scholarly journals Understanding men’s psychological reactions and experience following a cardiac event: a qualitative study from the MindTheHeart project

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029560 ◽  
Author(s):  
Jalila Jbilou ◽  
Jean Grenier ◽  
Marie-Helene Chomienne ◽  
France Talbot ◽  
Heather Tulloch ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Psychosocial Adjustment ◽  
Cardiac Event ◽  
Clinical Training ◽  
Healthcare Services ◽  
Post Traumatic Stress ◽  
Clinical Practices ◽  
Structured Interviews ◽  
Cardiac Rehabilitation Programme

ObjectivesEmotional issues such as depression, anxiety and post-traumatic stress disorder are common following a cardiac event. Despite their high prevalence, they often go undiagnosed and research suggests that men in particular are at higher risk. Therefore, a better understanding of men’s experiences with a cardiac event and ensuing health services is key for adapting approaches that meet their needs. The aim of this study was to describe the self-reported emotional challenges that men face following a cardiac event and to understand their patterns of psychosocial adjustment.DesignQualitative study (focus groups and one-on-one interviews) using an interpretive phenomenal analysis.SettingClinical settings (cardiac departments in hospitals, cardiac rehabilitation programme and family medicine clinics) and in the community in three Canadian provinces.ParticipantsA total of 93 men participated in the study through 22 focus groups and 5 semi-structured interviews, none has been excluded based on comorbidities.ResultsFour major themes emerged: (1) managing uncertainty and adversity; (2) distancing, normalising and accepting; (3) conformity to traditional masculine norms and (4) social, literacy and communication challenges.ConclusionsHealthcare professionals caring for men following a cardiac event must be aware of the psychological and social adjustments that accompany the physical challenges. However, there is a lack of explicit guidelines, tools and clinical training in men-sensitive approaches. Further research is required to better inform clinical practices and healthcare services.

scholarly journals Rethinking success, integrity, and culture in research (part 1) — a multi-actor qualitative study on success in science

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Noémie Aubert Bonn ◽  
Wim Pinxten
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Research Integrity ◽  
Current Paper ◽  
Research Quality ◽  
Structured Interviews ◽  
Community Members ◽  
Policy Makers ◽  
The Past ◽  
Research Students

Abstract Background Success shapes the lives and careers of scientists. But success in science is difficult to define, let alone to translate in indicators that can be used for assessment. In the past few years, several groups expressed their dissatisfaction with the indicators currently used for assessing researchers. But given the lack of agreement on what should constitute success in science, most propositions remain unanswered. This paper aims to complement our understanding of success in science and to document areas of tension and conflict in research assessments. Methods We conducted semi-structured interviews and focus groups with policy makers, funders, institution leaders, editors or publishers, research integrity office members, research integrity community members, laboratory technicians, researchers, research students, and former-researchers who changed career to inquire on the topics of success, integrity, and responsibilities in science. We used the Flemish biomedical landscape as a baseline to be able to grasp the views of interacting and complementary actors in a system setting. Results Given the breadth of our results, we divided our findings in a two-paper series, with the current paper focusing on what defines and determines success in science. Respondents depicted success as a multi-factorial, context-dependent, and mutable construct. Success appeared to be an interaction between characteristics from the researcher (Who), research outputs (What), processes (How), and luck. Interviewees noted that current research assessments overvalued outputs but largely ignored the processes deemed essential for research quality and integrity. Interviewees suggested that science needs a diversity of indicators that are transparent, robust, and valid, and that also allow a balanced and diverse view of success; that assessment of scientists should not blindly depend on metrics but also value human input; and that quality should be valued over quantity. Conclusions The objective of research assessments may be to encourage good researchers, to benefit society, or simply to advance science. Yet we show that current assessments fall short on each of these objectives. Open and transparent inter-actor dialogue is needed to understand what research assessments aim for and how they can best achieve their objective. Study Registration osf.io/33v3m.

scholarly journals ‘I was in control of it from the start’: A qualitative study of men’s experiences of positive adjustment following a heart attack

2016 ◽  
Vol 22 (10) ◽  
pp. 1345-1354
Author(s):  
Fran Smith ◽  
Elizabeth Banwell ◽  
Roby Rakhit
Keyword(s):  
Qualitative Study ◽  
Cardiac Rehabilitation ◽  
Coping Strategies ◽  
Heart Attack ◽  
Adaptive Coping ◽  
Structured Interviews ◽  
Cardiac Rehabilitation Programme ◽  
Positive Adjustment ◽  
Interpersonal Factors ◽  
Controllable Factors

A qualitative design was used to explore the experience of positive adjustment following a heart attack. Ten men attending a cardiac rehabilitation programme completed in-depth semi-structured interviews. An overarching theme: ‘I was in control of it from the start’ emerged with six subthemes, relating to intrapersonal and interpersonal factors and processes. The subthemes reflected the importance of identifying controllable versus non-controllable factors and employing adaptive coping strategies.

