scholarly journals A Condition of Uncertainty: A Qualitative Study Exploring Women´s Experiences of Preeclampsia

2021 ◽  
Author(s):  
Therése Hansson ◽  
Maria E. Andersson ◽  
Gerd Ahlström ◽  
Stefan R. Hansson
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Emergency Caesarean Section ◽  
Phenomenological Method ◽  
Maternity Ward ◽  
Southern Sweden ◽  
Severe Condition ◽  
Mother And Child ◽  
Qualitative Descriptive ◽  
Spontaneous Delivery

Abstract Background Preeclampsia is a severe condition that annually affects about 3-8% of pregnancies worldwide. Preeclampsia is thereby one of the most common pregnancy complications for both mother and child. Despite that, there is limited research exploring the women´s perspective of experiencing preeclampsia. Aim The aim of this study was to describe women´s experiences of preeclampsia to improve the support and care given during and after pregnancy. Methods A qualitative descriptive interview study was undertaken. Nine women, who were diagnosed with preeclampsia, were recruited from a maternity unit in southern Sweden. The descriptive phenomenological method according to Amadeo Giorgi was used to analyse the data. Results The essence of women’s experiences of PE were expressed as A condition of uncertainty, meaning that it was an unexpected and unknown situation. The five constituents forming the essence were incomprehensible diagnosis message, ambivalent feelings when the unexpected happens, confusing contradictory messages, appreciated support from the midwife, and need for continuous information. The nature of preeclampsia can sometimes deteriorate rapidly both for the mother and/or the child, often resulting in conversion from a planned vaginal spontaneous delivery to an emergency Caesarean section. The women narrated diffuse symptoms, and they experienced that they got contradictory information from different health care professionals regarding the severity of their disease. Detailed and continuous information is requested throughout the course of the disease, and the postpartum period. Conclusion Health care professionals must be aware that women and their partners need detailed, consistent and repeated information about severity and prognosis to diminish the condition of uncertainty, confusion and fearful experience. The clinical implication would be a standardized preeclampsia education for pregnant women early on in the pregnancy, to raise awareness of preeclamptic symptoms. Furthermore, there is a need for harmonized guidelines both at the antenatal care and the maternity ward and inpatient care at the hospital.

scholarly journals Making the Transition to Insulin Therapy: The Experiences of Samoan People with Type 2 Diabetes in New Zealand

2021 ◽  
Author(s):  
◽  
Sera Tapu-Ta'ala
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
New Zealand ◽  
Insulin Therapy ◽  
Health Care Professionals ◽  
Pacific People ◽  
Qualitative Descriptive

<p>Background Pacific people are dying younger compared to other New Zealanders because of complications resulting from uncontrolled type 2 diabetes mellitus. Good diabetes control is achievable with early use of insulin because of its effectiveness, and proven long term benefits to quality of life. An understanding of how Samoan people with type 2 diabetes make their transition to insulin therapy will assist in understanding how insulin is perceived, which will inform health care professionals in their work with those diagnosed with diabetes. Aim of Research The aim of the research is to explore and describe how Samoan people with type 2 diabetes in New Zealand made the transition to insulin therapy for better glycaemic control. Design The Fonofale Model was used as the theoretical framework, from which to understand Samoan peoples' experiences. This research used a qualitative descriptive methodology. In-depth interviews were used to gather the stories of four Samoan participants over the age of 18 years diagnosed with type 2 diabetes. The data was analysed using thematic analysis. Findings Three major themes emerged from the analysis of the participants' stories. These were: living with diabetes, making the transition to insulin therapy and realisation. The findings led to the creation of the Ia Malu model, which describes the experiences of the participants in this study. Conclusion This study confirmed that there are immense challenges and struggles encountered by people with diabetes. Their adjustment to the illness as well as making the transition to using insulin takes time. As a result of this, it is fundamental for nurses/health care professionals to understand that this is the reality for these people, and they must therefore provide time for people to adjust.</p>

scholarly journals Development and Implementation of Survivorship Tools to Enable Medical Follow-Up After Childhood Cancer Treatment in Southern Sweden

2019 ◽  
pp. 1-6
Author(s):  
Magnus Petersson-Ahrholt ◽  
Thomas Wiebe ◽  
Lars Hjorth ◽  
Thomas Relander ◽  
Helena M. Linge
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Health Care Professionals ◽  
Risk Group ◽  
Southern Sweden ◽  
Quality Registry ◽  
Treatment Summary ◽  
Group Stratification

