scholarly journals Cancer in children: the diagnostic itinerary

2007 ◽  
Vol 15 (5) ◽  
pp. 1025-1032 ◽  
Author(s):  
Aline Cristiane Cavicchioli ◽  
Maria José Menossi ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Problem Solving ◽  
Health Service ◽  
Qualitative Analysis ◽  
Signs And Symptoms ◽  
Study Data ◽  
Structured Interviews ◽  
Care Services ◽  
Specialized Care ◽  
Cancer In Children ◽  
Chronological Time

This study aims to describe the trajectory children and adolescents experience from the beginning of cancer signs and symptoms until the confirmation of the diagnosis, based on their parents' report. A total of eight mothers and two fathers participated in the study. Data were collected through semi structured interviews, and data were subject to qualitative analysis. We found that this period is significant for parents, who are capable of recognizing that something wrong started to happen to their children, expressed through signs and symptoms. They precisely reported the chronological time of this trajectory. The challenges they mentioned refer to the different diagnostic hypotheses, the difficulty to performing specific diagnostic exams and to be referred to specialized care services. This search for health service care revealed to be a difficult journey, which permits to identify that the Brazilian Basic Health System's principles of accessibility and problem-solving capacity are jeopardized.

scholarly journals Weaving networks: therapeutic itineraries of people with ostomy

2020 ◽  
Author(s):  
Antonio Dean Barbosa Marques ◽  
Ezequias Alexandre da Silva ◽  
Samara Aurélio Sales Vidal ◽  
Thereza Maria Magalhães Moreira ◽  
Virna Ribeiro Feitosa Cestari ◽  
...  
Keyword(s):  
Health Services ◽  
Care Management ◽  
Care Service ◽  
Signs And Symptoms ◽  
Descriptive Study ◽  
Qualitative Approach ◽  
Structured Interviews ◽  
Software Interface ◽  
Specialized Care ◽  
Informal Groups

Objective: To describe the therapeutic itinerary of people with an ostomy in search of specialized care. Method: exploratory, descriptive study with a qualitative approach, with ten people with ostomy treated at the Ostomy Care Service (Serviço de Atenção à Saúde da Pessoa Ostomizada), from August to November 2017. Reconstitution took place through semi-structured interviews, registration in a field diary and consultation with records of specialized health services, and processed by the software Interface de R pour les Analyses Multidimensionnelles de Texte et de Questionnaires. Results: the therapeutic itinerary begins with the discovery of signs and symptoms, when there is access to the nearest health services and later in search of specialized services. Marked by formal connections and supported by interrelated subsystems. The trajectories of search, production, health transport and health care management undertaken by individuals, families and informal groups express different paths and movements in the phase that precedes specialized care. Conclusion: the knowledge apprehended by the speeches enables the identification of basic needs presented by this clientele, facilities and barriers encountered in the course undertaken to obtain an adequate therapeutic plan.

scholarly journals Referência e contrarreferência de crianças em condição crônica: percepção de mães e profissionais da atenção secundária [Referral and counter-referral of children in chronic condition: perception of mothers and secondary care professionals] [Referencia y contrarreferencia de niños en condicion crónica: percepción de madres y profesionales de la atención secundaria]

2020 ◽  
Vol 28 ◽  
pp. e51186
Author(s):  
Elenice Maria Cecchetti Vaz ◽  
Thayse Da Silva Brito ◽  
Maria Carolina Salustino dos Santos ◽  
Paloma Mayara Vieira de Macena Lima ◽  
Erika Acioli Gomes Pimenta ◽  
...  
Keyword(s):  
Family Health ◽  
Structured Interviews ◽  
Care Services ◽  
Health Strategy ◽  
The Family ◽  
El Sistema ◽  
Family Health Strategy ◽  
Specialized Care ◽  
Referral Form ◽  
State Capital

