The identity of a new profession

In Canada, there is a growing interest in regulating the practices of acupuncture and Chinese herbology under the banner of ‘Traditional Chinese Medicine’ (TCM). However, the origins and definition of TCM are unclear and therefore disputed. While TCM is often used as an umbrella term to represent Chinese medical traditions that span millennia, numerous academics consider TCM to be a modern construct that has departed from the foundational roots of Chinese medicine. To better understand TCM and its implications for the profession, our study investigates: 1) historical precedents leading up to the formal creation of TCM; 2) characteristics and defining features of TCM; and 3) how this relates to education, practice and regulation of the profession in Canada. A mixed-methods study design was employed. Semi-structured interviews were conducted to explore perceptions of individuals who contributed to mediums that discussed the formation of TCM or traditions that exist outside of TCM. In addition, an anonymous web-based survey was sent to TCM-related professional organizations, who were asked to distribute the survey to their members to capture the views of persons practicing within TCM-related health professions in Canada. Due to a lack of participation from the organizations, no survey data was collected. Interviews revealed that TCM is a product of the standardization and simplification of Chinese medicine during the 1950’s and 60’s in China to meet healthcare needs at the time. Currently in Canada, there appears to be a lack of awareness that the establishment of TCM is not a comprehensive representation of Chinese medical traditions, and that many aspects of it may not be suited to the healthcare landscape of modern-day Canada. There is a need for more discussion surrounding the identity of this new profession.

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Rural citizen-patient priorities for healthcare in British Columbia, Canada: findings from a mixed methods study

BMC Health Services Research ◽

10.1186/s12913-021-06933-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jude Kornelsen ◽

Christine Carthew ◽

Kayla Míguez ◽

Matilda Taylor ◽

Catherine Bodroghy ◽

...

Keyword(s):

British Columbia ◽

Mixed Methods ◽

Rural Communities ◽

Mixed Methods Study ◽

Local Health ◽

Structured Interviews ◽

Rural Patient ◽

Healthcare Planning ◽

Healthcare Needs ◽

Survey Responses

Abstract Background The challenge of including citizen-patient voices in healthcare planning is exacerbated in rural communities by regional variation in priorities and a historical lack of attention to rural healthcare needs. This paper aims to address this deficit by presenting findings from a mixed methods study to understand rural patient and community priorities for healthcare. Methods We conducted a provincial survey of rural citizens-patients across British Columbia, Canada to understand their most pressing healthcare needs, supplemented by semi-structured interviews. Survey and interview participants were asked to articulate, in their own words, their communities’ most pressing healthcare needs, to explain the importance of these priorities to their communities, and to offer possible solutions to address these challenges. Open-text survey responses and interview data were analyzed thematically to elicit priorities of the data and their significance to answer the research questions. Results We received 1,287 survey responses from rural citizens-patients across BC, 1,158 of which were considered complete. We conducted nine telephone interviews with rural citizens-patients. Participants stressed the importance of local access to care, including emergency services, maternity care, seniors care, specialist services and mental health and substance use care. A lack of access to primary care services was the most pronounced gap. Inadequate local health services presented geographic, financial and social barriers to accessing care, led to feelings of vulnerability among rural patients, resulted in treatment avoidance, and deterred community growth. Conclusions Two essential prongs of an integration framework for the inclusion of citizen-patient voices in healthcare planning include merging patient priorities with population needs and system-embedded accountability for the inclusion of patient and community priorities.

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Holism, Chinese Medicine and Systems Ideologies: Rewriting the Past to Imagine the Future

10.3366/edinburgh/9781474400046.003.0003 ◽

2018 ◽

Author(s):

Volker Scheid

Keyword(s):

Eighteenth Century ◽

Chinese Medicine ◽

Medical Humanities ◽

Science And Technology Studies ◽

Human Beings ◽

The Past ◽

Starting Point ◽

The Us ◽

Shared Objective ◽

Definition Of

This chapter explores the articulations that have emerged over the last half century between various types of holism, Chinese medicine and systems biology. Given the discipline’s historical attachments to a definition of ‘medicine’ that rather narrowly refers to biomedicine as developed in Europe and the US from the eighteenth century onwards, the medical humanities are not the most obvious starting point for such an inquiry. At the same time, they do offer one advantage over neighbouring disciplines like medical history, anthropology or science and technology studies for someone like myself, a clinician as well as a historian and anthropologist: their strong commitment to the objective of facilitating better medical practice. This promise furthermore links to the wider project of critique, which, in Max Horkheimer’s definition of the term, aims at change and emancipation in order ‘to liberate human beings from the circumstances that enslave them’. If we take the critical medical humanities as explicitly affirming this shared objective and responsibility, extending the discipline’s traditional gaze is not a burden but becomes, in fact, an obligation.

