Exploring Professional Circus Artists’ Experience of Performance-Related Injury and Management: A Qualitative Study

AIMS: Circus is a physically demanding profession, but injury and help-seeking rates tend to be low. This qualitative interview study explored the perceptions and beliefs about injury and help-seeking of circus artists. METHODS: Ten professional circus artists (5 males, 5 females; mean age 33 yrs, range 27–42) were enrolled. Individual, semi-structured interviews were conducted until data saturation of themes was reached. Data were analysed thematically. FINDINGS: Four themes were identified: 1) the injured artist; 2) professionalism; 3) circus life; and 4) artists’ experience of healthcare. Most participants described the circus as central to their lives, and injuries had wide-ranging psychosocial consequences. Injury adversely affected participants’ mood and threatened their identity. Situational and personal factors (e.g., the belief that pain was normal) pushed participants to use adaptive strategies to perform when injured. Continuous touring and financial constraints affected help-seeking. Easy access to healthcare was rare and participants often self-managed injuries. Experiences of healthcare varied, and participants desired flexible and accessible approaches to prevention and injury management. A modified version of the integrated model of psychological response to injury and rehabilitation process and the concept of identity provided a framework to understand participants. CONCLUSION: Injuries had extensive negative consequences. Work schedules, financial factors, employer support, the artist’s perception of the importance of the show, and the relationship between circus and identity influenced injury management and help-seeking. Injury prevention and management strategies could be optimised by developing centres of expertise, online resources, and better regulations of the profession.

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How do people with knee osteoarthritis perceive and manage flares? A qualitative study

BJGP Open ◽

10.3399/bjgpo.2021.0086 ◽

2021 ◽

pp. BJGPO.2021.0086

Author(s):

Emma Parry ◽

Lisa Dikomitis ◽

George Peat ◽

Carolyn A. Chew-Graham

Keyword(s):

Acute Pain ◽

Help Seeking ◽

Management Strategies ◽

Self Management ◽

Structured Interviews ◽

Everyday Activity ◽

Minimal Impact ◽

Knee Oa ◽

Disturbed Sleep ◽

Qualitative Interview Study

BackgroundAcute flares in people with osteoarthritis (OA) are poorly understood. There is uncertainty around the nature of flares, their impact, and how these are managed.AimExplore understandings and experiences of flares in people with knee OA, describe self-management and help-seeking strategiesDesign & settingQualitative interview study of people with knee OA in England, United Kingdom.MethodSemi-structured interviews with 15 people with knee OA. Thematic analysis using constant comparison methods.ResultsWe identified four main themes: experiencing pain, consequences of acute pain, predicting and avoiding acute pain, and response to acute pain. People with OA described minor episodes which were frequent, fleeting, occurred during everyday activity, had minimal impact, and were generally predictable. This contrasted with severe episodes which were infrequent, had greater impact, and were less likely to be predictable. The latter generally led to feelings of low confidence, vulnerability and of being a burden. The term ‘flare’ was often used to describe the severe events but this was applied inconsistently and some would describe a flare as any increase in pain.Participants used numerous self-management strategies but tended to seek help when these had been exhausted, their symptoms led to emotional distress, disturbed sleep, or pain experience worse than usual. Previous experiences shaped whether people sought help and who they sought help from.ConclusionSevere episodes of pain are likely to be synonymous with flares. Developing a common language about flares will allow a shared understanding of these events, early identification and appropriate management.

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Causes of medical errors and its under-reporting amongst pediatric nurses in Iran: a qualitative study

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzy202 ◽

2018 ◽

Vol 31 (7) ◽

pp. 541-546

Author(s):

Razieh Sadat Mousavi-roknabadi ◽

Marzieh Momennasab ◽

Mehrdad Askarian ◽

Abbas Haghshenas ◽

Brahmaputra Marjadi

Keyword(s):

