scholarly journals Guidelines for Management of Urgent Symptoms in Patients with Cholangiocarcinoma and Biliary Stents or Catheters Using the Modified RAND/UCLA Delphi Process

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2375
Author(s):  
Renuka V. Iyer ◽  
Susan G. Acquisto ◽  
John A. Bridgewater ◽  
Michael A. Choti ◽  
Theodore S. Hong ◽  
...  
Keyword(s):  
Expert Panel ◽  
Unmet Need ◽  
Outpatient Setting ◽  
Delphi Process ◽  
Biliary Stents ◽  
Face To Face ◽  
Clinical Scenarios ◽  
Ascending Cholangitis ◽  
Before And After ◽  
The Uk

Background: Patients with cholangiocarcinoma often have indwelling biliary stents or catheters which are prone to obstructions and/or infections; studies show that 20–40% present with fever and/or jaundice requiring urgent treatment in the outpatient setting for which there are no uniform guidelines. The goal was to develop an expert panel consensus on this topic using the modified RAND/UCLA Delphi process to rate treatment appropriateness. Methods: Thirteen expert physicians from relevant specialties, geography, and practice settings were recruited for the panel. Patient scenarios were developed and panelists rated the therapies before and after a face-to-face discussion. The appropriateness of various therapies was rated on a scale from 1–9 and classified as appropriate, inappropriate, or uncertain. Scenarios with greater than 2 (>2) ratings of 1–3 (inappropriate) and greater than 2 (>2) ratings of 7–9 (appropriate) were considered to have disagreement and were not assigned an appropriateness rating. Results: Panelists were from all US regions and the UK (8%) and had practiced for a mean 16.5 years (4–33 years). Panelists rated 480 scenarios before the meeting and re-rated 288 of the clinical scenarios after the meeting. The panelists agreed that ongoing treatment with chemotherapy did not influence decision-making and, therefore, 192 scenarios were excluded from the final list. Disagreement decreased from 37.5% before to 10.4% after the meeting. Consensus on stent/tube manipulation and inpatient antibiotic therapy was obtained and summarized in patients as “appropriate” or “maybe appropriate” based on a patient’s bilirubin level at presentation. Conclusions: The Delphi process produced consensus guidelines to fill an unmet need in the urgent management of ascending cholangitis in patients with cholangiocarcinoma.

Guidelines for management of urgent symptoms in cholangiocarcinoma (CC) patients (pts) with biliary stents or catheters using the modified RAND/UCLA Delphi process.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15641-e15641
Author(s):  
Renuka V. Iyer ◽  
Susan G. Acquisto ◽  
John A. Bridgewater ◽  
Michael A. Choti ◽  
Theodore S. Hong ◽  
...  
Keyword(s):  
Expert Panel ◽  
Unmet Need ◽  
Delphi Process ◽  
Biliary Stents ◽  
Face To Face ◽  
Clinical Scenarios ◽  
Consensus Statements ◽  
Ascending Cholangitis ◽  
Before And After ◽  
The Uk

e15641 Background: CC pts with biliary stents or catheters are prone to have obstruction/infection and studies show 20-40% present with fever/or jaundice requiring urgent treatment for which there is no uniform guideline. We aimed to develop an expert panel consensus on this topic using the modified RAND/UCLA Delphi process to rate treatment appropriateness. Methods: We recruited 13 physician experts from relevant specialty, geography, and practice settings. Patient scenarios were developed and panelists rated the therapies before and after a face-to-face discussion. The appropriateness of various therapies was rated on a 1-9 scale and classified as appropriate, inappropriate, or uncertain. Scenarios with > 2 ratings of 1-3 (inappropriate) and > 2 ratings of 7-9 (appropriate) were considered to have disagreement and were not assigned an appropriateness rating. Results: Panelists were from all US regions (92%) and the UK (8%); had practiced for a mean 16.5 years (4-33 years). Panelists rated 480 scenarios before the meeting, but re-rated only 288 clinical scenarios as they felt that ongoing treatment with chemotherapy did not influence decision-making. Disagreement decreased from 37.5% before the meeting to 10.4% after. Consensus statements are summarized in the table below. Conclusions: The Delphi process produced consensus guidelines to fill an unmet need in urgent management of ascending cholangitis in pts with CC. (Support: The Cholangiocarcinoma Foundation). [Table: see text]