Objetivo: identificar a efetivação do sistema de referência e contrarreferência de crianças em condição crônica na percepção de mães e profissionais dos serviços especializados. Método: estudo qualitativo, mediante entrevista semiestruturada, com mães e especialistas em centros de atenção especializada de uma capital do Nordeste, entre dezembro de 2018 e março de 2019. Resultados: por ser iniciada na Estratégia Saúde da Família e critério indispensável para a marcação da consulta, a referência é efetiva. Porém, a contrarreferência, não é realizada pela atenção especializada, pois não é exigida na rede de atenção à saúde. Os especialistas não preenchem o formulário de contrarreferência, tornando-a inefetiva, com comprometimento da continuidade do cuidado. Conclusão: a contrarreferência precisa ser reconhecida pelos profissionais de saúde como ferramenta fundamental para um cuidado longitudinal, que atenda às necessidades de saúde da criança em condição crônica.ABSTRACTObjective: to identify the effectiveness of the referral and counter-referral system for children with chronic conditions as perceived by mothers and care personnel of specialized care services. Method: this qualitative study conducted semi-structured interviews of mothers and specialists at specialized care centers of a state capital in Brazil’s Northeast, between December 2018 and March 2019. Results: as referral has been instituted in the Family Health Strategy as indispensable criterion for scheduling appointments, referral is effectively in place. However, the specialized care services are not counter-referring, as this is not required in the health system.  The specialists fail to complete the counter-referral form, making it ineffective and hindering continuity of care. Conclusion: health personnel need to recognize that counter-referral is a tool fundamental to longitudinal care that meets the health needs of children with chronic conditions.RESUMENObjetivo: identificar la efectividad del sistema de referencia y contrarreferencia de niños con condiciones crónicas percibidas por las madres y el personal de atención de los servicios de atención especializada. Método: este estudio cualitativo realizó entrevistas semiestructuradas a madres y especialistas en centros de atención especializada de una capital del estado en el noreste de Brasil, entre diciembre de 2018 y marzo de 2019. Resultados: como referencia se ha instituido en la Estrategia de Salud de la Familia como criterio indispensable para la programación citas, la referencia está efectivamente en su lugar. Sin embargo, los servicios de atención especializada no son contrarreferencia, ya que esto no es requerido en el sistema de salud. Los especialistas no completan el formulario de contrarremisión, lo que lo vuelve ineficaz y dificulta la continuidad de la atención. Conclusión: el personal de salud debe reconocer que la contrarreferencia es una herramienta fundamental para la atención longitudinal que atiende las necesidades de salud de los niños con enfermedades crónicas.

scholarly journals Conversations of exclusion: An ethnographic exploration of doctor-patient interactions that result in homeless patients being excluded from the healthcare service

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0031
Author(s):  
Austin O'Carroll ◽  
David Wainwright
Keyword(s):  
Health Service ◽  
Critical Realism ◽  
Homeless People ◽  
Structured Interviews ◽  
Service Usage ◽  
Health Indices ◽  
Care Services ◽  
Primary Care Services ◽  
Poor Access ◽  
Outpatient Departments

BackgroundHomeless people have poor health indices and poor access to healthcare. Their health service utilization (HSU) is typified by late illness presentations; poor attendance rates at appointments; low usage of primary-care services and outpatient departments; and high utilization of Emergency Departments and Inpatient services. Why homeless people have these particular HSU patterns is poorly understood.AimThis research sought to explore barriers to health-service usage for homeless people.Design & SettingThe author conducted critical realist ethnography over 13 months in Dublin with three services for homeless people (a food-hall, a drop-in centre and on outreach with a rough-sleeper team) and an outreach service for rough sleepers.MethodsEthnographic research was supplemented with focus groups of hospital doctors and homeless people; and 47 semi-structured interviews with homeless people. The epistemological framework was critical realism.ResultsOne of the factors identified in the research as contributing to the HSU pattern of homeless people were recurrent interactions between health professionals and patients whereby patients were either excluded or discouraged from attending the health service or self-excluded themselves from that or other such services. These interactions were described as Conversations of Exclusion. Four such conversations were described, the Benzodiazepine Conversation; the Mistrustful Conversation; the Blaming Conversation; and the Assertive Conversation.ConclusionsThere are certain recurrent interactions between homeless people and doctors that result in the exclusion of the homeless people from the health-service.