PURPOSE Survival rates after childhood cancer have increased from 20% to 80% since the 1970s. The increased number of survivors emphasizes the importance of late effects and their monitoring. Late effects may have a strong impact on quality of life in survivors. The purpose of this study was to make key data in a quality registry available for direct clinical use, enabling health care professionals to perform efficient and appropriate long-term medical follow-up after childhood cancer treatment. METHODS The population-based quality registry upon which this study is centered contains data on all individuals diagnosed with childhood cancer (diagnosed at 18 years of age or younger) in southern Sweden since January 1, 1970, and treatment data on 5-year survivors. Web tools, which were developed and implemented in a health care setting, generate a personalized treatment summary for each patient and enable risk group stratification of survivors. RESULTS Generation of a personalized treatment summary and risk group stratification of survivors led to identification of women at risk for developing breast cancer as a consequence of childhood cancer treatment. Three novel cases of previously undiagnosed breast cancer were identified. CONCLUSION The registry, together with the developed tools, enabled health care professionals to perform medical follow-up in this at-risk patient population.

scholarly journals Perceived Drivers and Barriers to the Adoption of eMental Health by Psychologists: The Construction of the Levels of Adoption of eMental Health Model (Preprint)

2017 ◽  
Author(s):  
Milou A Feijt ◽  
Yvonne AW de Kort ◽  
Inge MB Bongers ◽  
Wijnand A IJsselsteijn
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Clinical Psychologists ◽  
Qualitative Descriptive ◽  
New Treatment ◽  
Health Model ◽  
Structured Representation

BACKGROUND The internet offers major opportunities in supporting mental health care, and a variety of technology-mediated mental and behavioral health services have been developed. Yet, despite growing evidence for the effectiveness of these services, their acceptance and use in clinical practice remains low. So far, the current literature still lacks a structured insight into the experienced drivers and barriers to the adoption of electronic mental health (eMental health) from the perspective of clinical psychologists. OBJECTIVE The aim of this study was to gain an in-depth and comprehensive understanding of the drivers and barriers for psychologists in adopting eMental health tools, adding to previous work by also assessing drivers and analyzing relationships among these factors, and subsequently by developing a structured representation of the obtained findings. METHODS The study adopted a qualitative descriptive approach consisting of in-depth semistructured interviews with clinical psychologists working in the Netherlands (N=12). On the basis of the findings, a model was constructed that was then examined through a communicative validation. RESULTS In general, a key driver for psychologists to adopt eMental health is the belief and experience that it can be beneficial to them or their clients. Perceived advantages that are novel to literature include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities due to eMental health. More importantly, a relation was found between the extent to which psychologists have adopted eMental health and the particular drivers and barriers they experience. This differentiation is incorporated in the Levels of Adoption of eMental Health (LAMH) model that was developed during this study to provide a structured representation of the factors that influence the adoption of eMental health. CONCLUSIONS The study identified both barriers and drivers, several of which are new to the literature and found a relationship between the nature and importance of the various drivers and barriers perceived by psychologists and the extent to which they have adopted eMental health. These findings were structured in a conceptual model to further enhance the current understanding. The LAMH model facilitates further research on the process of adopting eMental health, which will subsequently enable targeted recommendations with respect to technology, training, and clinical practice to ensure that mental health care professionals as well as their clients will benefit optimally from the current (and future) range of available eMental health options.

scholarly journals Health Care Professionals’ Pain Narratives in Hospitalized Children’s Medical Records. Part 1: Pain Descriptors

2013 ◽  
Vol 18 (5) ◽  
pp. e75-e83 ◽  
Author(s):  
Judy Rashotte ◽  
Geraldine Coburn ◽  
Denise Harrison ◽  
Bonnie J Stevens ◽  
Janet Yamada ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Medical Records ◽  
Written Language ◽  
Free Text ◽  
Hospitalized Children ◽  
Pediatric Hospitals ◽  
Qualitative Descriptive ◽  
Pain Descriptors ◽  
Children's Pain

BACKGROUND: Although documentation of children’s pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children.OBJECTIVES: To describe health care professionals’ use of written language related to the quality and quantity of pain experienced by hospitalized children.METHODS: Free-text pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized on 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was used.RESULTS: Pain narratives were documented a total of 5390 times in 1518 of the 3822 children’s medical records (40%). Overall, word choices represented objective and subjective descriptors. Two major categories were identified, with their respective subcategories of word indicators and associated cues: indicators of pain, including behavioural (eg, vocal, motor, facial and activities cues), affective and physiological cues, and children’s descriptors; and word qualifiers, including intensity, comparator and temporal qualifiers.CONCLUSIONS: The richness and complexity of vocabulary used by clinicians to document children’s pain lend support to the concept that the word ‘pain’ is a label that represents a myriad of different experiences. There is potential to refine pediatric pain assessment measures to be inclusive of other cues used to identify children’s pain. The results enhance the discussion concerning the development of standardized nomenclature. Further research is warranted to determine whether there is congruence in interpretation across time, place and individuals.

scholarly journals “After the transition is before the transition” – Experiences of medically induced treatment discontinuation of disease-modifying therapies in people with multiple sclerosis: A qualitative descriptive study.

