What counts as a voiceable concern in decisions about speaking out in hospitals: A qualitative study

Objectives Those who work in health care organisations are a potentially valuable source of information about safety concerns, yet failures of voice are persistent. We propose the concept of ‘voiceable concern’ and offer an empirical exploration. Methods We conducted a qualitative study involving 165 semi-structured interviews with a range of staff (clinical, non-clinical and at different hierarchical levels) in three hospitals in two countries. Analysis was based on the constant comparative method. Results Our analysis shows that identifying what counts as a concern, and what counts as a occasion for voice by a given individual, is not a straightforward matter of applying objective criteria. It instead often involves discretionary judgement, exercised in highly specific organisational and cultural contexts. We identified four influences that shape whether incidents, events and patterns were classified as voiceable concerns: certainty that something is wrong and is an occasion for voice; system versus conduct concerns, forgivability and normalisation. Determining what counted as a voiceable concern is not a simple function of the features of the concern; also important is whether the person who noticed the concern felt it was voiceable by them. Conclusions Understanding how those who work in health care organisations come to recognise what counts as a voiceable concern is critical to understanding decisions and actions about speaking out. The concept of a voiceable concern may help to explain aspects of voice behaviour in organisations as well as informing interventions to improve voice.

African burial practices as havens that promote the spread of cholera in Zimbabwe

The research presents the results of a qualitative study that investigated the African burial practices as ravens that promote the spread of cholera in Zimbabwe which has experienced such outbreaks in 1992/1993, 1998, 1999, 2002, 2008/2009 and 2018. Participants were ten representatives of ten families from Machivenyika Village of Zaka District in Masvingo Province, Zimbabwe who had cholera-deaths related during the 2018 outbreak. Data collection instruments were semi-structured questionnaires and focus-group discussions. The constant comparative method was used to analyse data for thematic coding. Findings indicated that participants viewed African burial practices one of the major contributing factors in the spread of cholera in Zimbabwe. Participants suggested ways of improving African burial practices to accomplish positive results. Recommendations were made for the relevant authorities.

Metacognitive failure in constructing proof and how to scaffold it

This research aims to describe the students’ metacognitive failure in constructing proof and the scaffolding support. The participants of this qualitative case study were eight preservice mathematics teachers of six-semester, State University of Malang. We carried out a test about proof construction problems in Abstract Algebra. Then we verified the data using triangulation of constant comparative method from a test and a task-based interview with the stimulated recall. The results indicated two groups of students in proving strategy. Group I performed “appropriate” syntactic strategy and Group II vice versa. Blindness was experienced by the subject that does not recognize errors detection or the ambiguity of the proof. Mirage occurred when the subject recognizes an error detection on the proper strategy or application of a theorem, then is unable to verify the truth of his work. Misdirection appeared when the subject recognizes a lack of progress, then uses an incomplete or irrelevant concept. Vandalism emerged with no progress or detection of errors of the strategy then the subject performs some irrelevant steps to the issue or uses a misconception. Practically, the teachers can use these results for learning innovations in scaffolding-based proof courses. The scaffolding might need some development and application in supporting students to overcome difficulty in proving mathematical sentences.

PERCEPCIÓN DE LOS PROFESIONALES SOBRE LA INTEGRACIÓN DE LA TEORÍA A LA PRÁCTICA EN LA FORMACIÓN DE ENFERMERAS/OS.