Consensus treatment guidelines for urgent symptoms in cholangiocarcinoma (CC) patients (pts) with biliary stents or catheters using the modified RAND/UCLA Delphi process.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 452-452 ◽  
Author(s):  
Renuka V. Iyer ◽  
Susan G. Acquisto ◽  
John A. Bridgewater ◽  
Michael A. Choti ◽  
Theodore S. Hong ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Unmet Need ◽  
Cost Of Care ◽  
Delphi Process ◽  
Biliary Stents ◽  
Clinical Scenarios ◽  
Consensus Statements ◽  
Before And After ◽  
The Uk ◽  
The Impact

452 Background: CC pts with biliary stents or catheters often present with fever and/or jaundice requiring urgent treatment for which there is no uniform guideline. We aimed to develop an expert panel consensus on this topic using the modified RAND/UCLA Delphi process to rate treatment appropriateness. Methods: We recruited 13 physician experts from relevant specialty, geography, and practice settings. Patient scenarios were developed based on a literature review, and therapies were rated by the experts before and after a face-to-face discussion. The appropriateness of various therapies was rated on a 1-9 scale and classified as appropriate, inappropriate, or uncertain. Scenarios with > 2 ratings of 1-3 (inappropriate) and > 2 ratings of 7-9 (appropriate) were considered to have disagreement and were not assigned an appropriateness rating. Results: Panelists were from all US regions (92%) and the UK (8%); had practiced for a mean 16.5 years (4-33 years) and reported seeing an average of 120 unique CC patients a year (0-900 pts). Panelists rated 288 clinical scenarios. Experts decided that ongoing treatment with chemotherapy did not influence decision-making. Disagreement decreased from 37.5% before the meeting to 10.4% after. Consensus statements are summarized in table 1. Conclusions: The Delphi process produced consensus guidelines to fill an unmet need in urgent management of ascending cholangitis in pts with CC. Studies of the impact of these guidelines on cost of care and pt outcomes are warranted. (Support: The Cholangiocarcinoma Foundation)[Table: see text]

scholarly journals Clinical Competencies for the Care of Hospitalized Patients with Alcohol Use Disorders

2020 ◽  
Vol 55 (4) ◽  
pp. 395-400 ◽  
Author(s):  
Thomas Phillips ◽  
Amy Porter ◽  
Julia Sinclair
Keyword(s):  
Alcohol Use ◽  
Expert Panel ◽  
Alcohol Use Disorders ◽  
Hospitalized Patients ◽  
Delphi Panel ◽  
Clinical Competencies ◽  
Face To Face ◽  
Expert Meeting ◽  
Occupational Standards ◽  
The Uk

Abstract Aims The UK government aims to develop alcohol care teams (ACTs) that provide care for alcohol dependence in general hospital settings. Service descriptors have been identified to support the development of ACTs. The aim of this study was to use Delphi panel principles to identify the clinical competencies required to provide these elements of service. Methods We formed an expert consensus panel of 24 senior clinical alcohol practitioners, leaders and experts by experience drawn from all regions of England. The study was divided into three distinct phases: (a) a review and synthesis of current literature in this area, (b) a face-to-face meeting of the expert panel and (c) subsequent iterations to refine the competencies until consensus was reached. Results Our initial search strategy resulted in 555 competency statements being extracted from a range of national clinical professional and occupational standards and other sources. The research team refined these statements to 98 competencies in advance of the expert meeting. The panel identified 14 additional statements and reduced the number of competencies to 78. Subsequent iterations finalized 72 competencies across the 8 service descriptors. Conclusions Drawing on the existing published resources and clinical experience, the expert panel has provided consensus on the core clinical competencies required for alcohol care teams in caring for hospitalized patients with alcohol use disorders. Whilst it is acknowledged that the range of current provision is variable, these competencies provide a template for clinical practice and the development of multidisciplinary ACTs.