2019 ◽  
Author(s):  
Robert Ammann ◽  
André Fringer
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Professionals ◽  
Research Question ◽  
Treatment Discontinuation ◽  
Repeated Treatment ◽  
Professional Advice ◽  
Disease Modifying Therapies ◽  
Qualitative Descriptive ◽  
Disease Modifying

Abstract Background: Treatment discontinuation and non-adherence are widely discussed topics in the context of multiple sclerosis (MS). However, little is known about the experience of medically induced discontinuation of disease-modifying therapies in people with MS. Serious side effects or treatment failure are possible reasons for discontinuation. Prevalence of treatment switches is high in people with MS. Doctors initiate almost 50% of treatment switches. Methods: The aim of this study was to explore how people with MS experience medically induced treatment discontinuation. Using a qualitative-descriptive approach, ten semi-structured interviews were conducted with adult persons suffering from MS. Data analysis followed the procedure suggested by Saldaña. Open and axial coding were applied. The analysis was continued until it was possible to draw conclusions about participantsˊ experiences and to answer the research question. At the end, the experiences could be synthesised into categories, resulting in a conceptual model. Results: „ After the transition is before the transition “ was identified as central phenomenon. People with MS experience medically induced discontinuation as part of a cycle of repeated treatment switches. They get to know treatment options, develop criteria for treatment and decide about treatment, taking into account professional advice and personal preferences. Once treatment starts, health care professionals and people with MS assess whether it is well-tolerated and effective. If not, a decision about treatment discontinuation is necessary. Discontinued treatment implies that the cycle begins again. Health personnel initiates the cycle and supports patients with professional advice. Family and friends ensure that the perspective of people with MS is considered in the decision process. Conclusions: Experiencing medically induced treatment discontinuation is a silent phenomenon requiring health care professionals′ attention. Uncertainty associated with treatment adds to uncertainty of the disease trajectory. Knowledge can contribute to a feeling of control. Finding normality in the context of a treatment switch is essential. People with MS need continuing support from health care professionals beyond the moment of treatment decision.

scholarly journals Making the Transition to Insulin Therapy: The Experiences of Samoan People with Type 2 Diabetes in New Zealand

2021 ◽  
Author(s):  
◽  
Sera Tapu-Ta'ala
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
New Zealand ◽  
Insulin Therapy ◽  
Health Care Professionals ◽  
Pacific People ◽  
Qualitative Descriptive

<p>Background Pacific people are dying younger compared to other New Zealanders because of complications resulting from uncontrolled type 2 diabetes mellitus. Good diabetes control is achievable with early use of insulin because of its effectiveness, and proven long term benefits to quality of life. An understanding of how Samoan people with type 2 diabetes make their transition to insulin therapy will assist in understanding how insulin is perceived, which will inform health care professionals in their work with those diagnosed with diabetes. Aim of Research The aim of the research is to explore and describe how Samoan people with type 2 diabetes in New Zealand made the transition to insulin therapy for better glycaemic control. Design The Fonofale Model was used as the theoretical framework, from which to understand Samoan peoples' experiences. This research used a qualitative descriptive methodology. In-depth interviews were used to gather the stories of four Samoan participants over the age of 18 years diagnosed with type 2 diabetes. The data was analysed using thematic analysis. Findings Three major themes emerged from the analysis of the participants' stories. These were: living with diabetes, making the transition to insulin therapy and realisation. The findings led to the creation of the Ia Malu model, which describes the experiences of the participants in this study. Conclusion This study confirmed that there are immense challenges and struggles encountered by people with diabetes. Their adjustment to the illness as well as making the transition to using insulin takes time. As a result of this, it is fundamental for nurses/health care professionals to understand that this is the reality for these people, and they must therefore provide time for people to adjust.</p>

scholarly journals Social Workers’ Experience of Moral Distress

2018 ◽  
Vol 35 (1) ◽  
pp. 91-107 ◽  
Author(s):  
Shannon Jaskela ◽  
Juliet Guichon ◽  
Stacey A. Page ◽  
Ian Mitchell
Keyword(s):  
Health Care ◽  
Social Workers ◽  
Health Care Professionals ◽  
Moral Distress ◽  
Descriptive Study ◽  
Common Theme ◽  
The Social ◽  
Qualitative Descriptive ◽  
The Common ◽  
The Right