Digital Health Innovation Ecosystems

2019 ◽  
Vol 8 (2) ◽  
pp. 1-14 ◽  
Author(s):  
Gloria Ejehiohen Iyawa ◽  
Marlien Herselman ◽  
Adele Botha
Keyword(s):  
Developing Countries ◽  
Qualitative Study ◽  
Digital Health ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Innovation Ecosystem ◽  
Health Innovation ◽  
Innovation Ecosystems ◽  
Governmental Organizations ◽  
Key Participants

The purpose of this paper was to identify key participants, benefits, and challenges of a digital health innovation ecosystem in Namibia. The paper also aimed to identify strategies for implementing digital health innovation ecosystems in Namibia. This is a qualitative study that adopted semi-structured interviews in meeting the objectives of the study. The findings suggest that implementing digital health innovation ecosystems within the Namibian context will result in better processes of delivering healthcare services to patients. However, implementing such an ecosystem would require resources from both academic and governmental organizations. The need for skilled experts for managing the ecosystem would also be required. Hence, adopting the guidelines for implementing a digital health innovation ecosystem in developing countries, the study proposed guidelines which would make a digital health innovation ecosystem work for the Namibian context. The findings of this study can be used by healthcare managers within the Namibian context.

scholarly journals Users’ Assessement of the Visualization with Gauges of a Guideline-Based Decision Support System Output: A Qualitative Study of Focus Groups

2021 ◽  
Author(s):  
Abir Abdellatif ◽  
Jacques Bouaud ◽  
Mélissa Tholomier ◽  
Joël Belmin ◽  
Brigitte Seroussi
Keyword(s):  
Decision Support ◽  
Qualitative Study ◽  
Focus Groups ◽  
Pressure Ulcer ◽  
Clinical Practices ◽  
Computerized Decision Support ◽  
Usability Problems ◽  
System Output ◽  
Computerized Decision Support Systems

Computerized decision support systems (CDSSs) are still poorly routinely implemented in clinical practices mainly because of usability problems related to the technology interface. We previously proposed to use gauges to visualize the output of a guideline-based CDSS applied to malnutrition and pressure ulcer management in nursing homes. This interface was assessed by four focus groups including 16 healthcare professionals with expertise in geriatrics. A USE-like questionnaire was distributed. Participants considered the dashboard-with-gauges visualization was useful (94%), easy to use (63%), easy to learn (88%), and 88% thought they could be satisfied with it. However, concerns were expressed about the difficulty to follow up multiple healthcare problems.

Clinicians’ perceptions of opioid error–contributing factors in inpatient palliative care services: A qualitative study

2019 ◽  
Vol 33 (4) ◽  
pp. 430-444 ◽  
Author(s):  
Nicole Heneka ◽  
Priyanka Bhattarai ◽  
Tim Shaw ◽  
Debra Rowett ◽  
Samuel Lapkin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
System Level ◽  
Quality And Safety ◽  
Specialist Palliative Care ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Care Services ◽  
Palliative Care Services

Background: Opioid errors are a leading cause of patient harm and adversely impact palliative care inpatients’ pain and symptom management. Yet, the factors contributing to opioid errors in palliative care are poorly understood. Identifying and better understanding the individual and system factors contributing to these errors is required to inform targeted strategies. Objectives: To explore palliative care clinicians’ perceptions of the factors contributing to opioid errors in Australian inpatient palliative care services. Design: A qualitative study using focus groups or semi-structured interviews. Settings: Three specialist palliative care inpatient services in New South Wales, Australia. Participants: Inpatient palliative care clinicians who are involved with, and/or have oversight of, the services’ opioid delivery or quality and safety processes. Methods: Deductive thematic content analysis of the qualitative data. The Yorkshire Contributory Factors Framework was applied to identify error-contributing factors. Findings: A total of 58 clinicians participated in eight focus groups and 20 semi-structured interviews. Nine key error contributory factor domains were identified, including: active failures; task characteristics of opioid preparation; clinician inexperience; sub-optimal skill mix; gaps in support from central functions; the drug preparation environment; and sub-optimal clinical communication. Conclusion: This study identified multiple system-level factors contributing to opioid errors in inpatient palliative care services. Any quality and safety initiatives targeting safe opioid delivery in specialist palliative care services needs to consider the full range of contributing factors, from individual to systems/latent factors, which promote error-causing conditions.