Introducción. La enfermería como disciplina y profesión científica, uno de su rol es proporcionar atención sanitaria en sus distintos niveles, teniendo en cuenta los metaparadigmas que orientan el cuidado a la persona familia y o comunidad. Una de las mayores preocupaciones de las Instituciones formadoras de Enfermeras en Latinoamérica y el mundo, es lograr que los estudiantes integren la teoría y la práctica en los diferentes campos de acción, evitando así que se genere una discordancia entre los aspectos cognitivos desde la teoría a la práctica. Para lograr el cuidado profesional que caracterizan a la enfermería. Objetivo Comprender las percepciones sobre la integración asistencial que tienen los profesionales hacia los estudiantes preprofesionales de Enfermería desde el punto de vista de la práctica. Métodos. Este artículo es resultado de un estudio de tipo cualitativo fenomenológico como prueba piloto. El procesamiento y análisis de datos se realizó con el método comparativo constante de Glaser y Strauss, donde se generó una matriz de categorización con enfoque inductivo, con 4 núcleos temáticos emergentes, y subcategorías asociadas. Conclusiones. Las actitudes y compromiso de las enfermeras (os) pueden influir en las actitudes de las estudiantes. Por lo que el Enfermero (a) debe de ser un ejemplo que seguir y debe de estar preparado científicamente para que los estudiantes puedan desempeñarse en su práctica formativa. Palabras claves: Enfermería, Práctica, Investigación cualitativa, Hospitales ABSTRACT Introduction. Nursing as a discipline and scientific profession, one of its role is to provide health care at different levels, taking into account the meta-paradigms that guide care to the person, family and or community. One of the major concerns of Nursing Training Institutions in Latin America and the world is to ensure that they integrate theory and practice in the different fields of action, thus avoiding the creation of a discordance between cognitive aspects from theory to theory. practice. To achieve the professional care that characterize nursing. Objective. To understand the perceptions of healthcare integration that professionals have towards students from the point of view of practice. Methods. This article is the result of a qualitative phenomenological study as a pilot test. The data processing and analysis was carried out with the constant comparative method of Glaser and Strauss, where a categorization matrix with an inductive approach was generated, with 4 emerging thematic cores, and associated subcategories. Conclusions. Nurses attitudes and commitment can influence student attitudes. Therefore, the Nurse must be an example to follow and must be scientifically prepared so that students can perform in their training practice. Keywords: Nursing, Practice, Qualitative research, Hospitals

Delivery of Home and Community Based Services During a Pandemic: Unexpected Consequences

The COVID-19 pandemic required AAAs to pause essential services, serving as a catalyst for innovation. We examined such innovations as part of an explanatory mixed-methods, positive deviance study of AAA partnerships with health and social service organizations. We identified 8 AAAs with many partners serving areas with lower levels of health care use, and 3 AAAs with few partners serving areas with higher levels of health care use. We interviewed AAA and partners, (total = 123). Using the constant comparative method, we identified recurrent themes: 1) AAAs adapted to increased demand for services by developing new ways to deliver services, 2) the pandemic raised awareness of unmet needs such as social connection, 3) changes in delivery of services included embracing technology, and 4) AAAs and their partners identified resources to rapidly pivot services. AAAs and partners demonstrated resiliency to not only to sustain programs, but to innovate throughout the pandemic.

Older Adults' Perceptions of College Campus Accessibility

The emerging Age-Friendly University Global Network encourages universities to engage older adults in university activities (Gerontological Society of America, 2019). As such, attention should be devoted to the accessibility of campus facilities to older adults as a potential mechanism to increase age diversity. Intergenerational interactions, which may take place on college campuses, promote better perceptions of other generations (Bertram et al., 2017), making campus accessibility for all age groups a priority. The present study sought to uncover older adults’ perceptions of campus accessibility via an online survey. Participants were recruited through local newsletters, word of mouth, and included 81 community members (Age mean=71.58 years; 79% female; 89% White; 43% traveled to campus every few months). Descriptive analyses were conducted for closed-ended responses and two members of the research team used a constant comparative method (Corbin & Strauss, 2015) to code open-ended responses. Participants felt that campus was somewhat accessible (M = 2.72;1(very inaccessible) to 5(very accessible)), moderately easy to walk around (M=3.79;1(extremely difficult) to 7(extremely easy)), and felt somewhat welcome on campus (M=3.27; 1(strongly disagree) to 7(strongly agree). The following general themes emerged in the open-ended responses: 1)inaccessibility on campus was due to parking, drop-off locations, and topography (e.g., due to stairs, distance, hills) constraints; 2)feeling welcome on campus was due to people being helpful; and 3)difficulty in attending events was due to parking and lack of knowledge about events. Implications for campus initiatives that aim to attract older adults, especially for campuses that have topography constraints, will be discussed.

