scholarly journals An Unrecognizable Pain: Neonatal Loss and The Needs of Fathers

2020 ◽  
pp. 1-8
Keyword(s):  
High Risk ◽  
Healthcare System ◽  
Public Hospital ◽  
Perinatal Death ◽  
Maternity Ward ◽  
Structured Interviews ◽  
Show Evidence ◽  
Prospective Research ◽  
Belo Horizonte

Objective: Verify the mourning and paternal suffering in the context of perinatal death, through interviews with the mothers that suffered a gestational loss. Methods: This study has a qualitative, longitudinal, and prospective research realized through two semi-structured interviews with parents who lost children with less than 22 weeks of gestation at the high-risk maternity ward at a public hospital, in Belo Horizonte, Brazil, from February-October 2019. In the interviews, a vital trait was paternal suffering, as evidenced by the mother's speech. This matter brought the authors attention. Results: The interviews in this study show evidence that men need to be tended regarding the time of neonatal loss. The women’s interviews expressed the suffering of their companions and demonstrated how they wished to share their pain with them during their period of mourning. The mothers provide evidence that they feel the need of their partners during gestational loss. Conclusions: Paternal suffering following neonatal loss is often ignored and forgotten about. Further research and directives of support, including supporting neonatal loss as part of the healthcare system, and meaningful steps to ensure quality treatment, are essential for making progress in this overlooked area.

scholarly journals A Mother’s Account About Lactation in the Context of Perinatal Death

2020 ◽  
pp. 9-15
Keyword(s):  
Content Analysis ◽  
Public Hospital ◽  
Longitudinal Research ◽  
Perinatal Death ◽  
Structured Interviews ◽  
Belo Horizonte ◽  
Mourning Process

Objective: To discuss the importance of listening and having a humanized intervention in regard to the donation of breastmilk in the context of perinatal death. Methodology: Content analysis of an interview with a mother in mourning that went through a traumatic lactation following a perinatal death. This case study is one of qualitative, longitudinal research, realized over two partially-structured interviews with parents who had lost their babies with less than 22 weeks of gestation at a public hospital, in Belo Horizonte, Brazil, from February to October 2019. Results: The interviews in the case of “Eva” (hypothetical name) presented significant suffering from lactation following the death of her child and her mourning process, which caught the authors’ attention about the importance of this topic. Conclusions: Women who have lost their babies before, during, or after birth should be offered the option of donating their breastmilk, to allow them to choose what to do with it, and then to counsel them during the mourning process.

Analysis of peripheral venous catheters fixation in premature newborns

2011 ◽  
Vol 5 (3) ◽  
pp. 628 ◽  
Author(s):  
Luciano Marques dos Santos ◽  
Deisielle Mota de Santana ◽  
Tatiana Ribas Gomes ◽  
Rosana Castelo Branco de Santana
Keyword(s):  
High Risk ◽  
Nursing Care ◽  
Public Hospital ◽  
Scientific Evidence ◽  
Structured Interviews ◽  
Premature Newborns ◽  
Neonatal Nursing ◽  
Care Protocol ◽  
Peripheral Venous Access ◽  
Terapia Intensiva