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“I’ve Heard of It, Yes, but I Can’t Remember What Exactly It Was”—A Qualitative Study on Awareness, Knowledge, and Use of the UV Index

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041615 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1615

Author(s):

Katharina Diehl ◽

Tatiana Görig ◽

Charlotte Jansen ◽

Maike Carola Hruby ◽

Annette B. Pfahlberg ◽

...

Keyword(s):

Qualitative Study ◽

Qualitative Content Analysis ◽

Sun Protection ◽

Structured Interviews ◽

Protection Factor ◽

Protection Measures ◽

Uv Index ◽

Correct Definition ◽

Definition Of

Pharmacists and pharmaceutical technicians play an important role in counselling customers regarding sunscreen use and sun protection measures. A potentially helpful tool that can be used during counselling is the ultraviolet index (UVI), which informs individuals when and what sun protection measures are needed at a specific place and time. Our aim in this qualitative study was to explore awareness, knowledge, and use of the UVI during counselling in pharmacies. We used semi-structured interviews with pharmacists and pharmaceutical technicians (n = 20) to answer our research questions. Interviews were audiotaped, transcribed verbatim, and analyzed using qualitative content analysis. During the interviews pharmacists and pharmaceutical technicians revealed a lot of uncertainty and lack of knowledge regarding the UVI. Eight professionals were able to give a correct definition of UVI. Amongst others, the UVI was confused with sun protection factor. Overall, the UVI was hardly used during the counselling of customers. The UVI was developed to provide guidance when which type of sun protection is required to avoid detrimental effects of ultraviolet radiation. For effective implementation, both the general population and health professionals (e.g., pharmacists) have to increase their knowledge about the UVI. This would strengthen its use during professional counselling in pharmacies and may help to reduce the incidence of skin cancer over the long term.

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Risk perception on the labour ward: A mixed methods study

Journal of Patient Safety and Risk Management ◽

10.1177/25160435211002428 ◽

2021 ◽

Vol 26 (2) ◽

pp. 56-63

Author(s):

Claire McCarthy ◽

Sarah Meaney ◽

Marie Rochford ◽

Keelin O’Donoghue

Keyword(s):

Mixed Methods ◽

Lived Experience ◽

Healthcare Providers ◽

Emergency Obstetric Care ◽

Obstetric Care ◽

Daily Basis ◽

Mixed Methods Study ◽

Structured Interviews ◽

Staff Support ◽

Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

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A Maximal Understanding of Sacrifice: Bataille, Richard Wagner, Pilgrimage and the Bayreuth Festival

Religions ◽

10.3390/rel12010048 ◽

2021 ◽

Vol 12 (1) ◽

pp. 48

Author(s):

Philip Smith ◽

Florian Stoll

Keyword(s):

Emotional Experience ◽

The Body ◽

Richard Wagner ◽

Mixed Methods Study ◽

Historical Research ◽

Structured Interviews ◽

Paradigm Case ◽

Comparative Sociology ◽

Sacred Spaces ◽

Classical Work

This paper calls for a broad conception of sacrifice to be developed as a resource for cultural sociology. It argues the term was framed too narrowly in the classical work of Hubert and Mauss. The later approach of Bataille permits a maximal understanding of sacrifice as non-utilitarian expenditures of money, energy, passion and effort directed towards the experience of transcendence. From this perspective, pilgrimage can be understood as a specific modality of sacrificial activity. This paper applies this understanding of sacrifice and pilgrimage to the annual Bayreuth “Wagner” Festival in Germany. Drawing on a multi-year mixed-methods study involving ethnography, semi-structured interviews and historical research, the article traces sacrificial expenditures at the level of individual festival attendees. These include financial costs, arduous travel, dedicated research of the artworks, and disciplines of the body. Some are lucky enough to experience transcendence in the form of deep emotional experience, and a sense of contact with sacred spaces and forces. Our study is intended as an exemplary paradigm case that can be drawn upon analogically by scholars. We suggest that other aspects of social experience, including many that are more ‘everyday’, can be understood through a maximal model of sacrifice and that a rigorous, wider comparative sociology could be developed using this tool.