A design contribution to the entrepreneurial experience

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Juan David ROLDAN ACEVEDO ◽  
Ida TELALBASIC
Keyword(s):  
Product Development ◽  
Qualitative Analysis ◽  
Design Research ◽  
Recent Literature ◽  
Early Stage ◽  
Entrepreneurial Activity ◽  
Value Proposition ◽  
Structured Interviews ◽  
User Centric ◽  
Constant Growth

In recent history, different design approaches have been entering fields like management and strategy to improve product development and service delivery. Specifically, entrepreneurship has adopted a user-centric mindset in methodologies like the business canvas model and the value proposition canvas which increases the awareness of the users’ needs when developing solutions. What happens when a service design approach is used to understand the entrepreneurs’ experience through the creation of their startups? Recent literature suggests that entrepreneurial activity and success is conditioned by their local entrepreneurship ecosystem. This study investigates the Entrepreneurship Ecosystem of Medellín, Colombia - an ecosystem in constant growth but that lacks qualitative analysis. The sample consists of 12 entrepreneurs in early-stage phase. The data was gathered with two design research methods: Cultural Probes and Semi-structured interviews. The analysis of the information collected facilitated the development of 4 insights about the entrepreneurs and an experience map to visualise and interpret their journey to create a startup. The results of this study reflected the implications of the ecosystem, the explanation of the users’ perceptions and awareness and propose a set of ideas to the local government to improve the experience of undertaking a startup in Medellín.

scholarly journals Reluctance to Accept Palliative Care and Recommendations for Improvement: Findings From Semi-Structured Interviews With Patients and Caregivers

2021 ◽  
pp. 104990912110126
Author(s):  
Valeria Cardenas ◽  
Anna Rahman ◽  
Yujun Zhu ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Controlled Trial ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Health Condition ◽  
Insurance Companies ◽  
Structured Interviews ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services

Background: Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care. Aim: To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers. Design: We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care. Setting/Participants: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone. Results: Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly. Conclusion: Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.

scholarly journals Integrating sport and exercise medicine clinics into the National Health Service: a qualitative study

2020 ◽  
Vol 6 (1) ◽  
pp. e000888
Author(s):  
Dane Vishnubala ◽  
Katherine Rose Marino ◽  
Margaret Kathryn Pratten ◽  
Andy Pringle ◽  
Steffan Arthur Griffin ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Thematic Analysis ◽  
Heavy Exercise ◽  
Structured Interviews ◽  
Ultrasound Education ◽  
Exercise Medicine ◽  
Sport And Exercise ◽  
Inductive Thematic Analysis

ObjectivesTo explore the services National Health Service (NHS)-based sport and exercise medicine (SEM) clinics can offer, and the barriers to creating and integrating SEM services into the NHS.MethodsSemi-structured interviews were undertaken to collect data from identified ‘stakeholders’. Stakeholders were identified as individuals who had experience and knowledge of the speciality of SEM and the NHS. An inductive thematic analysis approach was taken to analyse the data.ResultsN=15 stakeholder interviews. The management of musculoskeletal (MSK) injuries (both acute and chronic) and concussion were highlighted as the two key services that SEM clinics can offer that would most benefit the NHS. MSK ultrasound was also mentioned by all stakeholders as a critical service that SEM clinics should provide. While exercise medicine is an integral part of SEM, SEM clinics should perhaps not have a heavy exercise medicine focus. The key barriers to setting up SEM clinics were stated to be convincing NHS management, conflict with other specialities and a lack of awareness of the speciality.ConclusionThe management of acute MSK injuries and concussion should be the cornerstone of SEM services, ideally with the ability to provide MSK ultrasound. Education of others on the speciality of SEM, confirming consistent ‘unique selling points’ of SEM clinics and promoting how SEM can add value to the NHS is vital. If the successful integration of SEM into the NHS is not widely achieved, we risk the NHS not receiving all the benefits that SEM can provide to the healthcare system.

scholarly journals Which triggers could support timely identification of primary antibody deficiency? A qualitative study using the patient perspective

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lisanne M. A. Janssen ◽  
Kim van den Akker ◽  
Mohamed A. Boussihmad ◽  
Esther de Vries
Keyword(s):  
Respiratory Infections ◽  
Diagnostic Delay ◽  
Signs And Symptoms ◽  
Negative Influence ◽  
Primary Antibody ◽  
Emotional Impact ◽  
Structured Interviews ◽  
Timely Treatment ◽  
The Way

