scholarly journals Changing Home: Experiences of the Indigenous when Receiving Care in Hospital

2020 ◽  
Vol 38 (3) ◽  
Author(s):  
Juan Guillermo Rojas ◽  
Raquel Herrero Hahn

Objective. To understand the meaning of the experience of the indigenous when receiving care in a low-complexity hospital. Methods. Qualitative study with ethnographic approach conducted in a hospital of Antioquia, Colombia. The study had 12 indigenous participants who underwent semi-structured interviews. Observation was carried out in hospitalization wards, emergency, and outpatient services of the institution during 40 hours. The analysis process was performed descriptively. The methodological rigor was maintained by applying criteria of confirmability, credibility, transferability, and consistency. The study was approved by the Ethics Committee and authorized by the indigenous authorities to enter the field. Results. Five themes emerged: the context of caring for the indigenous, the need to consult the hospital, changes experienced by the indigenous in the hospital, experiences in relation with treatments, and relations established within the hospital. The meaning is constructed from a dichotomous perspective based on the favorable or unfavorable aspects of the situations and experiences, which for the indigenous is like “changing home”. Conclusion. The meaning of the experience of receiving care in hospital for the indigenous is constructed from the context in which they live and receive health services, the changes they live in the dimension of space by virtue of their traveling from their vital space to another space that, due to their physical characteristics, results strange and different, even not healing. Upon the difficulties, the indigenous develop strategies and actions to overcome limitations, whether through adaptation and learning.

Author(s):  
Viviana Dávalos-Batallas ◽  
Vinita Mahtani-Chugani ◽  
Carla López-Núñez ◽  
Víctor Duque ◽  
Fatima Leon-Larios ◽  
...  

Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals’ activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrés Cernadas ◽  
Ángela Fernández

Abstract Background In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. Methods A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. Results The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. Conclusions The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population.


2017 ◽  
Vol 25 ◽  
pp. e15379
Author(s):  
Larissa De Oliveira Ulisses ◽  
Lorena Fernanda Nascimento Santos ◽  
Cristina Nunes Vitor Araújo ◽  
Elenilda Farias de Oliveira ◽  
Climene Laura de Camargo

Objetivo: descrever o manejo da dor em crianças pela equipe de enfermagem. Metodologia: estudo qualitativo, realizado em unidade pediátrica de hospital universitário na cidade de Salvador, Bahia, em 2012. Participaram do estudo três enfermeiras, duas técnicas e duas auxiliares de enfermagem. Foram realizadas entrevistas semiestruturadas, analisadas por meio da técnica de análise de conteúdo, emergindo três categorias: Identificação da dor na criança internada; Instrumentos de avaliação da dor; Prevenção e Tratamento da dor, após aprovação do estudo pelo Comitê de Ética em Pesquisa da instituição, sob o parecer de número 79/11. Resultados: foram evidenciadas intervenções prioritariamente farmacológicas em detrimento das não-farmacológicas, intervenções insuficientes e pouco resolutivas, não utilização dos instrumentos adequados, além da não participação dos pais nesse cenário. Conclusão: percebe-se a necessidade de aprofundamento científico entre a equipe para o manejo da dor, além da reprodução do modelo biomédico no que concerne ao tratamento medicamentoso.ABSTRACTObjective: to describe pain management in children by the nursing team. Methodology: this qualitative study in a pediatric unit of a university hospital in Salvador, Bahia, was conducted in 2012, after approval by the research ethics committee (Opinion No. 79/11). Three nurses, two technicians and two nursing auxiliaries participated in the study. Semi-structured interviews were carried out and analyzed using content analysis, from which three categories emerged: identifying pain in the hospitalized child; pain assessment instruments; preventing and treating pain. Results: findings included pharmacological interventions prioritized over non-pharmacological interventions; insufficient and ineffective interventions; failure to use appropriate instruments; and parental non-participation in this scenario. Conclusion: the team needed more in-depth scientific training in pain management, beyond reproduction of the biomedical drug treatment model.RESUMEN: Objetivo: describir cómo el equipo de enfermería maneja el dolor en niños. Metodología: estudio cualitativo, realizado en unidad pediátrica de hospital universitario en la ciudad de Salvador, Bahía, en 2012. Participaron del estudio tres enfermeras, dos técnicas y dos auxiliares de la enfermería. Se realizaron entrevistas semiestructuradas, analizadas por medio de la técnica de análisis de contenido. Surgieron tres categorías: identificación del dolor en el niño internado; instrumentos de evaluación del dolor; prevención y tratamiento del dolor, tras la aprobación del estudio por el Comité de Ética en Investigación de la institución, bajo el parecer de número 79/11. Resultados: se evidenciaron intervenciones prioritariamente farmacológicas en detrimento de las no farmacológicas, intervenciones insuficientes y poco resolutivas, no utilización de los instrumentos adecuados, además de la no participación de los padres en ese escenario. Conclusión: se percibe la necesidad de profundización científica entre el equipo para el manejo del dolor, además de la reproducción del modelo biomédico en lo respecta al tratamiento medicamentoso. DOI: http://dx.doi.org/10.12957/reuerj.2017.15379