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Experiences of New Zealand Haemodialysis Patients in Relation to Food and Nutrition Management: A Qualitative Study

Nutrients ◽

10.3390/nu13072299 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2299

Author(s):

Rachael M. McLean ◽

Zhengxiu Xie ◽

Vicky Nelson ◽

Vili Nosa ◽

Hla Thein ◽

...

Keyword(s):

New Zealand ◽

Qualitative Study ◽

Thematic Analysis ◽

Extended Family ◽

Culturally Appropriate ◽

Structured Interviews ◽

Nutrition Management ◽

Healthcare Needs ◽

Food And Nutrition ◽

Major Disruption

People receiving haemodialysis have considerable and complex dietary and healthcare needs, including co-morbidities. A recent New Zealand study has shown that few patients on haemodialysis are able to meet nutritional requirements for haemodialysis. This study aims to describe the perspectives and experiences of dietary management among patients on haemodialysis in New Zealand. This exploratory qualitative study used in-depth semi-structured interviews. Purposive sampling was used to recruit participants from different ethnic groups. Forty interviews were conducted, audio-recorded and transcribed verbatim. An inductive approach was taken using thematic analysis. Forty participants were interviewed. Participants spoke of major disruption to their lives as a result of their chronic kidney disease and being on haemodialysis, including loss of employment, financial challenges, loss of independence, social isolation and increased reliance on extended family. Most had received adequate dietary information, although some felt that more culturally appropriate support would have enabled a healthier diet. These findings show that further support to make the recommended dietary changes while on haemodialysis should focus on socio-cultural factors, in addition to the information already provided.

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An intervention to decrease burnout and increase retention of early career nurses: a mixed methods study of acceptability and feasibility

BMC Nursing ◽

10.1186/s12912-020-00524-9 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Judy Brook ◽

Leanne M. Aitken ◽

Julie-Ann MacLaren ◽

Debra Salmon

Keyword(s):

Mixed Methods ◽

Nursing Students ◽

Focus Groups ◽

Academic Staff ◽

Skills Training ◽

Early Career ◽

Mixed Methods Study ◽

Healthcare Organisation ◽

Structured Interviews ◽

Over Time

Abstract Aims To understand the experiences of nursing students and academic staff of an intervention to decrease burnout and increase retention of early career nurses, in order to identify acceptability and feasibility in a single centre. Background Internationally, retention of nurses is a persistent challenge but there is a dearth of knowledge about the perspectives of stakeholders regarding the acceptability and feasibility of interventions to resolve the issue. This study reports an intervention comprising of mindfulness, psychological skills training and cognitive realignment to prepare participants for early careers as nurses. Methods This is an explanatory sequential mixed methods study, conducted by a UK university and healthcare organisation. Participants were final year pre-registration nursing students (n = 74) and academics (n = 7) involved in the implementation of the intervention. Pre and post measures of acceptability were taken using a questionnaire adapted from the Theoretical Framework of Acceptability. Wilcoxon Signed Ranks test was used to assess change in acceptability over time. Qualitative data from semi-structured interviews, focus groups and field notes were thematically analysed, adhering to COREQ guidelines. Data were collected February to December 2019. Results One hundred and five questionnaires, 12 interviews with students and 2 focus groups engaging 7 academic staff were completed. The intervention was perceived as generally acceptable with significant positive increases in acceptability scores over time. Student nurses perceived the intervention equipped them with skills and experience that offered enduring personal benefit. Challenges related to the practice environment and academic assessment pressures. Reported benefits align with known protective factors against burnout and leaving the profession. Conclusion Planning is needed to embed the intervention into curricula and maximise relationships with placement partners. Evaluating acceptability and feasibility offers new knowledge about the value of the intervention for increasing retention and decreasing burnout for early career nurses. Wider implementation is both feasible and recommended by participants.

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Satisfaction with Fertility Preservation Decisions among Adolescent Males with Cancer: A Mixed Methods Study

Cancers ◽

10.3390/cancers13143559 ◽

2021 ◽

Vol 13 (14) ◽

pp. 3559

Author(s):

Charleen I. Theroux ◽

Kylie N. Hill ◽

Anna L. Olsavsky ◽

James L. Klosky ◽

Nicholas D. Yeager ◽

...