scholarly journals Perceptions about the accessibility of healthcare services among ethnic minority women: a qualitative study among Arab Bedouins in Israel

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Haneen Shibli ◽  
Limor Aharonson-Daniel ◽  
Paula Feder-Bubis
Keyword(s):  
Qualitative Study ◽  
Ethnic Minority ◽  
Healthcare Services ◽  
Access To Healthcare ◽  
Minority Women ◽  
Structured Interviews ◽  
Gender Barriers ◽  
Values And Beliefs ◽  
Accessibility Issues ◽  
And Gender

Abstract Background Access to healthcare services has major implications for vulnerable populations’ health. Socio-cultural and gender characteristics shape the utilization and access of healthcare services among ethnic minorities worldwide. One such vulnerable ethnic minority is the Arab Bedouin women in Israel. As women, they are marginalized in their community, where women do not have full equity and they experience multiple barriers to healthcare services The main objective of this study is to provide a nuanced, experiential, emic description of healthcare accessibility issues among Bedouin women in Israel. Identifying the barriers, they face in accessing healthcare may help healthcare policymakers make changes based on and tailored to Bedouin women’s needs. Methods A qualitative study included in-depth semi-structured interviews with 21 Arab Bedouin village residents, consisting of 14 women and 7 men. Eligible participants were Arab Bedouins over 18 years of age and who used healthcare services at least once in the last 5 years. The interviews were carried out in Arabic-Bedouin dialect and included demographic questions, open-ended questions that asked about participants’ perceptions regarding their experiences with healthcare services, including the factors that helped and hindered them in accessing these services and questions regarding suggestions for improving the accessibility of healthcare services based on the identified needs. Data collected were analyzed using thematic analysis. Study trustworthiness was ensured using audit, reflexivity, and peer debriefing. Results Arab Bedouin women experienced varied barriers while accessing healthcare services. This study uncovered how language, cultural and gender barriers intersect with other disadvantages ingrained in social norms, values and beliefs and affect the access of a minority women subgroup to healthcare services. The participants identified subgroups of Bedouin women (e.g. elderly Bedouin women) affected differently by these barriers. Conclusion Taking into consideration the identified needs and the Arab Bedouin women’s unique characteristics, along with adopting the intersectional approach should help improve access to healthcare services among such a vulnerable subgroup and other subgroups within minorities worldwide.

scholarly journals Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrés Cernadas ◽  
Ángela Fernández
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Healthcare Workers ◽  
Service Providers ◽  
Universal Access ◽  
Healthcare Services ◽  
Medical Professional ◽  
Homeless Population ◽  
Public Health Services ◽  
Structured Interviews

Abstract Background In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. Methods A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. Results The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. Conclusions The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population.

scholarly journals Qualitative study on mental health and well-being of Syrian refugees and their coping mechanisms towards integration in the UK

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046065
Author(s):  
Priyamvada Paudyal ◽  
Mais Tattan ◽  
Maxwell J F Cooper
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Cultural Difference ◽  
Mental Health Problems ◽  
Community Support ◽  
Well Being ◽  
Healthcare Services ◽  
Coping Mechanisms ◽  
Syrian Refugees ◽  
Structured Interviews