Qualitative Study ◽

Teaching Hospital ◽

Medical Errors ◽

Reporting System ◽

Pediatric Nurses ◽

Personal Factors ◽

Structured Interviews ◽

Pediatric Department ◽

Data Saturation ◽

Context Specific

Abstract Objectives To explore the causes of medical errors (ME) and under-reporting amongst pediatric nurses at an Iranian teaching hospital. Design A qualitative study, based on individual, in-depth, semi-structured interviews and content analysis approach. Settings The study was conducted at the Pediatric Department of the largest tertiary general and teaching hospital in Shiraz, southern Iran. Participants The study population was all pediatrics nurses who work at Pediatric Department and they had been trained on ME, as well as methods to report them through the hospital’s ME reporting system. Purposive sampling was used by selecting key informants until data saturation was achieved and no more new information was obtained. Finally, 18 pediatric nurses were interviewed. Main outcome measure(s) Pediatrics nurses’ views on the causes of ME and under-reporting. Results We found five main factors causing ME and under-reporting: personal factors, workplace factors, managerial factors, work culture and error reporting system. These factors were further classified into proximal and distal factors. Proximal factors had direct relationship with ME and distal factors were contextual factors. Conclusion Causes of ME and under-reporting amongst pediatric nurses are complex and intertwined. Both proximal and distal factors need to be simultaneously addressed using context-specific approaches. Further research on other groups of healthcare workers and using a quantitative approach will be beneficial to elucidate the most appropriate interventions.

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How do older adults understand and manage distress? A qualitative study

10.21203/rs.2.18070/v1 ◽

2019 ◽

Author(s):

Alice Moult ◽

Tom Kingstone ◽

Carolyn Chew-Graham

Keyword(s):

Older Adults ◽

Primary Care ◽

Older People ◽

Help Seeking ◽

Management Strategies ◽

Healthcare Services ◽

Ethical Review ◽

Structured Interviews ◽

Management Options ◽

Community Groups

Abstract Background Anxiety and depression are prevalent in older adults, however, older people may be reluctant to seek medical help and may manage their own mood problems. Due to stigma, older adults are more likely to perceive and/ or recognise their mood problems as distress. Whilst previous literature has focused on how younger adults self-manage mood problems, little research has explored how older people self-manage distress. The study reported here seeks to address this gap through qualitative methods. Methods This study was approved by Keele University’s ethical review panel. Older adults who self-identified as distressed, depressed or anxious within the previous 12 months were recruited from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A public and patient involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. Results Data saturation was achieved after 18 interviews. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants’ distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. Conclusions To support older adults who are distressed, primary care healthcare professionals need to explore patients’ existing ways of managing mood problems, provide information about a range of management options and consider the use of sign-posting older adults to community resources.

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Barriers to seeking help among abused Iranian women

The Journal of Adult Protection ◽

10.1108/jap-03-2017-0007 ◽

2017 ◽

Vol 19 (5) ◽

pp. 261-273 ◽

Cited By ~ 2

Author(s):

Sakineh Taherkhani ◽

Reza Negarandeh ◽

Masoumeh Simbar ◽

Fazlollah Ahmadi

Keyword(s):

Help Seeking ◽

Policy Implications ◽

Abused Women ◽

Attitudes And Beliefs ◽

Negative Consequences ◽

Iranian Women ◽

Structured Interviews ◽

Content Type ◽

Seeking Help ◽

Education And Employment

Purpose The purpose of this paper is to identify barriers to seeking help among abused Iranian women. Design/methodology/approach This qualitative research was carried out using content analysis approach. The participants were 24 married women who were selected from health care centers, recreational centers, and two universities in Tehran, Iran. Semi-structured interviews were used to collect the data. Findings During data analysis, four themes emerged that explained barriers to seeking help in the participants: “fear of negative consequences of help-seeking,” “lack of resources,” “beliefs and attitudes,” and “indirect experiences of not being supported.” Originality/value This study has practice and policy implications for promoting help-seeking among abused women. Based on the results, to promote help-seeking, intervention plans must focus on empowering women to improve their education and employment, eliminating attitudes and beliefs hindering help-seeking, and fortifying formal and informal support systems for abused women.