Keyword(s):

Mixed Methods ◽

Fertility Preservation ◽

Childhood Cancer Survivors ◽

Mixed Methods Study ◽

Decision Quality ◽

Structured Interviews ◽

Short Term ◽

Male Adolescents ◽

Decisional Satisfaction ◽

Ongoing Support

Half of male childhood cancer survivors experience treatment-related fertility impairment, which can lead to distress. Survivors often regret forgoing fertility preservation (FP), and decisional dissatisfaction is associated with a lower quality of life. This mixed methods study examined short-term FP decisional satisfaction among families of male adolescents newly diagnosed with cancer who received an initial fertility consult and completed an FP values clarification tool. One-two months after the FP decision, thirty-nine families completed the Brief Subjective Decision Quality measure. Decisional satisfaction was compared for participants (mothers, fathers, adolescents) who did and did not attempt to bank. Semi-structured interviews included the following question: How do you/your family feel about the banking decision now/in the future? Decisional quality scores were moderate-high (M = 5.74–6.33 out of 7), with no significant differences between non-attempter (n = 15) and attempter (n = 24) families (adolescents: p = 0.83, d = 0.08; mothers: p = 0.18, d = 0.45; fathers: p = 0.32, d = 0.44). Three qualitative themes emerged among non-attempter families: (1) satisfaction with decision (50% of participants), (2) acceptance of decision (60%), and (3) potential for future regret (40%). Satisfaction with decision was the only theme identified in attempter families (93%). Quantitively, short-term decisional satisfaction was high regardless of the banking attempt. However, the qualitative findings suggest that the experiences of families who did not bank may be more nuanced, as several participants discussed a potential for future regret, highlighting the importance of ongoing support.

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Collaborative design in public services: a wicked problem-reframing case

The TQM Journal ◽

10.1108/tqm-12-2019-0300 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Patrícia Moura e Sá ◽

Catarina Frade ◽

Fernanda Jesus ◽

Mónica Lopes ◽

Teresa Maneca Lima ◽

...

Keyword(s):

Collaborative Design ◽

Success Factors ◽

Central Government ◽

Wicked Problem ◽

Low Density ◽

Structured Interviews ◽

Content Type ◽

Critical Success ◽

Definition Of ◽

The Right

PurposeWicked problems require collaborative innovation approaches. Understanding the problem from the users' perspective is essential. Based on a complex and ill-defined case, the purpose of the current paper is to identify some critical success factors in defining the “right problem” to be addressed.Design/methodology/approachAn empirical research study was carried out in a low-density municipality (case study). Extensive data were collected from official databases, individual semi-structured interviews and a focus group involving citizens, local authorities, civil servants and other relevant stakeholders.FindingsAs defined by the central government, the problem to be addressed by the research team was to identify which justice services should be made available locally to a small- and low-density community. The problem was initially formulated using top-down reasoning. In-depth contact with citizens and key local players revealed that the lack of justice services was not “the issue” for that community. Mobility constraints and the shortage of economic opportunities had a considerable impact on the lack of demand for justice services. By using a bottom-up perspective, it was possible to reframe the problem to be addressed and suggest a new concept to be tested at later stages.Social implicationsThe approach followed called attention to the importance of listening to citizens and local organisations with a profound knowledge of the territory to effectively identify and circumscribe a local problem in the justice field.Originality/valueThe paper highlights the limitations of traditional rational problem-solving approaches and contributes to expanding the voice-of-the-customer principle showing how it can lead to a substantially new definition of the problem to be addressed.

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Career Paths of Campus Recreational Sport Directors

Recreational Sports Journal ◽

10.1123/rsj.31.2.146 ◽

2007 ◽

Vol 31 (2) ◽

pp. 146-155 ◽

Cited By ~ 4

Author(s):

Craig M. Ross ◽

Terese Schurger

Keyword(s):

Career Paths ◽

Sport Management ◽

Professional Organizations ◽

Sport Administration ◽

Web Based ◽

Recreational Sport ◽

Successful Career ◽

Study Results ◽

Practical Experiences ◽

Relevant Factors

The purpose of this study was to examine the job profiles and career paths taken by directors in campus recreational sport. Using a Web-based survey of 52 closed-ended and 2 open-ended items, the study results provided a rich overview of the perceptions, issues, and patterns that 145 current directors identified as relevant factors contributing to successful career paths in campus recreational sport administration. Overall, the results of the study revealed that future campus recreational sport directors must gain diverse practical experiences, be actively involved in professional organizations, learn how to network effectively with professionals both at the institutional and nationwide levels, and be passionate about recreational sport management.

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