ABSTRACTObjective: to analyze of peripheral venous catheters fixation in premature newborns by nursing team at the High Risk Nursery of a public hospital in the interior of Bahia. Method: this is a descriptive-exploratory study from qualitative approach performed with sixteen professional nursing staff at the High Risk Nursery of a public hospital in the interior of Bahia from August to September 2009. Data were collected through semi-structured interviews and photographic records of peripheral venous access, and analyzed through content analysis of Bardin and semiological analysis of images, respectively. This study was approved by the Ethics Committee of the Faculty of Science and Technology, protocol number 01278-2009. Results: the results showed that the peripheral venous catheters fixation is achieved by inconsistent criteria and without scientific evidence. There is no standard to guide the professionals to carry out this practice. Conclusion: We suggest the elaboration of a care protocol to underpin these professionals and systematize this practice, based on quality and excellence of care. Conclusion: this study demonstrated the need for reform of practice and thus may contribute to the implementation of actions aimed at the attainment of nursing care with a focus on patient safety. Descriptors: neonatal nursing; infant, premature; catheterization, peripheral; intensive care units, neonatal; nursing care. RESUMOObjetivo: analisar as fixações de acessos venosos periféricos em recém-nascidos prematuros realizadas pela equipe de enfermagem do Berçário de Alto Risco de um hospital público do interior da Bahia. Método: estudo do tipo descritivo, exploratório e qualitativo, realizado no Berçário de Alto Risco de um hospital público do interior da Bahia, no período de agosto a setembro de 2009, com dezesseis membros da equipe de enfermagem, após aprovação pelo Comitê de Ética em Pesquisa da Faculdade de Tecnologia e Ciências, pelo parecer no 01.278-2009. Os dados foram coletados de entrevistas semi-estruturadas e registros fotográficos de acessos venosos periféricos, sendo analisados através da Análise de Conteúdo de Bardin e Análise Semiológica de Imagens, respectivamente. Resultados: evidenciou-se que a fixação dos acessos venosos periféricos é realizada através de critérios inconsistentes e sem evidências científicas, não havendo padronização que norteiem os profissionais a realizarem-na. Sugerimos a elaboração de um protocolo assistencial que embase estes profissionais e sistematize esta prática, pautada na qualidade e excelência do cuidado. Conclusão: a realização deste estudo demonstrou a necessidade da reformulação da prática e assim, pode contribuir para a implementação de ações que visem à realização de uma assistência de enfermagem com enfoque na segurança do paciente. Descritores: enfermagem neonatal; recém-nascido prematuro; cateterismo periférico; unidades de terapia intensiva neonatal; cuidados de enfermagem.RESUMENObjetivo: evaluar la fijación de catéteres venosos periféricos en recién nacidos prematuros a cabo por el personal de enfermería en un Vivero de alto riesgo de un hospital público del interior de Bahía. Método: este es un estudio descriptivo, exploratorio y cualitativo, que se celebró en un vivero de Alto Riesgo de un hospital público del interior de Bahía, en el período de agosto a septiembre de 2009, dieciséis miembros del personal de enfermería. Fue aprobado por el Comité de Ética de la Facultad de Tecnología y Ciencia, en el dictamen 01278-2009. Los datos fueron obtenidos de entrevistas semi-estructurada y registros fotográficos de una vía venosa periférica y de análisis de contenido de Bardin y el análisis semiológico de las imágenes, respectivamente. Resultados: los resultados mostraron que el establecimiento de una vía venosa periférica se realiza por criterios incoherentes y sin evidencia científica, no existe un estándar para guiar a los profesionales para llevar a cabo esta práctica. Se sugiere la elaboración de un protocolo de atención que dan soporte a los profesionales y sistematizar esta práctica, basada en la calidad y la excelencia de la atención. Conclusión: este estudio demostró la necesidad de una reforma de la práctica y por lo tanto puede contribuir a la aplicación de acciones encaminadas a la consecución de los cuidados de enfermería con un enfoque en la seguridad del paciente. Descriptores: enfermería neonatal; recién nacido prematuro; cateterismo periférico; unidades de terapia intensiva neonatal; atención de enfermería. 

scholarly journals Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Åse Lundin ◽  
Anna Bergenheim
Keyword(s):  
At Risk ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Qualitative Content Analysis ◽  
Western Hemisphere ◽  
Mental Wellbeing ◽  
Healthcare Personnel ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Patients At Risk

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.

scholarly journals Understanding low chemoprevention uptake by women at high risk of breast cancer: findings from a qualitative inductive study of women’s risk-reduction experiences

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tasleem J. Padamsee ◽  
Megan Hils ◽  
Anna Muraveva
Keyword(s):  
Breast Cancer ◽  
African American ◽  
High Risk ◽  
Risk Reduction ◽  
White Women ◽  
Future Research ◽  
Structured Interviews ◽  
Critical Gap ◽  
High Risk Women ◽  
Parent Project

Abstract Background Chemoprevention is one of several methods that have been developed to help high-risk women reduce their risk of breast cancer. Reasons for the low uptake of chemoprevention are poorly understood. This paper seeks a deeper understanding of this phenomenon by drawing on women’s own narratives about their awareness of chemoprevention and their risk-related experiences. Methods This research is based on a parent project that included fifty in-depth, semi-structured interviews with a purposive sample of African American and White women at elevated risk of breast cancer. This specific study draws on the forty-seven interviews conducted with women at high or severe risk of breast cancer, all of whom are eligible to use chemoprevention for breast cancer risk-reduction. Interviews were analyzed using grounded theory methods. Results Forty-five percent of participants, and only 21% of African American participants, were aware of chemoprevention options. Women who had seen specialists were more likely to be aware, particularly if they had ongoing specialist access. Aware and unaware women relied on different types of sources for prevention-related information. Those whose main source of information was a healthcare provider were more likely to know about chemoprevention. Aware women used more nuanced information gathering strategies and worried more about cancer. Women simultaneously considered all risk-reduction options they knew about. Those who knew about chemoprevention but were reluctant to use it felt this way for multiple reasons, having to do with potential side effects, perceived extreme-ness of the intervention, similarity to chemotherapy, unknown information about chemoprevention, and reluctance to take medications in general. Conclusions Lack of chemoprevention awareness is a critical gap in women’s ability to make health-protective choices. Future research in this field must consider complexities in both women’s perspectives on chemoprevention and the reasons they are reluctant to use it.

