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1.
PLoS One ; 15(2): e0229706, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32108179

RESUMEN

Providing direct health and social care services for people who exhibit behaviours that challenge can be a highly stressful occupation. Existing literature has suggested that there is a need to develop further theoretical understanding of how work related stress can be reduced in professions that consist of providing care for people who exhibit behaviours that challenge. The aim for this study was to use a Classic Grounded Theory approach to develop a theoretical framework to illustrate a common issue that could influence work related stress levels experienced when managing behaviours that challenge in health and social care settings. A series of focus groups and 1:1 semi-structured interviews were conducted to explore the articulated experiences of 47 health/social care professionals who provide care for people who exhibit behaviours that challenge. This led to the development of Therapeutic Engagement Stress Theory (TEST), which illustrates that the perceived capacity to therapeutically engage with people who exhibit behaviours that challenge is an issue that can influence the levels of stress experienced by health/social care professionals. TEST provides a framework that could be applied to identify specific factors that inhibit staff to successfully deliver caring interventions for people who exhibit behaviours that challenge, and also inform bespoke support mechanisms to reduce stress in health/social care professionals.


Asunto(s)
Teoría Fundamentada , Personal de Salud/psicología , Estrés Laboral/etiología , Problema de Conducta/psicología , Servicio Social , Adulto , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Salud Laboral , Estrés Laboral/prevención & control , Estrés Laboral/psicología , Relaciones Profesional-Paciente , Reino Unido , Compromiso Laboral , Adulto Joven
2.
Int J Gynaecol Obstet ; 148 Suppl 2: 29-35, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31975397

RESUMEN

OBJECTIVE: To explore the perceptions and experiences of pregnant women in accessing healthcare services during the epidemic in Colombia during 2015-2016. METHODS: A qualitative study using semistructured interviews was conducted in Villavicencio. Six women who had been diagnosed with Zika virus infection during their pregnancies and whose fetus had suspected microcephaly participated in the investigation. Grounded theory was used and thematic content analysis was made for each category identified. RESULTS: Three main themes affecting access to healthcare services were identified: (1) women knew basic information about the virus, but it was limited; (2) access to services was delayed due to their lack of availability or limited supply in the municipality; and (3) most of the participants made out-of-pocket payments to get access to services that were not provided. CONCLUSIONS: Several gaps were identified in the provision of healthcare services to pregnant women during the Zika epidemic. Policy makers need to utilize the results from affected communities to develop and implement public policies that adapt and respond to their priorities and needs.


Asunto(s)
Accesibilidad a los Servicios de Salud/normas , Complicaciones Infecciosas del Embarazo/terapia , Infección por el Virus Zika/terapia , Adulto , Colombia , Epidemias , Femenino , Enfermedades Fetales/diagnóstico , Enfermedades Fetales/virología , Teoría Fundamentada , Accesibilidad a los Servicios de Salud/economía , Humanos , Recién Nacido , Microcefalia/diagnóstico , Microcefalia/virología , Evaluación de Necesidades , Embarazo , Investigación Cualitativa , Virus Zika , Infección por el Virus Zika/transmisión
3.
BMC Infect Dis ; 20(1): 31, 2020 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-31931733

RESUMEN

BACKGROUND: Life expectancy of people living with HIV (PLWH) is increasing. Effective biomedical prevention methods (treatment as prevention and preexposure prophylaxis) are being widely implemented in high-income nations. Therefore, research into quality of life, including sexual adjustment, is of increasing importance to HIV care. Yet, sexual adjustment of PLWH has been neglected in past research. We propose a new model of sexual adjustment to HIV which explores the dynamic process, facilitators and barriers characterising sexual life of PLWH overtime. METHOD: Thirty PLWH (19 male, 11 female) recruited from two HIV treatment centres as well as community groups, completed semi-structured interviews which were audio-recorded and transcribed verbatim for analysis using grounded theory. RESULTS: The model of sexual adjustment to HIV is the first to establish how undue fears of transmission of HIV during sex and/or fear of rejection by sexual partners determine initial sexual behaviour after diagnosis and also sexual adjustment over time. Within the model, sexual adjustment to HIV is facilitated by factors which assist PLWH to overcome such fears, including: partner acceptance, peer, community and health professional support, and accurate knowledge of risk of transmission including of undetectable viral load and pre-exposure prophylaxis. Adjustment is inhibited when undue fears of transmission and of rejection persist long term, resulting in maladaptive behaviours to cope with such fears including avoidance of sex and problematic drug and alcohol use. CONCLUSION: This model offers clear directions for promoting sexual adjustment to HIV. Health professionals should: (a) assess and intervene for sexual quality of life (not just risk) among PLWH; (b) be aware that serosorting facilitates adjustment in the short to medium term, but may interfere with adjustment long-term, (c) promote opportunities for positive connection between PLWH, and (d) intervene directly with PLWH and HIV negative sexual partners to promote accurate risk of transmission knowledge, including how this applies to their own sexual practices, and whether they are experiencing undue fear of transmission over time.


