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1.
BMC Med ; 22(1): 417, 2024 Sep 27.
Article in English | MEDLINE | ID: mdl-39334196

ABSTRACT

BACKGROUND: The hearing health sector is an example of a health sector that is experiencing a period of rapid innovation driven by digital technologies. These innovations will impact the types of interventions and services available to support the communication of deaf and hard-of-hearing individuals. This study explored the perceptions of informed participants on the topic of innovation and regulation within hearing healthcare in Australia and the United Kingdom (UK). METHODS: Participants (N = 29, Australia [n = 16], UK [n = 13]) were purposively sampled and joined one of two online workshops. Participants included adults with hearing loss and family members, hearing health professionals, academics/researchers, representatives of hearing device manufacturers, regulators and policymakers. Workshop data were analysed using reflexive thematic analysis. RESULTS: Participants conceptualised the hearing health sector as a network of organisations and individuals with different roles, knowledge and interests, in a state of flux driven by innovation and regulation. Innovation and regulation were perceived as mechanisms to ensure quality and mitigate risk within a holistic approach to care. Innovations encompassed technological as well as non-technological innovations of potential benefit to consumers. Participants agreed it was essential for innovation and regulation to be congruent with societal values. Critical to ethical congruence was the involvement of consumers throughout both innovation and regulation stages, and the use of innovation and regulation to tackle stigma and reduce health disparities. Participants expressed the desire for accessible and inclusive innovation in the context of fair, transparent and trustworthy commercial practices. CONCLUSIONS: This study explored how stakeholders within the hearing health sector understand and make sense of innovation and the role of regulation. Overall, and despite reservations relating to health care professionals' changing roles and responsibilities, innovation and regulation were conceptualised as beneficial when situated in the context of holistic, whole-person, models of care. The results of this study will inform considerations to support the development and implementation of innovations and regulation within the hearing sector and across other health sectors influenced by technological advances.


Subject(s)
Hearing Loss , Humans , United Kingdom , Australia , Hearing Loss/therapy , Qualitative Research , Adult , Delivery of Health Care , Male , Female , Middle Aged
2.
Am J Med Genet A ; 194(2): 131-140, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37750194

ABSTRACT

Previous studies have explored patient experiences before being seen or at the beginning of their evaluation by undiagnosed diseases programs. This study provides additional insight into experiences after participation through in-depth, qualitative evaluation, allowing for reflection of current practice and patient/parent needs. Semi-structured interviews were conducted with patients and parents of patients seen at the University of Alabama at Birmingham (UAB)'s unique, clinically focused Undiagnosed Diseases Program (UDP). Analysis of the interviews was guided by a thematic approach. Participants had undergone a diagnostic odyssey before being evaluated by the UDP and remained hopeful for a diagnosis. They appreciated the opportunity to be seen by the UDP. However, perception of experiences differed based on whether evaluation by the UDP led to a diagnosis. Additionally, while participants were pleased with initial communication, they indicated that there were unmet needs regarding follow-up. Patients and parents of patients believe that participation in an undiagnosed diseases program is the best option for diagnosis. The findings of this study provide a general overview of patient experiences and highlight strengths of the UAB UDP while also emphasizing areas to focus the improvement to optimize the benefit to patients and families with undiagnosed and rare diseases, which could be used helpful in the development of similar clinics.


Subject(s)
Undiagnosed Diseases , Humans , Parents , Rare Diseases , Communication , Uridine Diphosphate , Qualitative Research
3.
J Surg Res ; 295: 567-573, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38086257

ABSTRACT

INTRODUCTION: Debriefing is a team discussion in a constructive, supportive environment. Barriers exist to consistent, effective team debriefing in the clinical setting, especially in operating theaters. The purpose of this study was to gain insights from frontline workers on how to set up an effective debriefing policy for our operating room. METHODS: This was a qualitative study in which we interviewed operating room workers in a tertiary children's hospital. Interviews were audio-recorded, transcribed, and coded. Data were analysed using the reflexive thematic analysis technique within a critical realism paradigm. RESULTS: Interviews were analysed from 40 operating room staff: 14 nurses, seven anesthetic technicians, seven anaesthetists, and 12 surgeons; 25 (65%) were female. The three key themes were (1) "commitment to learning"-healthcare workers are committed to teamwork and quality improvement; (2) "it is a safe space"-psychological safety is a prerequisite for, and is enhanced by, debriefing; and (3) "natural leader"-the value of leadership, but also constructs around leadership that maintain hierarchies. CONCLUSIONS: Psychological safety is both a prerequisite for and a product of debriefing. Leadership, if viewed as a collective responsibility, could help break down power structures. Given the results of this study and evidence in the literature, it is likely that routine debriefing, if well done, will improve psychological safety, facilitate team learning, reduce errors, and improve patient safety.