Family Caregivers of Persons With Mild Dementia Share Their Spiritual Struggles

The lives of family caregivers of persons with Alzheimer’s disease and related dementias (ADRD) may change dramatically with disease progression in their loved one. Many rely on spirituality as a resource for coping. There is evidence that persons experiencing transition/losses, as a consequence of disease/illness, can experience spiritual struggles or a crises in meaning. However, there is limited research related to spiritual struggles among family caregivers of persons with ADRD, particularly in the beginning stages of the disease process. In this study, three domains of spiritual struggle were identified after analyzing 27 caregiver interviews using the constant comparative method: 1) changes in relationship with their higher power (e.g., feelings of anger towards, feeling punished by, feeling disconnected from, and questioning); 2) changes in spiritual practices (e.g., decreased participation as a consequence of feeling unsupported, judged, or misunderstood by spiritual communities); and 3) dissonance between previously held core beliefs and current life circumstances (e.g., feelings of shame, doubt, and guilt as well as cessation of self-care activities due to the belief that they must sacrifice everything for their loved one). Notably, 74% experienced spiritual struggle in one domain; 33% in two domains, and 11% in three domains. The majority of participants had come to resolution of these spiritual struggles by the time they were interviewed. However, 40.7% were experiencing ongoing spiritual struggles, at the time of interview, suggesting the importance of identifying and addressing spiritual struggles in this population over time in order to enhance coping and adaptation.

Worker perspectives on the impact of non-standard workdays on worker and family well-being: A qualitative study

Background Non-standard work schedules (NSWSs), occurring outside of regular and predictable daytime hours, may negatively affect worker and family health. This qualitative study sought to understand worker perspectives on the health and well-being impacts of NSWSs among full-time, transportation maintainers, correctional, and manufacturing workers. Methods Forty-nine workers participated in 8 focus groups. Data were transcribed and analyzed with ATLAS.ti, using the constant comparative method to identify themes and sub-themes. Results Workers reported that long work hours and irregular and unpredictable schedules posed the biggest obstacles to their well-being. Workers reported that NSWSs were associated with behavior impacts (poor family and social connections, poor eating, poor sleep, lack of exercise recovery), physical health impacts (exhaustion, weight gain) and extended work exposures (increased stress, increased accidents). Conclusions This highlights the importance of developing and implementing effective workplace interventions to address these barriers to health and health behaviors.

Adjusting the family’s life: A grounded theory of caring for children with special healthcare needs in rural areas, Thailand

This study aims to understand the experiences of families of children with special healthcare needs in rural areas in Thailand. Grounded theory (GT) was employed to understand families’ experiences when caring for children with special healthcare needs (CSHCN) in rural areas. Forty-three family members from thirty-four families with CSHCN participated in in-depth interviews. Interviews were recorded and transcribed. The constant comparative method was used for data analysis and coding analysis. Adjusting family’s life was the emergent theory which included experiencing negative effects, managing in home environment, integrating care into a community health system, and maintaining family normalization. This study describes the process that families undergo in trying to care for CSHCN while managing their lives to maintain a sense of normalcy. This theory provides some intervention opportunities for health care professionals when dealing with the complexities in their homes, communities and other ambulatory settings throughout the disease trajectory, and also indicates the importance of taking into consideration the family’s cultural background.

ACTION RESEARCH ON USING SHORT STORIES TO BOOST EFL LEARNERS’ PERFORMANCE: A SYSTEMATIC REVIEW

Various conceptual and empirical research has revealed that short stories are effective learning tools teachers can use to boost English as a foreign language (EFL) learning performances. However, most EFL teachers are still find using short stories in EFL classrooms challenging. To solve the problem, conducting action research on using short stories in EFL teaching seems to be the best option. This study aims at reviewing action research on using short story use to increase EFL students’ learning achievement. Employing four inclusion and three exclusion criteria, 12 action research articles indexed in Google Scholar and published in 2011-2020 were selected. Data were analyzed using the constant comparative method. The results showed that the use of short stories employing the Before-During-After reading strategy, language-based model, and literature as content model managed to attain the intended outcomes in 2 to 3 cycles. This review is ended by highlighting some research gaps for future action research and future review as well.