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Participation experience for persons with oculomotor impairments after acquired brain injury

British Journal of Occupational Therapy ◽

10.1177/03080226211031804 ◽

2021 ◽

pp. 030802262110318

Author(s):

Sharon G Wagener

Keyword(s):

Brain Injury ◽

Management Strategies ◽

Acquired Brain Injury ◽

Negative Consequences ◽

Structured Interviews ◽

Limited Participation ◽

Everyday Activities ◽

Life Management ◽

Qualitative Responses ◽

Life Roles

Introduction While individuals with acquired brain injury (ABI) often receive occupational therapy, relatively little is known about how those with related oculomotor problems characterize their ability to participate in everyday activities and life roles. This study describes the difficulties experienced by this population. Method This study is a thematic analysis of qualitative responses to open-ended questions based on answers to a standardized assessment. Thirty rehabilitation outpatients with ABI-related oculomotor impairments participated in semi-structured interviews to describe their experiences of difficulties in everyday activities. Results Difficulties were associated with three themes: challenges of the activities and environments (activity requirements, physical and socioeconomic environments, and time), self-identified personal difficulties (physical, cognitive, and socioemotional), and changes in habits/roles/priorities (modifications to activities and environments, loss and negative consequences, and life management changes). Conclusion How people with ABI-related oculomotor impairments experience difficulties while participating in activities is dynamic and complex. Challenging activity requirements and environments often led to personal difficulties, which limited participation. Activity modifications, changes in priorities, and managing energy budget enhanced participation. A model of the experience is proposed. Findings suggest using activity analysis and teaching compensatory methods and life management strategies with individuals may assist in ability to participate.

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Reflections on volunteer nurses' work and caring experiences during COVID-19: a phenomenological study

Journal of Research in Nursing ◽

10.1177/17449871211007529 ◽

2021 ◽

pp. 174498712110075

Author(s):

Loretta Yuet Foon Chung ◽

Lin Han ◽

Yifei Du ◽

Libo Liu

Keyword(s):

Lived Experiences ◽

Phenomenological Study ◽

Management Strategies ◽

Sampling Strategy ◽

External Support ◽

Resource Utilisation ◽

Structured Interviews ◽

Familial Bonds ◽

Data Saturation ◽

Colaizzi's Method

Background With epidemics emerging at a hastened pace, a phenomenological study allows researchers to cast aside their perceptions to understand nurses’ lived experiences, and from there to discover previously unavailable insights at the epicentre of a pandemic. Aims To understand volunteer nurses’ lived experiences in Wuhan. Methods A descriptive phenomenological study with a purposive sampling strategy was used to describe volunteer nurses’ experiences in Wuhan. Interviews continued until data saturation. Ten semi-structured interviews of 30 to 60 minutes duration were conducted from 27 to 30 March 2020. The narrative data were audiotaped, transcribed and analysed using Colaizzi’s method. Results Four themes emerged: mission and challenges denoted the participants’ realisation of the grim challenges ahead; challenges called for actions that described the concerted actions through partnerships and familial bonds; caring acts from all around revealed an external support system; and actions that made a difference portrayed the interplay of actions with feelings, thoughts and further actions to accomplish the mission. Conclusions This phenomenological study showed the interplay of nurses’ intentions and actions, and ‘actions speak louder than words’ when nurses were motivated by workmates’ actions to change their feelings, thoughts and actions. The concerted efforts can be used to develop educational programmes, management strategies and institutional policy on structure, system and resource utilisation, as well as dissemination of scientific knowledge to global healthcare workers and the public.