Subject(s)
Operating Rooms , Psychological Safety , Child , Humans , Female , Male , Health Personnel , Qualitative Research , Attitude of Health Personnel , Patient Care Team
4.
J Surg Res ; 302: 850-856, 2024 Sep 09.
Article in English | MEDLINE | ID: mdl-39255685

ABSTRACT

INTRODUCTION: As numeric data are becoming increasingly scarce in general surgery residency applications, the personal statement (PS) may be key to identifying candidates to interview. This study sought to determine if PSs of candidates invited for interview at our residency program had different qualities when compared to those not invited. MATERIALS AND METHODS: This single-institution study retrospectively reviewed the PSs of applications for a categorical general surgery position (2022). The scores assigned to PSs were compared. The content of PSs was qualitatively analyzed based on an a priori coding scheme. The codes of interest related to program alignment were the following: diversity, equity, and inclusion efforts, social determinants of health, and service to underserved communities. RESULTS: Of 308 applications, 112 (36%) applicants were invited to the interview. For applicants who were invited to the interview, the PSs were scored higher compared to those who were not invited (median 4.25 versus 3.5, P < 0.001). Highly scored PSs were more likely to include a personal story (74% versus 59%, P = 0.01) and mention diversity, equity, and inclusion efforts, social determinants of health, or service to under-served communities (62% versus 37%, P < 0.001). Also, a greater proportion of applicants who were invited to the interview wrote about these topics (71% versus 33%, P < 0.0001). CONCLUSIONS: At our institution, PS quality and content is associated with interview selection. A high-quality PS tended to include personal story about the applicants and signal value alignment with our institution. PSs should be placed at greater importance in the review process and emphasized as a marker for candidate and institutional alignment.

5.
Int J Equity Health ; 23(1): 180, 2024 Sep 11.
Article in English | MEDLINE | ID: mdl-39261839

ABSTRACT

INTRODUCTION AND AIM: Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents' experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden. METHODS: Researchers' engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis. RESULTS: The analysis resulted in three main themes and seven sub-themes representing different aspects of the program's meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls' physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences. CONCLUSIONS: The program's activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.


Subject(s)
Parents , Residence Characteristics , Humans , Sweden , Female , Male , Parents/psychology , Adult , Ethnicity/psychology , Exercise/psychology , Middle Aged , Health Promotion/methods , Child , Qualitative Research
6.
Int J Equity Health ; 23(1): 98, 2024 May 13.
Article in English | MEDLINE | ID: mdl-38741119

ABSTRACT

INTRODUCTION: Almost one third of people affected by leprosy in Colombia suffer from disability, which often results from delayed diagnosis and treatment. We aimed to explore the experience of people affected by leprosy during the process of diagnosis and treatment and if and how this experience was influenced by peers. METHODS: A qualitative study using body map stories was conducted from October 2019 to February 2020 in Colombia. Adult people affected by leprosy were recruited through patient associations in different cities. We conducted three sessions with an average duration of 2-3 h per participant, during which the participants created a painted map of their body and chose symbols to represent their experience, while being engaged in an informal interview. The sessions were audio recorded, transcribed verbatim and analyzed thematically by an interdisciplinary team, consisting of physicians, social workers and a person affected by leprosy. RESULTS: The 17 study participants (11 female) were aged 20 to 70 years. Leprosy-related manifestations ranged from no to advanced disability. Some participants were active members of associations for people affected by leprosy. Three main themes were identified during analysis: (1) A long pathway to diagnosis, (2) Therapy as a double-edged sword and (3) The influence of other people affected by leprosy. The participants described an often years-long process until being diagnosed, which was marked by insecurities, repeated misdiagnosis, and worsening mental and physical health. Delayed diagnosis was related to late health care seeking, but also to inadequate health communication, lack of leprosy-related knowledge and negligence among health care workers. A high desire to cure motivated the participants to take their medication rigorously, despite the high treatment burden. Support from peers, either within the own social environment or provided from associations, contributed to a faster diagnosis and increased therapy adherence. Peers helped to recognize the symptoms, urged patients to seek care, recommended physicians with leprosy-related knowledge and provided a realistic example of both disease severity and curability. CONCLUSION: People affected by leprosy experience a significant burden during the process of diagnosis and treatment. Involving well-trained peers could foster early diagnosis, treatment compliance and prevention of disability.