Abstract Background Patients with predominantly (primary) antibody deficiencies (PADs) commonly develop recurrent respiratory infections which can lead to bronchiectasis, long-term morbidity and increased mortality. Recognizing symptoms and making a diagnosis is vital to enable timely treatment. Studies on disease presentation have mainly been conducted using medical files rather than direct contact with PAD patients. Our study aims to analyze how patients appraised their symptoms and which factors were involved in a decision to seek medical care. Methods 14 PAD-patients (11 women; median 44, range 16-68 years) were analyzed using semi-structured interviews until saturation of key emergent themes was achieved. Results Being always ill featured in all participant stories. Often from childhood onwards periods of illness were felt to be too numerous, too bad, too long-lasting, or antibiotics were always needed to get better. Recurrent or persistent respiratory infections were the main triggers for patients to seek care. All participants developed an extreme fatigue, described as a feeling of physical and mental exhaustion and thus an extreme burden on daily life that was not solved by taking rest. Despite this, participants tended to normalize their symptoms and carry on with usual activities. Non-immunologists, as well as patients, misattributed the presenting signs and symptoms to common, self-limiting illnesses or other ‘innocent’ explanations. Participants in a way understood the long diagnostic delay. They know that the disease is rare and that doctors have to cover a broad medical area. But they were more critical about the way the doctors communicate with them. They feel that doctors often don’t listen very well to their patients. The participants’ symptoms as well as the interpretation of these symptoms by their social environment and doctors had a major emotional impact on the participants and a negative influence on their future perspectives. Conclusions To timely identify PAD, ‘pattern recognition’ should not only focus on the medical ‘red flags’, but also on less differentiating symptoms, such as ‘being always ill’ and ‘worn out’ and the way patients cope with these problems. And, most important, making time to really listen to the patient remains the key.

scholarly journals Teaching digital models: secondary technology teachers’ experiences

2021 ◽  
Author(s):  
Helen Brink ◽  
Nina Kilbrink ◽  
Niklas Gericke
Keyword(s):  
Problem Solving ◽  
Empirical Data ◽  
Digital Tools ◽  
Digital Models ◽  
Structured Interviews ◽  
Digital Competence ◽  
Technology Teachers ◽  
Teachers Experiences ◽  
Digital Modelling ◽  
Single Idea

AbstractIn secondary technology education, models of artifacts, systems and processes, visualized and simulated through digital tools (digital models) are a relatively new element. Technology teachers teach digital models to meet syllabus criteria of digital competence, applicable to for instance problem solving and documentation using digital tools. However, there is a lack of knowledge concerning how teachers use digital models in their teaching, what their intentions are, and what content they choose. It is known, though, that teachers’ experiences influence the teaching. Therefore, the aim of this study is to investigate teachers’ experiences of teaching digital models in compulsory school, to contribute to more knowledge of teaching in this area. This study takes a phenomenological lifeworld approach, and 12 semi-structured interviews with lower secondary technology teachers form the empirical data. The data were analyzed thematically and the results are four themes of experiencing the teaching of digital models, indicating that technology teachers teach with different aims and purposes; Enhancing and integrating other subjects, Visualizing technology to the pupils, Enabling digital modelling, and Preparing pupils for the future. Further, the results also indicate that the content and methods of teaching differ and that teachers did not experience digital models as one single idea but as an amalgam of multiple ideas. These findings can be used as a basis for further research and development of teaching concerning digital models.

scholarly journals Aging out of foster care: The experiences of former foster youth who successfully navigated this transition

2021 ◽  
pp. 251610322110194
Author(s):  
Margot Hedenstrom
Keyword(s):  
Foster Care ◽  
Foster Youth ◽  
Life Experiences ◽  
Study Data ◽  
Aging Out ◽  
Structured Interviews ◽  
Former Foster Youth ◽  
Making A Difference ◽  
Human Costs ◽  
Poor Outcomes

Foster youth face high risks and poor outcomes after aging out of care resulting in great economic and human costs to society. The purpose of the study was to describe life experiences of children aging out of the foster care system from the perspectives of adults who have successfully navigated this transition. Their life experiences during this period provided meaningful information for this study which helped to identify themes. Their perceptions of the periods during and after their transitions were explored to investigate supportive relationships, education, and workplace stability. Phenomenology was used to describe the experiences of nine young adults who had aged out of foster care. Participant ages ranged from 20 to 25 years old. Audiotaped semi-structured interviews were conducted for the study. Data analysis was ongoing throughout data collection. Four themes were identified: (1) “Facing a transition”; (2) “Depending on adults for help”; (3) “Making a difference for others”; and (4) “Moving forward with my life.” These four themes highlighted the participants’ experiences as they aged out of foster care. This study contributes to our understanding of the life experiences of former foster youth who are successful after the transition out of foster care. Recommendations for practice and research are identified.

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