Author(s):  
Mandana Mirmohammad Ali Ie ◽  
Alireza Nikbakht Nasrabadi ◽  
Sanaz Sohrabizadeh ◽  
Reaza Khani Jazani

Abstract Objective: Educated midwives have a range of abilities to use their skills in normal situations. Given that working under normal situations is different from critical conditions, the recognition of skills and competencies required for midwifery practice is important. The purpose of this study was to explore specific professional competencies that midwives need to have for the provision of reproductive health services during disasters. Methods: This was a qualitative study using a content analysis method. Subjects were 19 midwives with the work experience of practice in disaster situations. Data were collected using semi-structured interviews and analysis was based on the approach suggested by Graneheim and Lundman. Results: Six major categories developed in this study were “safe pregnancy,” “safe childbirth,” “women’s health care,” “contraception,” “violence and sexually transmitted infections,” and “infant care.” Conclusions: Midwives can play a very important role in the provision of reproductive health services. Therefore, they must have special capabilities and capacities. Policies and curriculum development are recommended in accordance with the needs of reproductive health in disaster-affected communities.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e054145
Author(s):  
Dell D Saulnier ◽  
Dawin Thol ◽  
Ir Por ◽  
Claudia Hanson ◽  
Johan von Schreeb ◽  
...  

ObjectiveHealth system resilience can increase a system’s ability to deal with shocks like floods. Studying health systems that currently exhibit the capacity for resilience when shocked could enhance our understanding about what generates and influences resilience. This study aimed to generate empirical knowledge on health system resilience by exploring how public antenatal and childbirth health services in Cambodia have absorbed, adapted or transformed in response to seasonal and occasional floods.DesignA qualitative study using semi-structured interviews and thematic analysis and informed by the Dimensions of Resilience Governance framework.SettingPublic sector healthcare facilities and health departments in two districts exposed to flooding.ParticipantsTwenty-three public sector health professionals with experience providing or managing antenatal and birth services during recent flooding.ResultsThe theme ‘Collaboration across the system creates adaptability in the response’ reflects how collaboration and social relationships among providers, staff and the community have delineated boundaries for actions and decisions for services during floods. Floods were perceived as having a modest impact on health services. Knowing the boundaries on decision-making and having preparation and response plans let staff prepare and respond in a flexible yet stable way. The theme was derived from ideas of (1) seasonal floods as a minor strain on the system compared with persistent, system-wide organisational stresses the system already experiences, (2) the ability of the health services to adjust and adapt flood plans, (3) a shared purpose and working process during floods, (4) engagement at the local level to fulfil a professional duty to the community, and (5) creating relationships between health system levels and the community to enable flood response.ConclusionThe capacity to absorb and adapt to floods was seen among the public sector services. Strategies that enhance stability and flexibility may foster the capacity for health system resilience.


Author(s):  
Bente Lilljan Lind Kassah ◽  
Hilde Nordahl-Pedersen ◽  
Wivi-Ann Tingvoll1

Leaders of municipal nursing homes face challenges when they seek to secure a balance between the quality demands of authorities and the services they provide. In this chapter, we present a qualitative study on the leadership challenges in the municipal nursing homes. The aim is to develop knowledge on leadership challenges and the managerial discretions leaders employ to address the challenges. We interviewed seven middle-level leaders in five nursing homes in three medium-sized Norwegian municipalities using semi-structured interviews. The study revealed challenges connected to temporal nursing home placements made permanent, the time-consuming nature of the search for substitute workers, and the need to improve worker attitudes towards substitute workers’ experience-based knowledge. Attitude change is necessary because different forms of knowledge have different statuses in the nursing homes. The study shows that the leaders seek to meet the challenges connected to nursing home placements by establishing teams of professionals, while they try to persuade the Specialist Health Services to take over the responsibilities for the patients in transition. To meet the substitute worker challenge, the leaders use subjective managerial discretions to develop different strategies, including establishing substitute worker bases, substitute worker lists and delegation of substitute worker search. The leaders promote attitude change by stressing the importance of the substitute workers’ experience-based knowledge in both formal and informal contexts and implementing concrete competence measures. The study indicates that leaders who use subjective managerial discretions save time that they employ to create a balance between different leadership functions. The use of managerial discretions by leaders may affect the learning and organizational changes in nursing homes.