Subject(s)
Leprosy , Qualitative Research , Humans , Leprosy/psychology , Leprosy/therapy , Leprosy/diagnosis , Colombia , Female , Male , Adult , Middle Aged , Aged , Young Adult , Delayed Diagnosis/psychology , Peer Group , Disabled Persons/psychology
7.
Support Care Cancer ; 32(5): 325, 2024 May 03.
Article in English | MEDLINE | ID: mdl-38700712

ABSTRACT

People with advanced cancer and cachexia experience significant body weight loss, adversely impacting physical function and quality of life (QOL). Effective, evidence-based treatments for cancer cachexia are lacking, leaving patients with unmet needs. Exercise holds promise to improve patient QOL. However, information on patients' experiences of exercise, including their ability to cope with structured exercise, is limited. PURPOSE: To explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer. METHODS: Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis. RESULTS: Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included the following: (1) Deciding to exercise involves balancing concerns and expectations, (2) the exercise program is a positive experience, and (3) moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased convenience. Participants emphasized the need to recommend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits. CONCLUSION: Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.


Subject(s)
Cachexia , Exercise Therapy , Neoplasms , Qualitative Research , Quality of Life , Humans , Cachexia/etiology , Cachexia/therapy , Female , Neoplasms/complications , Neoplasms/psychology , Male , Middle Aged , Exercise Therapy/methods , Aged , Adult , Feasibility Studies , Videoconferencing , Interviews as Topic
8.
Support Care Cancer ; 32(10): 673, 2024 Sep 18.
Article in English | MEDLINE | ID: mdl-39292365

ABSTRACT

OBJECTIVE: Understanding how glioma patients value cognitive outcomes is essential to personalizing their treatment plans. The purpose of this study was to identify the modifiable cognitive functions most affected by treatment and most important to patient quality of life. METHODS: Patients with gliomas were prospectively enrolled in focus groups and individual interviews using a standardized guide focusing on cognitive functions until saturation was achieved. Patient values and treatment preferences were elicited and compared to the frequency of reported deficits. NVivo natural language processing software was used to perform thematic qualitative analyses. Quantitative analysis with Fischer's exact test was used for each cognitive function to assess for an association between experiencing a deficit and rating that function as important to quality of life. RESULTS: Twenty participants participated, of whom 60% were female. Racial identification consisted of 75% White, 15% Black/African American, and 10% Other Racial Identification. The cognitive functions most essential to the quality of life in this cohort were sense of self (80% of participants), memory (70% of participants), and communication (25% of participants). The functions that experienced the most deficits because of treatment were memory (65% of participants), concentration (65% of participants), and special senses (40% of participants). "Dealbreakers" to treatment were complete loss of independence, sense of self, and/or the ability to interact with loved ones. Fischer's exact test showed no associations between experiencing a cognitive function deficit and rating that function as important to quality of life. CONCLUSIONS: Glioma patients in this study prioritized cognitive functions according to memory, personal identity, and their ability to communicate with loved ones independently of experiencing deficits in these functions. Further study should compare patient prioritization and decision-making between surgically curable and noncurable grade gliomas as well as investigate the quality of life benefits of incorporating the connectomics of highly valued cognitive functions in surgical planning.


Subject(s)
Brain Neoplasms , Cognition , Focus Groups , Glioma , Patient Preference , Quality of Life , Humans , Glioma/psychology , Female , Male , Middle Aged , Prospective Studies , Brain Neoplasms/psychology , Brain Neoplasms/complications , Adult , Cognition/physiology , Aged
9.
Int J Eat Disord ; 57(6): 1390-1398, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38366386