Asunto(s)
Teoría Fundamentada , Infecciones por VIH/prevención & control , Seroclasificación por VIH/psicología , Parejas Sexuales/psicología , Adulto , Femenino , Infecciones por VIH/tratamiento farmacológico , Personal de Salud , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Educación del Paciente como Asunto , Influencia de los Compañeros , Profilaxis Pre-Exposición , Calidad de Vida , Carga Viral
4.
J Sports Sci ; 38(4): 357-365, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31810403

RESUMEN

Basic values, defined as trans-situational goals that vary in importance and act as guiding principles in life, have been linked with unethical cognitions, emotions and actions. Their roles in doping, a form of cheating in sport, have yet to established. College athletes reported doping likelihood in hypothetical scenario-based situations and completed measures of basic values, moral disengagement, and anticipated guilt. Correlation analysis showed that doping likelihood was positively associated with self-enhancement values but negatively associated with self-transcendence values and conservation values. Moral disengagement correlated positively with self-enhancement values and negatively with self-transcendence values, whereas guilt correlated positively conservation values and negatively with self-enhancement values and openness to change values. Regression analyses showed that self-enhancement values positively predicted doping likelihood directly, self-transcendence values negatively predicted doping likelihood indirectly via moral disengagement and guilt, and conservation values negatively predicted doping likelihood indirectly via guilt. In line with theory and evidence concerning the relationship between basic value systems and moral thought and action, we found that the values of athletes are directly (self-enhancement) and indirectly (self-transcendence, conservation) linked with likely use of banned performance enhancing substances, an expression of cheating in sport.


Asunto(s)
Doping en los Deportes/psicología , Valores Sociales , Doping en los Deportes/ética , Femenino , Teoría Fundamentada , Culpa , Humanos , Masculino , Principios Morales , Motivación , Autoimagen
5.
Rev. Esc. Enferm. USP ; 54: e03556, 2020. graf
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1091975

RESUMEN

Abstract Objective: Understand limitations and possibilities in university management performed by nursing managers of the undergraduate nursing course of a public university. Method: A qualitative study with theoretical and methodological framework anchored in the Grounded Theory. Data collection took place between May and September 2016, and the studied scenario was the Nursing Department of a public university in southern Brazil. Results: The entrepreneurial profile and the leadership in interpersonal relations were highlighted among the possibilities, in addition to the co-responsibility in raising public resources to solve the university educational demands; as limitations, the scarcity of financial resources and the high demand for bureaucratic activities which have repercussions on the slowness of university public management processes. Conclusion: The nursing manager experiences limitations through their actions and interactions with people, and recognizes possibilities in the structure and processes of coordinating issues of collective interest in the university educational context.


Resumen Objetivo: Comprender los límites y posibilidades en la gestión universitaria realizada por enfermeros gestores de la carrera de licenciado en enfermería de una universidad pública. Método: Investigación cualitativa, con marco de referencia teórico metodológico anclado en la Teoría Fundamentada en los Datos. La recolección de datos ocurrió entre mayo y septiembre de 2016, y el escenario estudiado fue el Departamento de Enfermería de una universidad pública de la región Sur de Brasil. Resultados: Entre las posibilidades, se destacaron el perfil emprendedor y el liderazgo en las relaciones interpersonales, además de la corresponsabilización en la captación de recursos públicos para resolución de las demandas educativas universitarias; como límites, la escasez de recursos financieros y la elevada demanda de actividades burocráticas que repercuten en morosidad de los procesos de gestión pública universitaria. Conclusión: El enfermero gestor, mediante sus acciones e interacciones con las personas, enfrenta límites y reconoce posibilidades en la estructura y los procesos de la coordinación de temas de interés colectivo en el marco educativo universitario.