scholarly journals Couples’ experiences with expanded carrier screening: evaluation of a university hospital screening offer

2021 ◽  
Author(s):  
Ivy van Dijke ◽  
Phillis Lakeman ◽  
Naoual Sabiri ◽  
Hanna Rusticus ◽  
Cecile P. E. Ottenheim ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Center ◽  
Informed Choice ◽  
Carrier Screening ◽  
University Hospital ◽  
Structured Interviews ◽  
Expanded Carrier Screening ◽  
Post Test ◽  
Future Child ◽  
Clinically Significant

AbstractPreconception carrier screening offers couples the possibility to receive information about the risk of having a child with a recessive disorder. Since 2016, an expanded carrier screening (ECS) test for 50 severe autosomal recessive disorders has been available at Amsterdam Medical Center, a Dutch university hospital. This mixed-methods study evaluated the experiences of couples that participated in the carrier screening offer, including high-risk participants, as well as participants with a general population risk. All participants received genetic counselling, and pre- (n = 132) and post-test (n = 86) questionnaires and semi-structured interviews (n = 16) were administered. The most important reason to have ECS was to spare a future child a life with a severe disorder (47%). The majority of survey respondents made an informed decision (86%), as assessed by the Multidimensional Measure of Informed Choice. Among the 86 respondents, 27 individual carriers and no new carrier couples were identified. Turn-around time of the test results was considered too long and costs were perceived as too high. Overall, mean levels of anxiety were not clinically elevated. High-risk respondents (n = 89) and pregnant respondents (n = 13) experienced higher levels of anxiety before testing, which decreased after receiving the test result. Although not clinically significant, distress was on average higher for carriers compared to non-carriers (p < 0.0001). All respondents would opt for the test again, and 80.2% would recommend it to others. The results suggest that ECS should ideally be offered before pregnancy, to minimise anxiety. This study could inform current and future implementation initiatives of preconception ECS.

scholarly journals Network governance forms in healthcare: empirical evidence from two Italian cancer networks

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Romiti ◽  
Mario Del Vecchio ◽  
Gino Sartor
Keyword(s):  
Healthcare System ◽  
Governance Structure ◽  
Network Governance ◽  
Public Healthcare ◽  
Structured Interviews ◽  
General Validity ◽  
Regional Administration ◽  
Trade Offs ◽  
Italian Regions ◽  
Cancer Networks

Abstract Background This study focuses on the application of Provan and Kenis’ modes of network governance to the specific field of public healthcare networks, extending the framework to an analysis of systems in which networks are involved. Thus, the aim of this study is to analyze and compare the governance of two cancer networks in two Italian regions that underwent system reconfiguration processes due to reforms in the healthcare system. Methods A qualitative study of two clinical networks in the Italian healthcare system was conducted. The sample for interviews included representatives of the regional administration (n = 4), network coordinators (n = 6), and general and clinical directors of health organizations involved in the two networks (n = 25). Data were collected using semi-structured interviews. Results Our study shows that healthcare system reforms have a limited impact on network governance structures. In fact, strong inertial tendencies characterize networks, especially network administrative organization models (NAO). Networks tend to find their own balance with respect to the trade-offs analyzed using a mix of formal and informal ties. Our study confirms the general validity of Provan and Kenis’ framework and shows how other specific factors and contingencies may affect the possibility that cancer networks find positive equilibria between competing needs of inclusivity and efficiency, internal and external legitimacy, and stability and flexibility. It also shows how networks react to external changes. Conclusions Our study shows the importance of considering three factors and contingencies that may affect network effectiveness: a) the importance of looking at network governance modes not in isolation, but in relationship to the governance of regional systems; b) the influence of a specific network’s governance structure on the network’s ability to respond to tensions and to achieve its goals; and c) the need to take into account the role of professionals in network governance.

scholarly journals Safer Prescribing and Care for the Elderly (SPACE): feasibility of audit and feedback plus practice mail-out to patients with high-risk prescribing