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What are the implications for patient safety and experience of a major healthcare IT breakdown? A qualitative study

Digital Health ◽

10.1177/20552076211010033 ◽

2021 ◽

Vol 7 ◽

pp. 205520762110100

Author(s):

Arabella Scantlebury ◽

L Sheard ◽

Cindy Fedell ◽

J Wright

Keyword(s):

Patient Safety ◽

Qualitative Study ◽

Patient Experience ◽

Management Strategies ◽

Wait Time ◽

Negative Consequences ◽

Structured Interviews ◽

Healthcare It ◽

Safety Incident ◽

The Impact

Introduction To explore the impact of a three-week downtime to an electronic pathology system on patient safety and experience. Methods Qualitative study consisting of semi-structured interviews and a focus group at a large NHS teaching hospital in England. Participants included NHS staff ( n = 16) who represented a variety of staff groups (doctors, nurses, healthcare assistants) and board members. Data were collected 2–5 months after the outage and were analysed thematically. Results We present the implications which the IT breakdown had for both patient safety and patient experience. Whilst there was no actual recorded harm to patients during the crisis, there was strong and divided opinion regarding the potential for a major safety incident to have occurred. Formal guidance existed to assist staff to navigate the outage but there was predominantly a reliance on informal workarounds. Junior clinicians seemed to struggle without access to routine blood test results whilst senior clinicians seemed largely unperturbed. Patient experience was negatively affected due to the extensive wait time for manually processed diagnostic tests, increasing logistical problems for patients. Conclusion The potential negative consequences on patient safety and experience relating to IT failures cannot be underestimated. To minimise risks during times of crisis, clear communication involving all relevant stakeholders, and guidance and management strategies that are agreed upon and communicated to all staff are recommended. To improve patient experience flexible approaches to patient management are suggested.

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Cancer-Related Cognitive Impairment: A Mixed-Methods Evaluation of A Standard Factsheet

10.21203/rs.3.rs-786241/v1 ◽

2021 ◽

Author(s):

Chloe Yi Shing Lim ◽

Sharon He ◽

Joanne Shaw ◽

Haryana M Dhillon

Keyword(s):

Cognitive Impairment ◽

Cancer Survivors ◽

Health Beliefs ◽

Help Seeking ◽

Management Strategies ◽

Stepped Care ◽

Structured Interviews ◽

Major Barrier ◽

Framework Approach ◽

The Impact

Abstract Purpose: To understand the impact of cancer survivors accessing a standard factsheet regarding cancer-related cognitive impairment (CRCI), publicly available to the Australian public via Cancer Council Australia’s websites. Methods: Twenty-three cancer survivors completed a questionnaire assessing pre-factsheet knowledge of CRCI. Semi-structured interviews were conducted to explore participants’ experiences of CRCI and perceptions of the factsheet. Interviews were analysed via thematic analysis using a framework approach. Finally, participants completed another questionnaire assessing post-factsheet change in knowledge of CRCI.Results: Pre- and post-factsheet questionnaire change scores indicated increased knowledge and greater confidence about CRCI. Interview data resulted in five themes: generally positive perceptions of the factsheet’s layout and wording; survivors, regardless of treatments received, experienced CRCI symptoms, with some having strong negative emotional responses to their symptoms; perceptions of the factsheet’s strategies to manage CRCI ranged from relevant and useful, to impractical or unrealistic if symptoms were too severe; interactions with healthcare system influenced survivors’ perceptions of help-seeking, with negative healthcare experiences a major barrier; and, generally positive impacts of the factsheet, with survivors praising the factsheet’s ability to validate the CRCI experience, increase CRCI knowledge, influence health beliefs, and prompt help-seeking.Conclusion: The factsheet presentation and wording were acceptable to participants. Its ability to normalise and raise awareness for CRCI validated participants’ symptoms. The factsheet’s potential as a first-line intervention in a stepped-care approach was identified, with participants finding the suggested self-management strategies practical. The factsheet may overcome barriers to self-reporting by encouraging patients to talk with HCPs about CRCI.

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16 Delirium care of hospice patients: a qualitative interview study with staff and volunteers

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2018-mariecurie.16 ◽

2018 ◽

Vol 8 (3) ◽

pp. 365.3-366

Author(s):

Imogen Featherstone ◽

Miriam Johnson ◽

Lesley Jones ◽

Eleonora Coppo ◽

Annmarie Hosie ◽

...

