The Perceptions of Families of Comatose Patients in the Intensive Care Unit: A Qualitative Study

Background: There are specific challenges regarding the perceptions of families of comatose patients in Intensive Care Units (ICUs). Identifying these perceptions may attract the cooperation of families with nurses and provide better care for patients. This study aimed to explore the perceptions of families of comatose patients in ICUs. Methods: This was a qualitative content-analysis study. Seventeen families with comatose patients were recruited by the purposive sampling technique. The necessary data were generated by semi-structured interviews, continued until data saturation, and concurrently analyzed by an inductive content analysis method. Results: Four main categories were manifested, including shock and disbelief, the effort for adaptation, exhaustion, and burnout, as well as hope and support. Conclusion: The obtained results signified the importance of nurses’ awareness concerning the family members’ perceptions of their comatose patient status in ICUs. The relevant findings reflected the need for nurses to pay attention to the feelings and emotions of the families of these patients.

Mothers' Experiences of Husband’s Involvement in Maternal Fetal Attachment: A Qualitative Study

Background: The involvement of husbands during pregnancy within the Iranian culture is one of the challenging topics. In this context, efforts to encourage male involvement in the maternal health issues can strengthen family bonds and consequently improve the relationships between men and women in societies. Objectives: This qualitative study aimed to elucidate the involvement of husbands in maternal-fetal attachment (MFA). Methods: Using a qualitative approach and conventional content analysis, 11 pregnant women referring to the health care centers in Sari, Iran were interviewed from March 2020 to February 2021. The participants met the maximum diversity criteria in terms of age, level of education, occupation, and socioeconomic status. Deep and unstructured interviews were utilized to obtain the research data. All the interviews were then transcribed verbatim and analyzed using the qualitative content analysis method developed by Graneheim and Lundman in MAXQDA Software. Results: A total of 350 codes emerged from the data. We identified a main theme entitled ‘husband support’, which included four categories and 11 sub-categories. The main categories were: (1) empathic response, (2) emotional support, (3) continued support, and (4) attention to fetus. Conclusions: Interventions to enhance husband support could increase MFA. Planning to promote male participation in pregnancy process is essential to promote maternal and child health.

Workplace Health Promotion in German Social Firms—Offers, Needs and Challenges from the Perspectives of Employees, Supervisors and Experts

On the general labor market, social firms provide 30–50% of people with different types of disabilities the opportunity to gain employment. However, the topic of workplace health promotion (WHP), needs for improvement and accompanied challenges are neglected in the current research and were the focus of the present study. Therefore, data triangulation was used between July and December 2020 by combining three focus groups with employees (n = 14 employees) with 16 interviews with supervisors from several social firms in Northern Germany (e.g., from catering, cleaning or bicycle repair sectors). 17 semi-structured telephone interviews with experts in the field of WHP or social firms were added. All approaches were audio-taped, transcribed and anonymized. To analyze the data, Mayring’s qualitative content analysis was used. The results indicated that several offers for WHP, including sport, nutrition and relaxation, were offered, as well as those on smoking cessation, cooperation with external organizations or training and education offers. Needs for improvement were stated referring to additional sport offers, support for implementing a healthy diet, offers for relaxation, financial incentives or collaborations with external organizations. A low take-up of offers; a lack of resources, structures or management support; compatibility of offers with work time and organization; challenges with available trainings or the consideration of individual needs and capacities were highlighted as challenges. Overall, there is a need for further interventional and longitudinal research on WHP in social firms.

Exploring the experiences of nurses caring for patients with COVID-19: a qualitative study in Iran