ABSTRACT

OBJECTIVE: This novel study sought to understand lived experience and carer perspectives on the use of adaptive trials to evaluate interventions for eating disorders, in addition to understanding the factors and outcomes of most importance in eating disorder research and treatments from a lived experience perspective. METHOD: A total of 73 people with either lived or carer experience consented, 70 started the questionnaire, and 36 (51%) completed all questions. Participants were asked Likert scale and open-ended questions to understand what factors and outcomes of eating disorder interventions were most important to them and understand their pre-existing knowledge of clinical trials. Two videos were then used to explain randomized controlled trials (RCTs) and adaptive trials and participants were asked their opinions, including perceived benefits and concerns, of each trial type. RESULTS: The thematic analysis found two key themes regarding factors important in eating disorder treatment: Person-centred care and Evidence-based and effective treatment; and two key themes regarding outcomes of treatment: Sustained, full recovery and The bigger picture. Both RCTs and adaptive trials were viewed favorably, however, there was a slight preference for adaptive trials. Key themes for both demonstrated perceived benefits and ethical, practical, and scientific considerations unique to each. DISCUSSION: Findings demonstrate the support of adaptive trials in eating disorder interventions from people with lived experience and their carers. It is recommended that researchers consider the use of adaptive designs and the incorporation of lived experience perspectives when designing future intervention trials. PUBLIC SIGNIFICANCE: This novel study found that the use of adaptive trials in eating disorder intervention research is supported by people with lived experience and carers. Furthermore, the factors and outcomes of most importance to participants in this study are comparable to those previously identified in the emerging literature. The use of adaptive designs and the incorporation of lived experience are recommended in further clinical trials.


Subject(s)
Feeding and Eating Disorders , Humans , Feeding and Eating Disorders/therapy , Feeding and Eating Disorders/psychology , Female , Adult , Surveys and Questionnaires , Male , Middle Aged , Randomized Controlled Trials as Topic , Caregivers/psychology
10.
Arch Sex Behav ; 53(8): 3173-3186, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38914863

ABSTRACT

Parental communication about sex is an important aspect of sexual socialization. However, research has primarily focused on sexual communication's presence, frequency, or topics, with less research on the specific messages parents communicate. Further, few studies have differentiated between communication received before and after youth initiated sex. Therefore, in this paper, we coded open-ended survey responses to explore the sex-related messages young adults report receiving from their caregiver(s) before they began engaging in sex. As part of a larger study, 381 U.S. young adults (Mage = 21.0 years, SD = 2.0) completed an online survey and responded to an open-ended question about messages their caregiver(s) communicated before they began engaging in sex. Participants identified as cisgender women (62.2%), cisgender men (12.1%), and gender diverse (25.7%), and were primarily lesbian, gay, bisexual, queer, questioning, or otherwise non-heterosexual (LGBQ+; 70.6%) young adults. Through thematic analysis, we identified six themes for caregivers' sex-related messages: sex-restrictive, safety and consequences, no, negative, sex-positive, and informational messages. In addition, we found that messages varied by young adults' gender identity and sexual orientation. Our findings suggest that young adults may not receive proper education about healthy sexual relationships and demonstrate the need for interventions with caregivers, as well as sexual health resources for adolescents and young adults, particularly LGBTQ+ youth.


Subject(s)
Sexual Behavior , Humans , Male , Female , Young Adult , Sexual Behavior/psychology , Caregivers/psychology , Adult , Parent-Child Relations , Sexual Abstinence/psychology , Surveys and Questionnaires , Sexual and Gender Minorities/psychology , Communication , Adolescent
11.
BMC Psychiatry ; 24(1): 464, 2024 Jun 21.
Article in English | MEDLINE | ID: mdl-38907237

ABSTRACT

BACKGROUND: The prevalence of hazardous substance use is highest in the age between 18 and 25, but few young adults enter treatment. Community Reinforcement and Family Training (CRAFT) is a support program for concerned significant others (CSOs) of individuals with diverse substance use disorders and is proven efficacious in promoting treatment entry. The aim of the current study was to investigate the experiences of CRAFT among parents of substance using young adults. METHODS: We used a qualitative design conducting semi-structured interviews with 10 parents of young adults (18-24 years) with hazardous substance use. The participants were recruited from a randomized controlled trial of the CRAFT program. The transcribed interviews were analyzed using thematic analysis. RESULTS: We divided the results into three overall domains-Reasons for entering the CRAFT program, Strengths of the CRAFT program and Limitations of the CRAFT program - with three to four themes under each domain. The parents appreciated the accessible support at a time when they needed it due to feelings of shock and powerlessness, and they described communication strategies together with positive reinforcement as the two most helpful CRAFT-sessions. Regarding limitations of CRAFT in the current population, the parents wanted more accessible support for the young adults when they were ready to enter treatment, and described difficulties to practice CRAFT-components due to changing life-circumstances and fear of aggravated health for their young adults. CONCLUSION: The results provide arguments for the health care system to implement support programs to parents of young adults with hazardous substance use. The results show that CRAFT is suitable for the current population, but with some possible additions due to changing circumstances that are common in the young adult developmental phase emerging adulthood. TRIAL REGISTRATION: The trial was pre-registered at isrctn.com, reference number ISRCTN12212515 date: November 7, 2018.