2011 ◽  
Vol 5 (8) ◽  
pp. 2066
Author(s):  
Fabiane Da Fontoura Messias De Melo ◽  
Melissa Andrea Vieira de Medeiros

ABSTRACTObjective: to investigate the experiences of pleasure and pain at work of the psychologists of Hospital de Urgencia e Emergencia of Rio Branco, Acre, Brazil, and to identify the defense strategies used by these professionals. Method: this is a qualitative study, as it prioritizes observation and listening to the worker's point of view according to her/his uniqueness. Study approved by the Research Ethics Committee of Universidade Federal do Acre (Protocol 23107.020349/2010-55), on November 2010. For carrying out the research observations, notes in field diary, and individual semi-structured interviews were used, which underwent thematic content analysis later. The theoretical basis adopted for interpreting the health/illness and work issue was the Christophe Dejours’ Work Psychodynamics. Results: due to the lack of researches in the Amazon region, it is expected to contribute to the development of new studies on the psychologist’s mental health and allow reflections on the current meanings of work and the notion of health/illness from the perspective of psychologists. Descriptors: work; pleasure; psychology; mental health.RESUMOObjetivo: investigar as vivências de prazer e sofrimento no trabalho dos psicólogos do Hospital de Urgência e Emergência de Rio Branco-AC e identificar as estratégias de defesa utilizadas por esses profissionais. Método: trata-se de estudo qualitativo, pois prioriza a observação e a escuta do trabalhador do ponto de vista de sua singularidade. Estudo aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Acre (Protocolo n. 23107.020349/2010-55), em novembro de 2010. Para a pesquisa foram realizadas observações, registro em diário de campo e entrevistas individuais semiestruturadas, as quais foram posteriormente submetidas à análise de conteúdo temática. O referencial teórico adotado para a interpretação da problemática saúde/ doença e trabalho foi a Psicodinâmica do Trabalho de Christophe Dejours. Resultados: diante da escassez de pesquisas na região amazônica, espera-se contribuir para o fomento de novos estudos sobre a saúde mental do psicólogo e possibilitar reflexões sobre as significações existentes do trabalho e a noção de saúde/doença a partir da perspectiva dos psicólogos. Descritores: trabalho; prazer; psicologia; saúde mental.RESUMENObjetivo: investigar las experiencias de placer y sufrimiento en el trabajo de los psicólogos del Hospital de Urgência e Emergência de Rio Branco, Acre, Brasil, y identificar las estrategias de defensa usadas por eses profesionales. Método: esto es un estudio cualitativo, pues prioriza la observación y la escucha del trabajador desde el punto de vista de su singularidad. Estudio aprobado por el Comité de Ética en Investigación de la Universidade Federal do Acre (Protocolo 23107.020349/2010-55), en noviembre de 2010. Para la investigación se llevaron a cabo observaciones, registro en diario de campo y entrevistas individuales semi-estructuradas, que más tarde fueron sometidas a análisis de contenido temático. El referencial teórico para la interpretación de la problemática salud/enfermedad y trabajo fue la Psicodinámica del Trabajo de Christophe Dejours. Resultados: frente a la escasez de investigaciones en la región amazónica, se espera contribuir al desarrollo de nuevos estudios acerca de la salud mental del psicólogo y posibilitar reflexiones sobre las posibles significaciones del trabajo y la noción de salud/enfermedad desde la perspectiva de los psicólogos. Descriptores: trabajo; placer; psicología; salud mental.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Torunn Hatlen Nøst ◽  
Arild Faxvaag ◽  
Aslak Steinsbekk

Abstract Background Recently, there has been an increasing focus among healthcare organisations on implementing patient portals. Previous studies have mainly focussed on the experiences of patient portal use. Few have investigated the processes of deciding what content and features to make available, in particular for shared portals across healthcare domains. The aim of the study was to investigate views on content and experiences from the configuration process among participants involved in setting up a shared patient portal for primary and specialist health services. Methods A qualitative study including 15 semi-structured interviews with persons participating in patient portal configuration was conducted from October 2019 to June 2020. Results Whether a shared patient portal for all the health services in the region should be established was not questioned by any of the informants. It was experienced as a good thing to have numerous participants present in the discussions on configuration, but it also was said to increase the complexity of the work. The informants considered a patient portal to be of great value for patient care, among other things because it would lead to improvements in patient follow-up and increased patient empowerment. Nevertheless, some informants advocated caution as they thought the patient portal possibly could lead to an increase in healthcare providers’ workloads and to anxiety and worries, as well as to inequality in access to health care among patients. The findings were categorized into the themes ‘A tool for increased patient involvement’, ‘Which information should be available for the patient’, ‘Concerns about increased workload’, ‘Too complex to use versus not interesting enough’, ‘Involving all services’ and ‘Patient involvement’. Conclusions Establishing a shared patient portal for primary and specialist health services was considered unproblematic. There was, however, variation in opinions on which content and features to include. This variation was related to concerns about increasing the workload for health care providers, causing anxiety and inequality among patients, and ensuring that the solution would be interesting enough to adopt.