scholarly journals Early Supported Discharge for patients with febrile neutropenia – Experience at a large district hospital in the UK

2019 ◽  
Vol 18 (1) ◽  
pp. 10-15
Author(s):  
Clair I. W. Brunner ◽  
◽  
Joanne Botten ◽  
Nic Wennike ◽  
Lucy Ford ◽  
...  
Keyword(s):  
Cost Effective ◽  
Outpatient Setting ◽  
Septic Complications ◽  
Neutropenic Sepsis ◽  
Early Supported Discharge ◽  
Same Day Discharge ◽  
Before And After ◽  
Life Threatening ◽  
The Uk

Neutropenic sepsis can be life threatening, with mortality 2-21%. The heterogeneity of patients referred with “suspected neutropenic sepsis” has led to strategies being developed to risk-stratify patients and identify those with a low risk of septic complications that could be managed in the outpatient setting, such as The Multinational Association for Supportive Care in Cancer score (MASCC). Outcomes for patients referred with suspected neutropenic sepsis were assessed before and after use of MASCC guided early-supported discharge. 50/123 (41%) patients over 24 months were eligible for early-supported discharge. 26/50 patients had same-day discharge, 14 had overnight admission, 8 stayed 2 nights and 2 stayed 3 nights. Patients received on average 2 follow-up telephone consultations. There were 5 readmissions (10%) and no adverse events. In comparison group; 8 patients over 3-months would have been suitable, potentially saving 40 bed-days. This shows MASCC guided early-supported discharge is safe and cost-effective.

scholarly journals P067 Virtual care: the future, but to what extent?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Zoe Rutter-locher ◽  
Nikita Arumalla ◽  
Zoe Bright ◽  
Toby Garrood
Keyword(s):  
Healthcare Providers ◽  
Patient Survey ◽  
Outpatient Setting ◽  
Face To Face ◽  
Virtual Care ◽  
Potential Strategy ◽  
Set Up ◽  
Feedback Data ◽  
The Uk ◽  
Virtual Clinic

Abstract Background/Aims  The COVID-19 pandemic has necessitated profound changes to the delivery of healthcare in the UK. Our aim was to analyse whether a move to virtual care is beneficial and sustainable in a rheumatology outpatient setting. Methods  Data on volume of unscheduled access to an outpatient rheumatology service and questionnaire feedback responses from patients and rheumatology clinicians on virtual consultations, was analysed. Results  During the COVID-19 pandemic period of March - July 2020, our department saw a majority of face to face outpatient rheumatology clinic appointments transferred to virtual (telephone/video) with a significant reduction in the number of scheduled clinics. In addition, the volume of telephone appointments booked online by patients saw a 27.2% rise (n = 2248) compared to March - July 2019 (n = 1767), with a 23.7% increase in telephone helpline calls in the 2020 period (n = 3246) compared to 2019 (n = 2624) and over a 300% increase in email helpline activity. Questionnaire responses were obtained from 382 patients (Table 1). 86% of patients felt they got a lot out of a virtual appointment, but 13% would prefer not to use it again. Of the 16 healthcare providers that responded, 12 (75%) were satisfied with the virtual clinic set up, but only 2/16 (13%) felt the same could be achieved for patients in a virtual setting compared to a face-to-face visit. The lack of clinical examination was a major limitation for clinicians 12/16 (75%) and was similarly identified amongst patient feedback (42/260) (16%). Conclusion  Virtual care with the provision for patient-led care allows convenience for the patient with high patient satisfaction, however this is not necessarily an approach that suits all. Clinicians must beware the non-complaining patient, and careful selection of those suitable for virtual care may be needed. Our model of patient led care using telephone appointments booked online by patients coupled with telephone/email helplines is a potential strategy for other centers to develop. Ongoing patient and healthcare provider feedback, data on the effect on clinical outcomes and detailed quality improvement cycles are vital to adjust services over the coming months. P067 Table 1:Results of patient survey on Virtual Clinic experienceDemographicsGenderFemale293 (77%)AgeAge 16-64269 (70%)Age 65-80+94 (25%)RaceWhite British233 (60%)BAME72 (18%)ConsultationsModeTelephone366 (96%)Video11 (3%)TypeNew45 (13%)Follow up333 (87%)ClinicianDoctor324 (85%)Nurse32 (8%)AHP26 (7%)Time from appointment to contactOn time or early195(51%)Up to 15 minutes57 (15%)15-30 minutes36 (9%)>30 minutes41 (11%)Length of appointment<15 minutes184 (48%)15-30 minutes164 (43%)>30 minutes23 (6%)FeedbackWas the length of the appointment right?About right352 (92%)Too short19 (5%)Did you get everything out of this appointment as you would in a face-to-face session?Yes, definitely206 (54%)Yes, to some extent121 (32%)No49 (13%)Did you feel involved in the decision made about your care?Yes, definitely277 (73%)Yes, to some extent57 (15%)No21 (6%)Did you feel you received the information you required?Yes, definitely251 (66%)Yes, to some extent92 (24%)No16 (4%)How would you rate the appointment?Very good/good327 (86%)Neither good nor poor24 (6%)Poor/very poor14 (4%)Would you prefer to use this again for your next appointment?Yes, definitely124 (32%)Yes, to some extent182 (48%)No61 (16%)*Missing data if patient did not respond to the questions. Disclosure  Z. Rutter-locher: None. N. Arumalla: None. Z. Bright: None. T. Garrood: None.