Subject(s)
Parents , Qualitative Research , Substance-Related Disorders , Humans , Substance-Related Disorders/therapy , Substance-Related Disorders/psychology , Male , Female , Young Adult , Adolescent , Parents/psychology , Adult , Social Support , Reinforcement, Psychology , Family Therapy/methods
12.
BMC Pregnancy Childbirth ; 24(1): 596, 2024 Sep 11.
Article in English | MEDLINE | ID: mdl-39367297

ABSTRACT

The phenomenon of perinatal distress in terms of depression, anxiety, bipolar, and psychotic disorders is well-explored in the West but barely investigated in South Asia; particularly research evidence highlighting the cultural expression of couples' mental health with respect to Pakistan is rare. The purpose of this research is to focus on the exploration of psycho-socio-cultural expression of couples' perinatal distress and coping strategies used in the Pakistani context in relation to maternal and paternal mental health, with implications for the wellbeing of their unborn or born progeny. The research design focused on qualitative interpretative approaches. In data triangulation, reflexive thematic analysis and interpretative phenomenological analyses were applied on the verbatim of the semi-structured interviews conducted with the mental health professionals (n = 9) and the couples (n = 8), screened positive for perinatal distress. Four couples were screened out of 325 perinatal women visiting the gynaecological ward of Aziz Bhatti Shaheed Teaching Hospital, Gujrat. Edinburg Postnatal Depression Scale, Generalized Anxiety Disorder-7 and Washington Early Recognition Center Affectivity and Psychosis Screen are the standardized instruments considered to be used for screening perinatal distress among couples. The Urdu version of WERCAP Screen was developed by a standardized forward-backward translation procedure. The rest of the four couples were purposively selected from the psychiatric ward of the same hospital. The Simplified Negative and Positive Symptoms Interviews were administered to the couples after getting approval for the Urdu version form. All couples were probed with an indigenously developed Structured Clinical Interview Schedule for DSM Disorders based on DSM-5-TR. The triangulation carried out with reflexive thematic analysis and interpretative phenomenological analysis revealed cultural conception of perinatal distress as perceived by the mental health professionals and experienced by the couples during the antenatal and postnatal period of their lives. They were enlightened with a constructive view aimed at promoting transformational change in terms of their mental health care and coping. The implications suggested implementation of a psychotherapeutic intervention for reduction in the level of distress and subsequent enhancement of well-being in couples during the perinatal period.


Subject(s)
Adaptation, Psychological , Qualitative Research , Humans , Pakistan/ethnology , Female , Adult , Pregnancy , Male , Stress, Psychological/psychology , Psychological Distress , Mental Health , Pregnancy Complications/psychology , Spouses/psychology
13.
BMC Pregnancy Childbirth ; 24(1): 112, 2024 Feb 06.
Article in English | MEDLINE | ID: mdl-38321392

ABSTRACT

BACKGROUND: In many countries, abortions at 20 weeks and over for indications other than fetal or maternal medicine are difficult to access due to legal restrictions and limited availability of services. The Abortion and Contraception Service at the Royal Women's Hospital in Victoria, Australia is the only service in the state that provides this service. The views and experiences of these abortion providers can give insight into the experiences of staff and women and the abortion system accessibility. The aim of this study was to examine health providers' perceptions and experiences of providing abortion care at 20 weeks and over for indications other than fetal or maternal medicine, as well as enablers and barriers to this care and how quality of care could be improved in one hospital in Victoria, Australia. METHODS: A qualitative study was conducted at the Abortion and Contraception Service at the Royal Women's Hospital. Participants were recruited by convenience and purposive sampling. Semi-structured interviews were conducted one-on-one with participants either online or in-person. A reflexive thematic analysis was performed. RESULTS: In total, 17 healthcare providers from medicine, nursing, midwifery, social work and Aboriginal clinical health backgrounds participated in the study. Ultimately, three themes were identified: 'Being committed to quality care: taking a holistic approach', 'Surmounting challenges: being an abortion provider is difficult', and 'Meeting external roadblocks: deficiencies in the wider healthcare system'. Participants felt well-supported by their team to provide person-centred and holistic care, while facing the emotional and ethical challenges of their role. The limited abortion workforce capacity in the wider healthcare system was perceived to compromise equitable access to care. CONCLUSIONS: Providers of abortion at 20 weeks and over for non-medicalised indications encounter systemic enablers and barriers to delivering care at personal, service delivery and healthcare levels. There is an urgent need for supportive policies and frameworks to strengthen and support the abortion provider workforce and expand provision of affordable, acceptable and accessible abortions at 20 weeks and over in Victoria and in Australia more broadly.