Background The coronavirus disease (COVID-19) is now a major public health emergency in the world. Nurses as key members of the COVID-19 patient care team are exposed to most challenges caused by the disease. As exploring the experiences of nurses as patient supporters and caregivers can play an important role in improving the quality of care for patients with COVID-19 disease, the present study explored the experiences of nurses caring for patients with COVID-19. Methods The study employed a qualitative design. This study employed purposive sampling to select 10 nurses with bachelors and master’s degrees in nursing who were taking care of patients with COVID-19 in ICUs or inpatient wards in southern Iran. Data were collected through semi-structured interviews. The collected data were analyzed using the qualitative content analysis procedure proposed by Graneheim and Lundman. Results The analysis of the data revealed four main themes and ten sub-themes: A) physical, psychological, and social burden of care (excessive workload; fear, anxiety, worry; unpleasant social experiences; compassion fatigue) B) unmet needs (personal needs and professional needs) C) positive experiences (pleasant social experiences and inner satisfaction), and D) strategies (problem-solving strategies and stress symptom mitigation strategies). Conclusions An analysis of the themes and subthemes extracted in this study suggested that the nurses who participated in this study faced many personal and professional challenges. Therefore, health officials and specialists need to pay special attention to nurses’ challenges and needs.

Digitizing Social Counseling—Insights for Workplace Health Management

Working digitally can lead to changes in work organization and social interactions, as well as work pace and workload. Online counseling is more and more integrated in social counseling. Research exists on employees’ and users’ attitudes towards online counseling as well as on the advantages and disadvantages of online counseling. There is a lack of studies on the stressors and strains caused by the increasing digitalization and the associated health consequences in this context. With an interview study, we investigated the general work situation of counselors, with a focus on stressors, strain, and resources caused by online counseling. Consecutively, we discuss the results in relation to their impact on workplace health management. Twenty-two explorative interviews with counselors from a German welfare organization were conducted in 2019 and 2020. Qualitative content analysis according to Mayring was used for analysis. Counselors’ use of online devices depends on their own digital affinity and is likely to be used when advantages for clients are seen. Difficulties were mentioned in establishing a relationship of trust with the clients. Good teamwork and regular informal exchanges among colleagues contribute to job satisfaction. Overall, we found only few health-related effects. Results of the study suggest that digitization can have positive effects on the job satisfaction of counselors, if the associated changes are supported by organizational measures.

Elevers formande av arbetsplatsförlagt lärande i svensk gymnasial lärlingsutbildning

The article examines how students in Swedish upper secondary apprenticeship education contribute to the shaping of their education through their choices and actions in relation to work-based learning. Activity theory and the notion of interacting activity systems was used to emphasise the students’ perspective as active subjects. Data was collected through observations and interviews with 15 students in their second year of an apprenticeship. An initial qualitative content analysis revealed a pattern of actions that related to both school and work. The result of this analysis was further elaborated with activity theoretical concepts. Thereby dominating rules/norms and tools they made use of, contributed to identifying three potential objects for students’ actions: grades in vocational subjects, development of vocational skills, and inclusion in the workplace community. Depending on what objects the students held as superior and subordinate different outcomes could be achieved – an upper secondary vocational degree, development of vocational skills, and/or being employed while studying. One object did not necessarily exclude the others. It is concluded that the multiple expectations from students, school, and workplaces that coexist in relation to work-based learning need to be continuously communicated among all participants to strengthen the students’ possibility to achieve their desired educational outcome.

Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care

Background Low back pain (LBP) is common among military veterans seeking treatment in Department of Veterans Affairs (VA) healthcare facilities. As chiropractic services within VA expand, well-designed pragmatic trials and implementation studies are needed to assess clinical effectiveness and program uptake. This study evaluated veteran stakeholder perceptions of the feasibility and acceptability of care delivery and research processes in a pilot trial of multimodal chiropractic care for chronic LBP. Methods The qualitative study was completed within a mixed-method, single-arm, pragmatic, pilot clinical trial of chiropractic care for LBP conducted in VA chiropractic clinics. Study coordinators completed semi-structured, in person or telephone interviews with veterans near the end of the 10-week trial. Interviews were audiorecorded and transcribed verbatim. Qualitative content analysis using a directed approach explored salient themes related to trial implementation and delivery of chiropractic services. Results Of 40 participants, 24 completed interviews (60% response; 67% male gender; mean age 51.7 years). Overall, participants considered the trial protocol and procedures feasible and reported that the chiropractic care and recruitment methods were acceptable. Findings were organized into 4 domains, 10 themes, and 21 subthemes. Chiropractic service delivery domain encompassed 3 themes/8 subthemes: scheduling process (limited clinic hours, scheduling future appointments, attendance barriers); treatment frequency (treatment sufficient for LBP complaint, more/less frequent treatments); and chiropractic clinic considerations (hire more chiropractors, including female chiropractors; chiropractic clinic environment; patient-centered treatment visits). Outcome measures domain comprised 3 themes/4 subthemes: questionnaire burden (low burden vs. time-consuming or repetitive); relevance (items relevant for LBP study); and timing and individualization of measures (questionnaire timing relative to symptoms, personalized approach to outcomes measures). The online data collection domain included 2 themes/4 subthemes: user concerns (little difficulty vs. form challenges, required computer skills); and technology issues (computer/internet access, junk mail). Clinical trial planning domain included 2 themes/5 subthemes: participant recruitment (altruistic service by veterans, awareness of chiropractic availability, financial compensation); and communication methods (preferences, potential barriers). Conclusions This qualitative study highlighted veteran stakeholders’ perceptions of VA-based chiropractic services and offered important suggestions for conducting a full-scale, veteran-focused, randomized trial of multimodal chiropractic care for chronic LBP in this clinical setting. Trial registration ClinicalTrials.govNCT03254719