The impact of virtual medical student surgical conferences

2021 ◽  
pp. 1-9
Author(s):  
Charmilie Chandrakumar ◽  
Kaifeng Liang ◽  
A Raneesha Pillay ◽  
Soundarya Soundararajan ◽  
Pramod Achan
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Online Surveys ◽  
Face To Face ◽  
Internet Connection ◽  
Significant Difference ◽  
Before And After ◽  
Surgical Career ◽  
The Uk ◽  
The Impact

Background In recent years, the number of people pursuing a surgical career in the UK has decreased. The COVID-19 pandemic has led to the cancellation of surgical placements for medical students and has affected surgical education. This study evaluates the perceptions and impact of a 1-day virtual surgical conference for medical students considering pursuing a surgical career. Methods All delegates of the 2021 Barts and The London International Surgical Conference were invited to participate in two online surveys pre- and post-conference. Data were collected and analysed to evaluate delegates' reasons for attending the conference, and attitudes towards virtual conferences and a surgical career before and after the conference. Results Out of 132 participants, 106 (80.3%) completed both the pre- and post-conference surveys. Clinical students showed a statistically significant difference in interest in pursuing a surgical career after the conference than before (P=0.03), unlike pre-clinical students (P=0.12). Post-conference, 43 (40.6%) preferred a virtual to a face-to-face conference, which was a slight increase from 40 (37.7%) pre-conference, while 73 (68.9%) and 80 (75.5%) participants favoured virtual talks and presentations respectively. In contrast, only 12 (11.3%) and 21 (19.8%) students preferred workshops and networking virtually. Furthermore, delegates liked the global accessibility and environmentally-friendly nature of virtual conferences but found they can be less engaging and be disrupted by a poor internet connection. Conclusions Virtual surgical conferences have many benefits and can help encourage medical students towards a surgical career. They could help bridge the surgical educational gap in medical school during these unprecedented times. Virtual conferences, which have a broader and more inclusive reach, could be an important complement to conventional conferences after the pandemic.

scholarly journals Perioperative pain and addiction interdisciplinary network (PAIN): protocol for the perioperative management of cannabis and cannabinoid-based medicines using a modified Delphi process

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036472 ◽  
Author(s):  
Alexander McLaren-Blades ◽  
Karim Ladha ◽  
Akash Goel ◽  
Varuna Manoo ◽  
Yuvaraj Kotteeswaran ◽  
...  
Keyword(s):  
Expert Panel ◽  
Large Population ◽  
Perioperative Period ◽  
Delphi Process ◽  
Modified Delphi ◽  
Therapeutic Benefits ◽  
Clinical Scenarios ◽  
Narrative Literature ◽  
Modified Delphi Technique ◽  
Narrative Literature Review