Subject(s)
Abortion, Induced , Attitude of Health Personnel , Pregnancy , Female , Humans , Victoria , Abortion, Induced/psychology , Contraception , Health Personnel/psychology , Qualitative Research , Health Services Accessibility
14.
Hum Resour Health ; 22(1): 41, 2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38890735

ABSTRACT

Employer of choice (EOC) is a relatively new phenomenon, particularly in Human Resources Management. Existing employees and prospective talent have reasons and expectations to designate an employer as an EOC. While EOC has received extensive attention from both academics and practitioners over the past few years, the work has mostly focused on managerial and marketing perspectives, and thus far lacks a strong theoretical foundation. Drawing on Social Exchange Theory (SET), based on Human Resources and employees' perceptions and experiences, this research aims to explore and investigate the factors that constitute/designate an employer as an Employer of Choice EOC. Two qualitative triangulated data sets were collected from existing full-time employees at a Saudi multinational corporation: open interviews and document analysis (cross-sectional and longitudinal). Thematic analysis (TA) was employed to analyze both methods. The findings reveal that company image, training, and development, satisfaction, involvement and commitment, fairness, work culture, reward, opportunities for growth, teamwork, motivation, and corporate social responsibility are the factors that lead employees to designate an employer as an EOC. This research contributes to knowledge conceptually, theoretically, and empirically, mainly in the area of Human Resources Management. This research represents one of the first studies to empirically identify and investigate employee-related factors and evaluate them all together in a multinational Saudi organization. Recognizing the findings of this empirical-based research assists HR managers in designating their organizations as an EOC for current employees and prospective talents.


Subject(s)
Qualitative Research , Humans , Saudi Arabia , Female , Male , Cross-Sectional Studies , Motivation , Workplace , Job Satisfaction , Organizational Culture , Employment , Adult , Longitudinal Studies , Choice Behavior
15.
Article in English | MEDLINE | ID: mdl-39353576

ABSTRACT

BACKGROUND: Postoperative mortality might be influenced by postoperative care, vigilance, and competence to rescue. This study aims to describe the course of events preceding death in a high-risk surgical cohort. METHODS: We analyzed hospital records of patients who died within 30 days after surgery in 4 high volume hospitals using (1) reflective narrative thematic approach to identify recurring themes reflecting issues with conduct of care and (2) Global Trigger Tool to describe incidence, timing, and types of adverse events (AEs) leading to harm. RESULTS: Preoperative predicted median risk of death in the studied group was 9%/13% according to SORT/P-POSSUM, respectively. Nine recurring themes were identified. Prominent themes were "consensus concerning aim and/or risk with planned surgery," "level of (intraoperative) competence and monitoring," and in the postoperative period "level of care and vigilance" on signs of deterioration. We found a total of 303 AEs, with only three patients (5%) having no adverse events. Most common severity category was "I," that is "contributed to patient's death" (n = 110, 36% of all AEs). Of these, 60% were classified as preventable or probably preventable. The peak incidence of AEs was seen on the day of index surgery. Most common types of AEs were "failure of vital functions" (n = 79, 26%), followed by infections (n = 45, 15%). CONCLUSIONS: A high predicted risk of death and a peak of adverse events on the day of index surgery were detected. Identified themes reflect lack of documented multi-professional consensus on how to handle prevalent perioperative risk, vigilance, and postoperative level of care.