Resumo Objetivo: Compreender limites e possibilidades na gestão universitária realizada por enfermeiros gestores do curso de graduação em enfermagem de uma universidade pública. Método: Pesquisa qualitativa, com referencial teórico-metodológico ancorado na Teoria Fundamentada nos Dados. A coleta de dados ocorreu entre maio e setembro de 2016, e o cenário estudado foi o Departamento de Enfermagem de uma universidade pública da região Sul do Brasil. Resultados: Dentre as possibilidades, destacaram-se o perfil empreendedor e a liderança nas relações interpessoais, além da corresponsabilização na captação de recursos públicos para resolução das demandas educacionais universitárias; como limites, a escassez de recursos financeiros e a elevada demanda de atividades burocráticas que repercutem em morosidade dos processos de gestão pública universitária. Conclusão: O enfermeiro gestor, por meio das suas ações e interações com as pessoas, vivencia limites e reconhece possibilidades na estrutura e nos processos da coordenação de assuntos de interesse coletivo no contexto educacional universitário.


Asunto(s)
Humanos , Universidades/organización & administración , Educación en Enfermería/organización & administración , Docentes de Enfermería , Investigación Cualitativa , Teoría Fundamentada
6.
Rev. Esc. Enferm. USP ; 54: e03540, 2020. graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1091966

RESUMEN

Abstract Objective: To understand the experience of maternal overload in caring for children with cancer from the mother's perspective. Method: Symbolic Interactionism was adopted as a theoretical framework and the Grounded Theory as methodological framework. The study was conducted in a public hospital, which is reference in pediatric oncology. Data was collected from six mothers through semi-structured interviews in the second semester of 2017. Results: Mothers of children with cancer attributed meaning to the care experience when trying to cope with the emotional, social, physical, financial, family-related, information and moral overload. Maternal overload arises as a dynamic inter-relation process between the many types of overload. Conclusion: The maternal figure is the main person involved in care and experiences overload in caring for their sick child, facing limitations and responsibilities. The research acted as a key element to broaden the analysis and intervention of the family nurse, not only contributing to the theoretical construct related to maternal overload, but also and mainly to the scope of practice in patient care.


Resumo Objetivo: Compreender a experiência da sobrecarga materna no cuidado dos filhos com câncer do ponto de vista da mãe. Método: O Interacionismo Simbólico foi adotado como um marco teórico e a Teoria Fundamentada nos Dados, como marco metodológico. O estudo foi conduzido em um hospital público, que é referência em oncologia pediátrica. Os dados foram coletados de seis mães por meio de entrevistas semiestruturadas no segundo semestre de 2017. Resultados: As mães das crianças com câncer atribuíram significado à experiência do cuidado quando tentaram lidar com a informação emocional, social, física, financeira, relacionada à família e a sobrecarga moral. A sobrecarga materna emerge como um processo inter-relacional dinâmico entre os vários tipos de sobrecarga. Conclusão: A figura materna é a pessoa principal envolvida no cuidado e experimenta sobrecarga no cuidado com seus filhos doentes, enfrentando limitações e responsabilidades. A pesquisa agiu como um elemento-chave para ampliar a análise e intervenção do enfermeiro familiar, não apenas contribuindo para o construto teórico relacionado à sobrecarga materna, mas também e principalmente para o escopo da prática no cuidado com o paciente.


Resumen Objetivo: Comprender la experiencia de la sobrecarga materna en el cuidado a los hijos con cáncer desde el punto de vista de la madre. Método: El Interaccionismo Simbólico fue adoptado como un marco teórico y la Teoría Fundamentada en los Datos, como marco metodológico. Se llevó a cabo el estudio en un hospital público, que es referencia en oncología pediátrica. Se recogieron los datos de seis madres mediante entrevistas semiestructuradas en el segundo semestre de 2017. Resultados: Las madres de los niños con cáncer atribuyeron significado a la experiencia del cuidado cuando intentaron manejar la información emotiva, social, física, financiera, relacionada con la familia y la sobrecarga moral. La sobrecarga materna surge como un proceso interrelacional dinámico entre los distintos tipos de sobrecarga. Conclusión: La figura materna es la persona principal involucrada en el cuidado y experimenta sobrecarga en el cuidado a sus hijos enfermos, enfrentando limitaciones y responsabilidades. La encuesta actuó como un elemento clave para ampliar el análisis y la intervención del enfermero familiar, no solo contribuyendo al constructo teórico relacionado con la sobrecarga materna, sino también y especialmente al marco de la práctica en el cuidado con el paciente.