Keyword(s):

Current Practice ◽

Management Strategies ◽

List Type ◽

Structured Interviews ◽

Allied Health Professionals ◽

Qualitative Interview Study ◽

Hospice Patients ◽

Delirium Prevention ◽

Care Gaps ◽

Case Vignettes

IntroductionDelirium is a distressing condition which is commonly experienced by hospice patients. Although delirium can be prevented by around one-third in hospital inpatients (Siddiqi et al. 2016) there has been little research into effective strategies to prevent and manage delirium in hospices. Greater insight into the current practice attitudes and understanding of hospice staff and volunteers would inform the development of interventions that are tailored to improve delirium care in hospices.AimTo explore the understanding attitudes and practice of hospice staff and volunteers regarding the care of patients with delirium.Methods36 qualitative semi-structured interviews were conducted at two hospices. Participants were purposively sampled to include different disciplines (9 health care assistants, 8 nurses, 5 doctors, 4 volunteers, 3 board members, 2 allied health professionals, 2 managers, 2 domestic workers and 2 fundraisers). A topic guide and case vignettes prompted participants to describe their experiences in relation to delirium prevention recognition assessment and management. Three researchers are conducting thematic analysis to identify analyse and interpret themes from the interview data.ResultsProvisional results include themes of: ‘Supporting the distressing experience of delirium’; ‘Management strategies’ and ‘The burden of delirium care.’ Gaps in current practice relate to delirium prevention recognition and screening. Potential facilitators for developing interventions in hospices include education flexibility in staffing the role of volunteers and a supportive staff culture.ConclusionThis study will provide important insights into staff and volunteers’ current practice which will inform the development of a targeted intervention to improve delirium care in hospices.Reference. Siddiqi N, Harrison J, Clegg A, Teale E, Young J, Taylor J, Simpkins S. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database of Systematic Reviews2016;(3). Art. No.: CD005563. doi:10.1002/14651858.CD005563.pub3

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Barriers, facilitators and solutions for active inclusive play for children with a physical disability in the Netherlands: a qualitative study

BMC Pediatrics ◽

10.1186/s12887-021-02827-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

L. van Engelen ◽

M. Ebbers ◽

M. Boonzaaijer ◽

E. A. M. Bolster ◽

E. A. H. van der Put ◽

...

Keyword(s):

Active Role ◽

Outdoor Play ◽

Typically Developing ◽

Personal Factors ◽

Structured Interviews ◽

Active Play ◽

Physically Active ◽

Important Barrier ◽

Data Saturation ◽

Inclusive Society

Abstract Background Children with physical disabilities (PD) are less physically active than typically developing peers. The most important contributor to physical activity for primary school-aged children is outside play and therefore this should be part of every child’s life. However, children with PD experience multiple barriers to participation in playgrounds. Despite recent improvements in the accessibility of Dutch playgrounds, the participation of children with PD has not increased. This study aims to explore facilitators, barriers and solutions influencing the participation of children with PD in Dutch outdoor playgrounds, from parents’ and professionals’ perspectives. Methods Twelve semi-structured interviews with parents of children with PD aged 2–12 years and five focus group meetings with professionals working with these children were conducted. To ensure data saturation, we performed three member-check meetings. Two independent researchers analyzed the data using an inductive thematic approach. Results Similar barriers, facilitators and solutions were mentioned by parents and professionals. Three main themes were identified: the emotional barrier versus the physical barrier, play as a part of an inclusive society and the role of professionals in facilitating active inclusive play. The most important personal factors were physical and social problems experienced when children with PD wanted to join outdoor play. Interestingly, parents and professionals believed the social barrier was far more important than the physical one. The most important environmental factor was that the Dutch society is not sufficiently inclusive. Conclusions According to both parents and professionals, the most important barrier to active inclusive outdoor play was social, hindering the participation of children with PD in play with typically developing peers. To overcome such problems, professionals should take an active role in empowering children with PD and their parents. Furthermore, it is important to introduce outdoor active play early, so it becomes part of normal daily life. In addition, a change in the mindset of typically developing children and their parents seems essential to achieve true inclusive active play.

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