16.
BMC Womens Health ; 24(1): 346, 2024 Jun 15.
Article in English | MEDLINE | ID: mdl-38877503

ABSTRACT

BACKGROUND: Approximately 13% of women in the United States of reproductive age seek infertility services. Assisted reproductive technology (ART), including in vitro fertilization, is used to help patients achieve pregnancy. Many people are not familiar with these treatments prior to becoming patients and possess knowledge gaps about care. METHODS: This study employed qualitative methods to investigate how patients interact with information sources during care. Patients who underwent ART including embryo transfer between January 2017 and April 2022 at a large urban healthcare center were eligible. Semi-structured, in-depth interviews were conducted between August and October 2022. Fifteen females with an average age of 39 years participated. Reflexive thematic analysis was performed. RESULTS: Two main themes emerged. Participants (1) utilized clinic-provided information and then turned to outside sources to fill knowledge gaps; (2) struggled to learn about costs, insurance, and mental health resources to support care. Participants preferred clinic-provided resources and then utilized academic sources, the internet, and social media when they had unfulfilled information needs. Knowledge gaps related to cost, insurance, and mental health support were reported. CONCLUSION: ART clinics can consider providing more information about cost, insurance, and mental health support to patients. TRIAL REGISTRATION: The Massachusetts General Hospital Institutional Review Board approved this study (#2022P000474) and informed consent was obtained from each participant.


Subject(s)
Information Seeking Behavior , Qualitative Research , Reproductive Techniques, Assisted , Humans , Female , Adult , Reproductive Techniques, Assisted/psychology , Health Knowledge, Attitudes, Practice , Middle Aged , United States , Pregnancy
17.
BMC Womens Health ; 24(1): 110, 2024 Feb 09.
Article in English | MEDLINE | ID: mdl-38336660

ABSTRACT

BACKGROUND: Intimate partner sexual violence (IPSV) is a prevalent but misunderstood form of gender-based violence with significant impacts women's health and well-being. Research suggests that IPSV has a specific context and unique impacts, but little is known about how to tailor service responses. To address this gap, we explored help-seeking experiences and needs among IPSV survivors after disclosure. METHODS: This study draws on qualitative data from a subsample of women who participated in a cross-sectional survey about the service needs of intimate partner violence survivors. Women who reported IPSV and provided information about IPSV-specific help-seeking needs after disclosure were included in the analysis. Open-ended text responses of 37 IPSV survivors were analysed using thematic analysis. RESULTS: IPSV was invisible and silenced in service responses. Three themes suggest potential ways forward. In the first theme, 'Don't dismiss it', women needed providers to take their disclosures seriously and listen to the significant impacts of IPSV on their well-being and safety. In the second theme, 'See the bigger picture', women needed service providers to understand that IPSV fits into broader patterns of abuse, and that psychological abuse and coercive control impacts women's ability to consent. In the third theme, 'counteract the gaslighting', women needed providers to educate them about the continuum of IPSV and help them label IPSV as a form of violence. CONCLUSIONS: Our exploratory findings extend the limited evidence base on IPSV and highlight a need for further in-depth research to explore a tailored approach to supporting IPSV survivors. To avoid contributing to the silencing of IPSV survivors, service responses should recognise the harmful and sexualised nature of IPSV, challenge cultural stereotypes that minimise IPSV, and understand that co-occurring psychological abuse may exacerbate shame and prevent women from articulating the source of their distress.


Subject(s)
Intimate Partner Violence , Sex Offenses , Female , Humans , Cross-Sectional Studies , Gaslighting , Sex Offenses/psychology , Sexual Behavior , Sexual Partners , Survivors
18.
Anaesthesia ; 79(7): 694-705, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38629288

ABSTRACT

Gender inequity remains an issue in anaesthesia despite increasing numbers of women training and achieving fellowship in the speciality. Women are under-represented in all areas of anaesthetic research, academia and leadership. The Gender Equity Subcommittee of the Australian and New Zealand College of Anaesthetists recently conducted a survey asking "Does gender still matter in the pursuit of a career in anaesthesia in 2022?". The survey was distributed to a randomly selected sample of 1225 anaesthetic consultants and completed by 470 respondents (38% response rate) with 793 free-text comments provided. Three overarching themes were identified: gender effects on the career and family interface; women do not fit the mould; and gender equity changes the status quo. Women respondents described a need to make a choice between career and family, which was not described by men, as well as stigmatisation of part-time work, a lack of access to challenging work and negative impacts of parental leave. Women respondents also described a sense of marginalisation within anaesthesia due to a 'boys' club' mentality, a lack of professional respect and insufficient structural supports for women in leadership. This was compounded for women from ethnically and culturally diverse backgrounds. A need for specific strategies to support anaesthetic careers for women was described as well as normalisation of flexibility in workplaces, combined with a broadening of our definition of success to allow people of all genders to experience fulfilment both at home and at work. This study is the first published qualitative data on factors affecting gender equity for anaesthetists in Australia and Aotearoa New Zealand. It highlights the need for further exploration, as well providing a foundation for changes in attitude and structural changes towards advancing gender equity.