ObjectiveThis study aimed to explore the mental well-being of Syrian refugees and identify their coping mechanisms and pathways towards integration into new communities.DesignQualitative study using in-depth semi-structured interviews.Setting and participantsAdult Syrian refugees (>18 years old) currently residing in South East of England.Results12 participants (3 women and 9 men) took part in the study, all were born in Syria and the majority (n=9) were over 45 years of age. Our findings show that Syrian refugees face constant challenges as they try to integrate into a new society. Loss of and separation from loved ones as well as the nostalgia for the homeland were often cited as a source of psychological distress that created an overwhelming sense of sadness. Participants reported that they struggled for connectedness due to cultural difference and the problematic nature of rapidly formed migrant communities in their new setting. They believed in ‘being their own doctor’ and turning to faith, ritual and nature for healing and comfort. Taboo and stigma around mental health and language barriers were cited as barriers to accessing mental healthcare services.ConclusionPast experiences and present challenges frame Syrian refugees’ sense of well-being, impact use of healthcare and risk future mental health problems. It is hoped that this study will act as a catalyst for further research on this vulnerable group to promote integration, community support and culturally sensitive mental health services.

scholarly journals The Influential Factors in the Performance of Medical Students in the Clinical Competency Exam: A Qualitative Study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Atiye Faghihi
Keyword(s):  
Medical Students ◽  
Qualitative Study ◽  
Clinical Assessment ◽  
Clinical Training ◽  
Influential Factors ◽  
Clinical Competency ◽  
Sample Population ◽  
Medical Sciences ◽  
Structured Interviews

Background: Clinical assessment in medicine is a pillar of education, which should measure the competence and practical abilities of medical students. The viewpoint of students as one of the most important stakeholders in clinical assessment could guide planners in problem-solving and proper corrective actions. Objectives: The present study aimed to investigate the influential factors in the performance of medical students in the clinical competency exam. Methods: This qualitative study was conducted using the directed content analysis approach during 2018 - 2019. The sample population included 10 medical students of internship at Isfahan University of Medical Sciences in Isfahan, Iran. The participants were selected via purposive sampling. Data were collected via semi-structured interviews. Data analysis was performed in the MAXQDA 10 software. Results: The students mentioned several influential factors in their performance on the competency exam. Their viewpoints were divided into seven categories, including content and resources, pre-exam requirements, time, cases (scenarios), stations, examiners, and the role of the clinical training course. Conclusions: Similar to other clinical exams, the clinical competency exam has some drawbacks despite its positive aspects, which may affect the performance of students. Several factors could influence the performance of students in this exam, and the contribution of these factors and their impact on the performance of students vary. Therefore, special attention should be paid to these factors to help officials and policymakers in future planning and improving the quality of these exams.

scholarly journals Rethinking success, integrity, and culture in research (part 1) — A multi-actor qualitative study on success in science

2020 ◽  
Author(s):  
Noémie Aubert Bonn ◽  
Wim Pinxten
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Research Integrity ◽  
Current Paper ◽  
Research Quality ◽  
Structured Interviews ◽  
Community Members ◽  
Policy Makers ◽  
The Past ◽  
Research Students

ABSTRACTBackgroundSuccess shapes the life and careers of scientists. But success in science is difficult to define, let alone to translate in indicators that can be used for assessment. In the past few years, several groups expressed their dissatisfaction with the indicators currently used for assessing researchers. But given the lack of agreement on what should constitute success in science, most propositions remain unanswered. This paper aims to complement our understanding of success in science and to document areas of tension and conflict in research assessments.MethodsWe conducted semi-structured interviews and focus groups with policy makers, funders, institution leaders, editors or publishers, research integrity office members, research integrity community members, laboratory technicians, researchers, research students, and former-researchers who changed career to inquire on the topics of success, integrity, and responsibilities in science. We used the Flemish biomedical landscape as a baseline to be able to grasp the views of interacting and complementary actors in a system setting.ResultsGiven the breadth of our results, we divided our findings in a two-paper series, with the current paper focusing on what defines and determines success in science. Respondents depicted success as a multi-factorial, context-dependent, and mutable factor. Success appeared to be an interaction between characteristics from the researcher (Who), research outputs (What), processes (How), and luck. Interviewees noted that current research assessments overvalued outputs but largely ignored the processes deemed essential for research quality and integrity. Interviewees sustained that we need a diversity of indicators to allow a balanced and diverse view of success; that assessments should not blindly depend on metrics but also value human input; that we must value quality over quantity; and that any indicators used must be transparent, robust, and valid.ConclusionsThe objective of research assessments may be to encourage good researchers, to benefit society, or simply to advance science. Yet we show that current assessments fall short on each of these objectives. Open and transparent inter-actor dialogue is needed to understand what research assessments aim for and how they can best achieve their objective.Trial Registrationosf.io/33v3m

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