A qualitative analysis of dental professionals’ beliefs and concerns about providing aerosol generating procedures early in the COVID-19 pandemic

Introduction In response to the COVID-19 pandemic, the Scottish Dental Clinical Effectiveness Programme (SDCEP) initiated a rapid review of the evidence related to the generation and mitigation of aerosols in dental practice. To support this review, a survey was distributed to better understand the provision of aerosol generating procedures (AGPs) in dentistry. Methods An online questionnaire was distributed to dental professionals asking about their current practice and beliefs about AGPs. Data were analysed using qualitative content analysis. Results Analysis revealed confusion and uncertainty regarding mitigation of AGPs. There was also frustration and scepticism over the risk of SARS-COV-2 transmission within dental settings, the evidence underpinning the restrictions and the leadership and guidance being provided, as well as concern over financial implications and patient and staff safety. Discussion The frustration and concerns expressed by respondents mirrored findings from other recent studies and suggest there is a need for reflection within the profession so that lessons can be learned to better support staff and patients. Conclusion Understanding the profession’s views about AGP provision contributed to the SDCEP rapid review and provides insights to help inform policymakers and leaders in anticipation not only of future pandemics but in considering the success of any large scale and/or rapid organisational change.

What could we do differently next time? Australian parents’ experiences of the short-term and long-term impacts of home schooling during the COVID-19 pandemic

Background COVID-19 lockdowns have resulted in school closures worldwide, requiring curriculum to be delivered to children remotely (home schooling). Qualitative evidence is needed to provide important context to the positive and negative impacts of home schooling and inform strategies to support caregivers and children as the pandemic continues. This study aimed to explore the experiences of home schooling caregivers at multiple time-points during the pandemic. Methods Data were obtained from a longitudinal survey of a representative Australian sample conducted over 8 waves during 2020 and 2021. Participants who had home schooled at least one child during COVID-19 completed open-ended questions at Wave 4 (May 2020; n = 176), Wave 7 (June 2020; n = 145), and Wave 8 (March 2021; n = 57). Participants were asked to describe what they found positive and challenging about home schooling (Wave 4), what they would do differently if they home schooled their children again (Wave 7), and the longer-term impacts of home schooling on caregivers and children (Wave 8). Results 91% of participants at Wave 4 reported at least one positive and/or negative aspect of home schooling. At Wave 8, 32% and 29% of participants reported no long-term positive or negative impacts of home schooling respectively. Using a qualitative content analysis approach, six themes were developed from the data, encompassing the impacts of home schooling on parents, and the perceived impacts on children. Impacts on parents included connecting with children, managing the work-life-school balance, and the challenge of home schooling when parents are not teachers. Perceived impacts on children included: quieter and safer learning at home, and the negatives of managing schoolwork load and social isolation. At Wave 7, 56 participants (44%) identified at least one thing they would do differently. Conclusions Despite some participants reporting positive experiences associated with home schooling, it remains challenging for many parents and their children. Supports for parents and children engaged in home schooling should provide clear and flexible guidance on how to balance schoolwork with other competing demands, assist parents who lack confidence in supporting their children’s remote learning, and address risks associated with social isolation.