2017 ◽  
Vol 9 (2) ◽  
pp. 145 ◽  
Author(s):  
Katharine Wallis ◽  
Rebecca Tuckey
Keyword(s):  
General Practice ◽  
High Risk ◽  
The Elderly ◽  
Audit And Feedback ◽  
Structured Interviews ◽  
Medicines Information ◽  
Care For The Elderly ◽  
Increased Risk ◽  
Information Brochure ◽  
Practice Methods

ABSTRACT INTRODUCTION High-risk prescribing in general practice is common and places patients at increased risk of adverse events. AIM The Safer Prescribing and Care for the Elderly (SPACE) intervention, comprising audit and feedback plus practice mail-out to patients with high-risk prescribing, was designed to promote medicines review and support safer prescribing. This study aims to test the SPACE intervention feasibility in general practice. METHODS This feasibility study involved an Auckland Primary Health Organisation (PHO), a clinical advisory pharmacist, two purposively sampled urban general practices, and seven GPs. The acceptability and utility of the SPACE intervention were assessed by semi- structured interviews involving study participants, including 11 patients with high-risk prescribing. Interviews were audio-recorded, transcribed verbatim and analysed using a general inductive approach to identify emergent themes. RESULTS The pharmacist said the SPACE intervention facilitated communication with GPs, and provided a platform for their clinical advisory role at no extra cost to the PHO. GPs said the feedback session with the pharmacist was educational but added to time pressures. GPs selected 29 patients for the mail-out. Some GPs were concerned the mail-out might upset patients, but patients said they felt cared for. Some patients intended to take the letter to their next appointment and discuss their medicines with their GP; others said there were already many things to discuss and not enough time. Some patients were confused by the medicines information brochure. DISCUSSION The SPACE intervention is feasible in general practice. The medicines information brochure needs simplification. Further research is needed to test the effect of SPACE on high-risk prescribing.

Big data and artificial intelligence for health system sustainability: The case of Veneto Region

2021 ◽  
pp. 31-52
Author(s):  
Grazia Dicuonzo ◽  
Francesca Donofrio ◽  
Antonio Fusco ◽  
Vittorio Dell’Atti
Keyword(s):  
Artificial Intelligence ◽  
Big Data ◽  
Healthcare System ◽  
Care Delivery ◽  
Research Question ◽  
Health Agency ◽  
Time Frame ◽  
Structured Interviews ◽  
Case Study Methodology ◽  
The Impact

This paper investigates the digitalization challenges facing the Italian healthcare system. The aim of the paper is to support healthcare organizations as they take advantage of the potential of big data and artificial intelligence (AI) to promote sustainable healthcare systems. Both the development of innovative processes in the management of health care activities and the introduction of healthcare forecasting systems are valuable resources for clinical and care activities and enable a more efficient use of inputs in essential-level care delivery. By examining an innovative project developed by the Regional Social Health Agency (ARSS) of Veneto, this study analyses the impact of big data and AI on the sustainability of a healthcare system. In order to answer the research question, we used a case study methodology. We conducted semi-structured interviews with key members of the organizational group involved in the case. The results show that the implementation of AI algorithms based on big data in healthcare both improves the interpretation and processing of data, and reduces the time frame necessary for clinical processes, having a positive effect on sustainability.

scholarly journals Managing high risk offenders in the community: Compliance, cooperation and consent in a climate of concern

2014 ◽  
Vol 6 (3) ◽  
pp. 278-295 ◽  
Author(s):  
Beth Weaver ◽  
Monica Barry
Keyword(s):  
High Risk ◽  
Community Safety ◽  
Community Supervision ◽  
Service Users ◽  
Active Engagement ◽  
Structured Interviews ◽  
Safety Control ◽  
Active Involvement ◽  
Supervisory Process ◽  
Very High

It is increasingly accepted that the change process underpinning the intended outcomes of community supervision, namely community safety, social rehabilitation and reintegration, cannot be achieved without the service user’s active involvement and participation in the process. Their consent, compliance and cooperation is therefore necessary to achieving these outcomes and yet, when it comes to very high risk sexual and violent offenders, in the pursuit of community safety, control oriented, preventative practices predominate over change focused, participatory approaches. Semi-structured interviews were conducted with 26 professionals and 26 service users to explore how, under the auspices of MAPPA, the supervisory process is enacted and experienced, and the extent and means through which it affects people’s willingness to accept or invest in not only the process but also the purpose of supervision. It is argued that how the process of community supervision is experienced and what it comprises not only shapes the outcomes of supervision but also the nature of consent, compliance and cooperation. We conclude by advocating for more participatory processes and practices to promote service users’ active engagement in, and ownership of, the process of change, and in that, the realisation of both the normative dimensions and intended outcomes of community supervision.

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