IntroductionAt the conception of this study (January 2019), a literature search by the authors found no evidence-based or consensus perioperative guidelines for patients consuming cannabis products, or for those patients in whom a cannabinoid medication could be considered for perioperative treatment. Currently, there is a large global population that consumes cannabis. The availability of cannabis has also increased this decade with greater legal access to cannabis products in some countries such as USA, Canada, Uruguay, Israel, Australia and Germany. There are recognised possible therapeutic benefits for the use of cannabis in patients with chronic pain, chronic neuropathic pain and chemotherapy-induced nausea and vomiting. There are also potential side effects from cannabis use such as psychosis, cannabis hyperemesis syndrome, misuse disorder and cannabis withdrawal syndrome. There is evidence that cannabis may also affect factors in the perioperative period such as monitoring, quality of analgesia, sleep and opioid consumption. Given the large population of persons using cannabis, the heterogeneity of cannabis products and the paucity (and heterogeneity) of perioperative literature surrounding it, perioperative guidelines for cannabis consuming patients are both lacking and necessary. In this paper, we present the design for a modified Delphi technique that has been started with the intent of deriving cannabis perioperative guidelines from the available medical literature and the consensus of multidisciplinary experts.Materials, methods and analysisThis study will use a scoping narrative literature review and modified Delphi process to generate cannabis perioperative guidelines. A scoping narrative review of cannabis in the perioperative period by the authors of this proposal was completed and provided to a panel of 17 experts. These experts were recruited for their knowledge and expertise regarding cannabis and/or perioperative medicine. They were asked to rate a series of indications and clinical scenarios in two rounds. During the first round, the expert panel was blinded to each other’s participation. During the second round of this process, the expert panel met after being provided with an analysis of the first round’s submissions so they could be discussed further and, if possible, reach a further consensus regarding them. Using the results obtained from the Delphi review process, a draft of proposed cannabis perioperative guidelines will be generated. These proposed guidelines will be returned to the expert panel for critiquing prior to their finalisation.Ethics and disseminationStudy and panellist data will be deidentified and stored as per institutional (Toronto General Hospital) guidelines. Institutional research ethics board provided a waiver for this modified Delphi protocol. Findings will be presented and published in peer-reviewed publications and conferences.

scholarly journals Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services: Linguistic Ethnographic Study of Video-Mediated Interaction (Preprint)

2020 ◽  
Author(s):  
Sara E Shaw ◽  
Lucas Martinus Seuren ◽  
Joseph Wherton ◽  
Deborah Cameron ◽  
Christine A'Court ◽  
...  
Keyword(s):  
Heart Failure ◽  
Communication Strategies ◽  
Ethnographic Study ◽  
Face To Face ◽  
Depth Analysis ◽  
Video Consultation ◽  
Before And After ◽  
Video Link ◽  
Uk National Health Service ◽  
The Uk