Sains Insani ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. 15-21
Author(s):  
Zulkefli Aini ◽  
Abdul Ghafar Don ◽  
Ahmad Irdha Mokhtar ◽  
Nur Uswah Ahmad Fauzi

One of the factors that can affect a person's behavior is a communication message. In the context of the da`wah, preachers who involved actively in da`wah communication with the Orang Asli should be able to ensure that the message conveyed can be understood by the target group. In addition, the selection of the correct messages of da`wah based on the foremost priority simplify the process of sharing information between the preachers and the Orang Asli. Accordingly, this article aims to identify specific topics of Islamic faith (akidah) submitted by the Orang Asli in the process of da`wah communication and to identify verbal feedback given by the preachers to the Orang Asli of the topics. This qualitative study using case study design and data was collected through semi-structured interviews. Interviews involving nine preachers were active in da`wah activity to the Orang Asli community in Selangor. Data were analyzed thematically according to the specified objectives. The study found that the topics frequently raised by the Orang Asli is concerned about belief in Allah, belief in Malaikat, and belief in Qada' and Qadar. The topics may be found within the framework of worldview in their beliefs and practice of ancient traditions. Therefore, the preachers gave verbal feedback on these topics is based on a clear and precise sample corresponding to the level of their thinking. The emphasis on these topics is very important to strengthen and purify the faith of the community.Keywords: Communication; Message; Preacher; Indigenous community Abstrak: Elemen mesej dalam komunikasi merupakan salah satu faktor yang dapat memberi kesan terhadap perubahan tingkah laku seseorang. Dalam konteks dakwah, pendakwah yang terlibat dalam proses komunikasi dakwah dengan Orang Asli seharusnya berkebolehan memastikan kandungan mesej yang disampaikan boleh difahami oleh sasaran dakwahnya. Di samping itu, pemilihan mesej dakwah yang betul mengikut keutamaan memudahkan proses perkongsian maklumat antara pendakwah dengan Orang Asli. Sehubungan dengan itu, artikel ini bertujuan untuk mengenalpasti topik-topik tertentu dalam mesej akidah yang dikemukakan oleh masyarakat Orang Asli kepada pendakwah dan mengenalpasti maklum balas lisan yang diberikan oleh pendakwah kepada Orang Asli terhadap topik tersebut. Kajian kualitatif ini menggunakan reka bentuk kajian kes dengan pengumpulan data melalui temu bual separa struktur. Temu bual melibatkan sembilan orang pendakwah yang aktif dalam aktiviti dakwah masyarakat Orang Asli di Selangor. Data kajian dianalisis secara tematik mengikut objektif yang ditentukan. Kajian ini mendapati bahawa topik-topik yang sering dikemukan oleh Orang Asli kepada pendakwah dalam penyampaian mesej akidah ialah berkenaan tentang keimanan kepada Allah SWT, keimanan kepada malaikat, dan keimanan kepada qada’ dan qadar. Topik-topik berkenaan didapati berada dalam kerangka worldview kepercayaan dan amalan tradisi mereka. Sehubungan dengan itu, pendakwah memberikan maklum balas lisan terhadap topik-topik tersebut adalah berdasarkan keterangan yang jelas dan contoh yang tepat bersesuaian dengan tahap pemikiran mereka. Penekanan terhadap topik-topik tersebut merupakan perkara yang penting dalam rangka mengukuhkan dan memurnikan akidah masyarakat Orang Asli.Kata kunci: Komunikasi; Mesej; Pendakwah; Komuniti Orang Asli


2019 ◽  
Vol 26 (2) ◽  
pp. 429-447
Author(s):  
Henrik Taarsted Jørgensen ◽  
Sine Agergaard ◽  
Michalis Stylianou ◽  
Jens Troelsen

In the context of implementing a physical activity policy as part of a national school reform in Denmark, the purpose of this study was to explore lower secondary teachers’ interpretations and perceptions of the physical activity policy with a focus on movement integration. In total, 14 teachers from four different schools were selected to take part in this qualitative study, which involved semi-structured interviews, focus group interviews, go-along observations and informal interviews. A thematic analysis framework was employed to identify and describe patterns of meaning within data. The findings showed substantial diversity among teachers’ interpretations and perceptions of movement integration, and consequently a lack of definitional clarity regarding movement integration and a possible misalignment between policy and practice. Teachers’ perceptions and interpretations of movement integration were influenced by other and more prioritised policies and discourses regarding academic achievement, as well as by intrapersonal, interpersonal and institutional factors. The findings also suggested a lack of support and collaboration within the school and provided insights into the strengths and weaknesses associated with the autonomy afforded in the Danish school reform.


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