When health care professionals know the right thing to do, but are prevented from doing so, they can suffer from moral distress. Although moral distress in nursing has been studied extensively, it has been a neglected topic with regard to the social work profession. This paper presents findings of a qualitative descriptive study on health care social workers’ experiences of moral distress, focusing mainly on the situations that caused such moral distress. The effects of moral distress, the coping strategies these social workers used to deal with their experience and the common theme of “pushing the rules” are also presented. Finally, we offer recommendations, which were made by participants, to assist social workers with decreasing the effects of moral distress. By following these recommendations, social workers’ experience of moral distress may decrease which will, in turn, positively affect the organizations for which they work and the patients they serve.

scholarly journals Health Care Professionals’ Pain Narratives in Hospitalized Children’S Medical Records. Part 2: Structure and Content

2013 ◽  
Vol 18 (5) ◽  
pp. e84-e93
Author(s):  
Judy Rashotte ◽  
Denise Harrison ◽  
Geraldine Coburn ◽  
Janet Yamada ◽  
Bonnie J Stevens ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Pain ◽  
Health Care Professionals ◽  
Medical Records ◽  
Management Plan ◽  
Free Text ◽  
Pain Status ◽  
Pain Intervention ◽  
Qualitative Descriptive ◽  
Numerical Representations

BACKGROUND: Although clinical narratives – described as free-text notations – have been noted to be a source of patient information, no studies have examined the composition of pain narratives in hospitalized children’s medical records.OBJECTIVES: To describe the structure and content of health care professionals’ narratives related to hospitalized children’s acute pain.METHODS: All pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized in 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was performed.RESULTS: Three major structural elements with their respective categories and subcategories were identified: information sources, including clinician, patient, parent, dual and unknown; compositional archetypes, including baseline pain status, intermittent pain updates, single events, pain summation and pain management plan; and content, including pain declaration, pain assessment, pain intervention and multidimensional elements of care.CONCLUSIONS: The present qualitative analysis revealed the multidimensionality of structure and content that was used to document hospitalized children’s acute pain. The findings have the potential to inform debate on whether the multidimensionality of pain narratives’ composition is a desirable feature of documentation and how narratives can be refined and improved. There is potential for further investigation into how health care professionals’ pain narratives could have a role in generating guidelines for best pain documentation practice beyond numerical representations of pain intensity.

scholarly journals Physiotherapy students’ perceptions of the dual role of the clinical educator as mentor and assessor: Influence on the teaching–learning relationship

2017 ◽  
Vol 73 (1) ◽  
Author(s):  
Ilse S. Meyer ◽  
Alwyn Louw ◽  
Dawn Ernstzen
Keyword(s):  
Health Care ◽  
Clinical Education ◽  
Health Care Professionals ◽  
Dual Role ◽  
Structured Interviews ◽  
Negative Effects ◽  
Clinical Educator ◽  
Qualitative Descriptive ◽  
Teaching Learning

Background: Clinical education is widely considered to be the cornerstone of health care professionals’ education. Clinical educators (CEs) fulfil many roles and act as both mentors and assessors in the learning process of students’ undergraduate health care professions education. However, changing from being a mentor to being an assessor may present particular challenges for both the CE and the students.Objective: To explore students’ perceptions of how the dual role of a CE as mentor and assessor influenced the teaching–learning (T-L) relationship.Method: A qualitative descriptive study, involving seven individual semi-structured interviews and two focus group discussions, was conducted with students in the Division of Physiotherapy, Stellenbosch University. A contextualised interpretive content analysis was used to analyse the data. By following an iterative process, themes were identified and categories were reviewed and refined.Results: Challenges were experienced when CEs had to act and change as both mentors and assessors to the needs of the students. This influenced the T-L relationship and consequently impacted the learning of students. The expectations of students and CEs were often not fulfilled. Contradictions were disclosed regarding the dual role of CEs.Conclusion: The findings of the study, grounded in the perceptions and experiences of students on the dual role of the CE, are highlighted. It is important to consider the challenges that the students face in order to minimise any negative effects these challenges could have on students’ learning processes.

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