BACKGROUND Video-mediated clinical consultations offer potential benefits over conventional face-to-face in terms of access, convenience, and sometimes cost. The improved technical quality and dependability of video-mediated consultations has opened up the possibility for more widespread use. However, questions remain regarding clinical quality and safety. Video-mediated consultations are sometimes criticized for being not as good as face-to-face, but there has been little previous in-depth research on their interactional dynamics, and no agreement on what a good video consultation looks like. OBJECTIVE Using conversation analysis, this study aimed to identify and analyze the communication strategies through which video-mediated consultations are accomplished and to produce recommendations for patients and clinicians to improve the communicative quality of such consultations. METHODS We conducted an in-depth analysis of the clinician-patient interaction in a sample of video-mediated consultations and a comparison sample of face-to-face consultations drawn from 4 clinical settings across 2 trusts (1 community and 1 acute care) in the UK National Health Service. The video dataset consisted of 37 recordings of video-mediated consultations (with diabetes, antenatal diabetes, cancer, and heart failure patients), 28 matched audio recordings of face-to-face consultations, and fieldnotes from before and after each consultation. We also conducted 37 interviews with staff and 26 interviews with patients. Using linguistic ethnography (combining analysis of communication with an appreciation of the context in which it takes place), we examined in detail how video interaction was mediated by 2 software platforms (Skype and FaceTime). RESULTS Patients had been selected by their clinician as <i>appropriate</i> for video-mediated consultation. Most consultations in our sample were technically and clinically unproblematic. However, we identified 3 interactional challenges: (1) opening the video consultation, (2) dealing with disruption to conversational flow (eg, technical issues with audio and/or video), and (3) conducting an examination. Operational and technological issues were the exception rather than the norm. In all but 1 case, both clinicians and patients (deliberately or intuitively) used established communication strategies to successfully negotiate these challenges. Remote physical examinations required the patient (and, in some cases, a relative) to simultaneously follow instructions and manipulate technology (eg, camera) to make it possible for the clinician to see and hear adequately. CONCLUSIONS A remote video link alters how patients and clinicians interact and may adversely affect the flow of conversation. However, our data suggest that when such problems occur, clinicians and patients can work collaboratively to find ways to overcome them. There is potential for a limited physical examination to be undertaken remotely with some patients and in some conditions, but this appears to need complex interactional work by the patient and/or their relatives. We offer preliminary guidance for patients and clinicians on what is and is not feasible when consulting via a video link. INTERNATIONAL REGISTERED REPORT RR2-10.2196/10913

scholarly journals Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services: Linguistic Ethnographic Study of Video-Mediated Interaction

10.2196/18378 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e18378 ◽  
Author(s):  
Sara E Shaw ◽  
Lucas Martinus Seuren ◽  
Joseph Wherton ◽  
Deborah Cameron ◽  
Christine A'Court ◽  
...  
Keyword(s):  
Heart Failure ◽  
Communication Strategies ◽  
Ethnographic Study ◽  
Face To Face ◽  
Depth Analysis ◽  
Video Consultation ◽  
Before And After ◽  
Video Link ◽  
Uk National Health Service ◽  
The Uk

Background Video-mediated clinical consultations offer potential benefits over conventional face-to-face in terms of access, convenience, and sometimes cost. The improved technical quality and dependability of video-mediated consultations has opened up the possibility for more widespread use. However, questions remain regarding clinical quality and safety. Video-mediated consultations are sometimes criticized for being not as good as face-to-face, but there has been little previous in-depth research on their interactional dynamics, and no agreement on what a good video consultation looks like. Objective Using conversation analysis, this study aimed to identify and analyze the communication strategies through which video-mediated consultations are accomplished and to produce recommendations for patients and clinicians to improve the communicative quality of such consultations. Methods We conducted an in-depth analysis of the clinician-patient interaction in a sample of video-mediated consultations and a comparison sample of face-to-face consultations drawn from 4 clinical settings across 2 trusts (1 community and 1 acute care) in the UK National Health Service. The video dataset consisted of 37 recordings of video-mediated consultations (with diabetes, antenatal diabetes, cancer, and heart failure patients), 28 matched audio recordings of face-to-face consultations, and fieldnotes from before and after each consultation. We also conducted 37 interviews with staff and 26 interviews with patients. Using linguistic ethnography (combining analysis of communication with an appreciation of the context in which it takes place), we examined in detail how video interaction was mediated by 2 software platforms (Skype and FaceTime). Results Patients had been selected by their clinician as appropriate for video-mediated consultation. Most consultations in our sample were technically and clinically unproblematic. However, we identified 3 interactional challenges: (1) opening the video consultation, (2) dealing with disruption to conversational flow (eg, technical issues with audio and/or video), and (3) conducting an examination. Operational and technological issues were the exception rather than the norm. In all but 1 case, both clinicians and patients (deliberately or intuitively) used established communication strategies to successfully negotiate these challenges. Remote physical examinations required the patient (and, in some cases, a relative) to simultaneously follow instructions and manipulate technology (eg, camera) to make it possible for the clinician to see and hear adequately. Conclusions A remote video link alters how patients and clinicians interact and may adversely affect the flow of conversation. However, our data suggest that when such problems occur, clinicians and patients can work collaboratively to find ways to overcome them. There is potential for a limited physical examination to be undertaken remotely with some patients and in some conditions, but this appears to need complex interactional work by the patient and/or their relatives. We offer preliminary guidance for patients and clinicians on what is and is not feasible when consulting via a video link. International Registered Report Identifier (IRRID) RR2-10.2196/10913