Subject(s)
Anesthesiology , Career Choice , Humans , New Zealand , Australia , Female , Male , Surveys and Questionnaires , Gender Equity , Adult , Anesthetists/psychology , Physicians, Women/psychology , Anesthesiologists/psychology , Qualitative Research , Sexism , Middle Aged
19.
Health Expect ; 27(4): e14129, 2024 08.
Article in English | MEDLINE | ID: mdl-38970211

ABSTRACT

AIM: To describe the life situation of spouses having a partner with heart disease and adolescents living at home. DESIGN: Qualitative inductive design. METHOD: Participants (n = 22) were included from three Scandinavian countries. Semi-structured interviews were analysed using thematic analysis with an inductive and latent approach. RESULTS: Three themes were derived. 'Being in spousal and parental role transition' described how daily life had been affected and parental responsibilities had been doubled due to their partner's heart disease. 'Living with unpredictability and insecurity' included how the unpredictable illness trajectory caused worries and affected the well-being of the family. 'Managing a challenging life situation' highlights how spouses coped with their partners' heart disease and adapted to a new life situation. CONCLUSION: Young spouses' life situation was greatly affected by their partner's heart disease, resulting in increased responsibilities and double parenthood. Having a positive attitude and mindset towards life was used as a strategy to cope with the changed life situation and find a new way of life. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: All family members are affected by heart disease. Spouses needed additional professional support and guidance on how to involve the children when a parent is ill. IMPACTS: This study highlights how young spouses, with adolescents living at home, experience their life situation. The life situation is unpredictable due to the partner's heart disease, as they must handle both caring for their partner and taking on double parenthood. Research involving family members can improve person- and family-centred care and treatment outcomes in health care and society. REPORTING METHOD: COREQ checklist was used preparing the manuscript. PATIENT OR PUBLIC CONTRIBUTION: Data collection included interviews with spouse. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: By highlighting the spouses changed life situation due to heart disease and the importance of including them in health care.


Subject(s)
Adaptation, Psychological , Heart Diseases , Interviews as Topic , Qualitative Research , Spouses , Humans , Female , Spouses/psychology , Male , Adolescent , Adult , Heart Diseases/psychology , Heart Diseases/therapy , Young Adult , Parents/psychology , Middle Aged
20.
BMC Geriatr ; 24(1): 338, 2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38609868

ABSTRACT

BACKGROUND: Research has highlighted a need to improve the quality of clinical documentation and data within aged care and disability services in Australia to support improved regulatory reporting and ensure quality and safety of services. However, the specific causes of data quality issues within aged care and disability services and solutions for optimisation are not well understood. OBJECTIVES: This study explored aged care and disability workforce (referred to as 'data-users') experiences and perceived root causes of clinical data quality issues at a large aged care and disability services provider in Western Australia, to inform optimisation solutions. METHODS: A purposive sample of n = 135 aged care and disability staff (including community-based and residential-based) in clinical, care, administrative and/or management roles participated in semi-structured interviews and web-based surveys. Data were analysed using an inductive thematic analysis method, where themes and subthemes were derived. RESULTS: Eight overarching causes of data and documentation quality issues were identified: (1) staff-related challenges, (2) education and training, (3) external barriers, (4) operational guidelines and procedures, (5) organisational practices and culture, (6) technological infrastructure, (7) systems design limitations, and (8) systems configuration-related challenges. CONCLUSION: The quality of clinical data and documentation within aged care and disability services is influenced by a complex interplay of internal and external factors. Coordinated and collaborative effort is required between service providers and the wider sector to identify behavioural and technical optimisation solutions to support safe and high-quality care and improved regulatory reporting.


Subject(s)
Data Accuracy , Documentation , Humans , Aged , Australia/epidemiology , Educational Status , Quality of Health Care
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