postschool Outcomes for Young Adults With Disabilities

2018 ◽  
Vol 56 (5) ◽  
pp. 337-353 ◽  
Author(s):  
Grace L. Francis ◽  
Judith M. S. Gross ◽  
Carlos E. Lavín ◽  
Lu Ankely Casarez Velazquez ◽  
Nicholas Sheets
Keyword(s):  
Service Providers ◽  
Family Members ◽  
The United States ◽  
Future Research ◽  
Competitive Employment ◽  
Negative Experiences ◽  
Postschool Outcomes ◽  
Working Age ◽  
Caregiver Experiences ◽  
Positive Experiences

Abstract The rate of competitive employment, or employment in community settings for minimum wage or higher, of working-age individuals with disabilities trails behind individuals without disabilities in the United States. These statistics are even more alarming among Hispanic individuals who have disabilities. The purpose of this study was to explore the negative and positive experiences of Hispanic caregivers from a Midwestern state as they support their family members with disabilities to achieve positive postschool outcomes, including competitive employment. We conducted semistructured interviews with 13 caregivers of family members with disabilities aged 14–25 years. Three key themes emerged from our analysis: (a) negative experiences with school educators, (b) negative experiences with community-based service providers, and (c) positive experiences and strategies for overcoming barriers. Implications for practice and future research are discussed.

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