İngiltere’den Türkiye’ye ‘Düzensiz’ Göçmen Dövizi Gönderme Davranışının Nedenleri Üzerine Nitel Bir İnceleme

2019 ◽  
Vol 6 (2) ◽  
pp. 173-190
Author(s):  
Fethiye Tilbe
Keyword(s):  
Cultural Values ◽  
Host Country ◽  
Regulatory Framework ◽  
Face To Face ◽  
Migrant Communities ◽  
The United Kingdom ◽  
Main Determinants ◽  
Money Transfers ◽  
The Uk ◽  
Migrant Groups

Bu makale, göçmen dövizi  akımlarında “düzensizlik” olarak ifade ettiğimiz, Türkiye’ye resmi kanallar dışında gönderilen enformel  göçmen dövizlerini, Birleşik Krallık’ta (özellikle Londra’da) yaşayan Türkiye kökenli göçmenler açısından incelemektedir. Her göçmen grubu, gerek ev sahibi ülkedeki düzenleyici çerçeve ve sosyo-ekonomik koşullar, gerek göçmen topluluğunun sosyo-kültürel değerleri tarafından belirlenen biçimde, farklı göçmen dövizi transfer biçimlerine eğilim sergilemektedir. Dolayısıyla farklı ülkelerdeki aynı kökenden göçmen toplulukları, ev sahibi ülkedeki dinamikler nedeniyle göçmen dövizlerinin formel ya da enformel (düzenli ya da düzensiz) gönderiminde farklılaşabilirken, aynı ülkedeki farklı ülke kökenli göçmen grupları da pek çok örüntünün etkisiyle farklı eğilim gösterebilmektedir. Nitel araştırma tasarımı kapsamında 27 göçmen ve 7 anahtar statüdeki katılımcıyla gerçekleştirilen yüz yüze görüşmelere dayalı olan bu çalışma, Birleşik Krallık’tan Türkiye’ye göçmen dövizi gönderimindeki düzensizlik olgusunu, her iki ülkenin sosyal, ekonomik ve kültürel dinamikleriyle ilişkilendirerek incelemeyi ve nedenlerini ortaya çıkarmayı amaç edinmektedir. Elde edilen sonuçlar, göçmenlik statüsü, gönderilen para miktar ve sıklığı ile geleneksel ilişki ağlarına olan güvenin yanında, Birleşik Krallık’taki sosyal yardım ve çalışma biçimine ilişkinin düzenleyici çerçevenin ve göçmenlerin sosyo-ekonomik durumlarının Türkiye’ye enformel göçmen dövizi gönderiminde temel belirleyici olduğunu ortaya koymaktadır.ABSTRACT IN ENGLISHA Qualitative Examination of Determinants of Remittances Sending Behaviour Among Immigrants from Turkey in the UKThis article examines the causes of irregularity in remittances flows from the United Kingdom (UK) to Turkey, from the perspective of migrants from Turkey living in the UK. Each group of migrants prefers different types of remittance sending methods, as determined by the regulatory framework and socio-economic conditions in the host country and the socio-cultural values of the migrant community. Therefore, migrant communities of the same origin in different countries may differ in using formal or informal sending methods of remittances due to the dynamics in the host country. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. This study aims to examine the phenomenon of irregularities in sending remittances by associating with the social, economic and cultural dynamics of both countries. For this purpose, face-to-face in-depth interviews were conducted with 27 immigrants and 7 key status participants by using qualitative research method. The obtained results reveal that the regulatory framework relating to social assistance and labour market in the UK, immigration status, the frequency and the amount of money sent and confidence in traditional relationship networks is the main determinants of informal money transfers to Turkey.

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