Asunto(s)
Humanos , Femenino , Adulto , Niño , Cuidadores/psicología , Madres/psicología , Neoplasias , Enfermería Oncológica , Enfermería de la Familia , Teoría Fundamentada , Interaccionismo Simbólico
7.
J Clin Nurs ; 29(1-2): 75-84, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31512306

RESUMEN

AIM: To develop a substantive theoretical explanation that makes sense of the decision-making process that clinical instructors use to place students on a learning contract. BACKGROUND: Clinical instructors are challenged with the task of objectively evaluating students using subjective tools such as anecdotal notes, diaries, unstructured observations and verbal feedback from other nurses. Clinical instructors' assessment decisions have a considerable impact on a variety of key stakeholders, not least of all students. DESIGN: Grounded theory method and its heuristic tools including the logic of constant comparison, continuous memoing and theoretical sampling to serve conceptualisation were used in the process of data collection and analysis. METHODS: Seventeen individual semi-structured interviews with clinical instructors in one university in Western Canada were conducted between May 2016-May 2017. Data were analysed using open, axial and selective coding consistent with grounded theory methodology. The study was checked for the Standards for Reporting Qualitative Research (SRQR) criteria (See Appendix S1). FINDINGS: Three subcategories, "brewing trouble," "unpacking thinking" and "benchmarking" led to the study's substantive theoretical explanation. "Gut feeling" demonstrates how clinical instructors reason in their decision-making process to place a student on a learning contract. CONCLUSION: Placing a student on a learning contract is impacted by personal, professional and institutional variables that together shift the process of evaluation towards subjectivity, thus influencing students' competency. A system-level approach, focusing on positive change through implementing innovative assessment strategies, such as using a smart phone application, is needed to provide some degree of consistency and objectivity. RELEVANCE TO CLINICAL PRACTICE: Making visible the objective assessments currently being done by clinical instructors has the potential to change organisational standards, which in turn impact patient and clinical outcomes.


Asunto(s)
Bachillerato en Enfermería/métodos , Docentes de Enfermería/psicología , Estudiantes de Enfermería/psicología , Canadá , Contratos , Evaluación Educacional/métodos , Teoría Fundamentada , Humanos , Intuición , Solución de Problemas , Investigación Cualitativa
8.
Am J Surg ; 219(2): 233-239, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31870534

RESUMEN

BACKGROUND: Developing autonomy is a critical component of becoming an attending surgeon. General surgery training has evolved in recent decades, however, leaving residents less time to work with attendings to establish entrustment. Limited entrustment can impact resident learning and engagement. METHODS: A constructivist grounded theory approach was used to guide interviews of 12 general surgery residents and 10 attendings. RESULTS: Engagement in the OR is perceived by both residents and attendings as fundamental to achieving autonomy. Our study uncovered three key tensions: 1. Residents and attendings both occupy dual roles in the OR; 2. System demands put those roles in tension and opposition constantly; 3. Residents and attendings do deploy strategies to seek balance in those tensions. CONCLUSIONS: In an academic OR setting, competing priorities can negatively impact resident engagement. Participants described some strategies for helping residents and attendings prioritize learning and teaching to better prepare residents for future practice.


Asunto(s)
Competencia Clínica , Cirugía General/educación , Relaciones Interprofesionales/ética , Cuerpo Médico de Hospitales/psicología , Quirófanos/organización & administración , Autonomía Profesional , Centros Médicos Académicos , Canadá , Educación de Postgrado en Medicina/métodos , Femenino , Teoría Fundamentada , Humanos , Internado y Residencia , Entrevistas como Asunto , Masculino
9.
J Clin Nurs ; 29(1-2): 208-220, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31633845

RESUMEN

AIMS AND OBJECTIVES: To understand why Western Australian (WA) midwives choose to remain in the profession. BACKGROUND: Midwifery shortages and the inability to retain midwives in the midwifery profession is a global problem. The need for effective midwifery staff retention strategies to be implemented is therefore urgent, as is the need for evidence to inform those strategies. DESIGN: Glaserian grounded theory (GT) methodology was used with constant comparative analysis. METHODS: Fourteen midwives currently working clinically area were interviewed about why they remain in the profession. The GT process of constant comparative analysis resulted in an overarching core category emerging. The study is reported in accordance with Tong and associates' (2007) Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS: The core category derived from the data was labelled-"I love being a midwife; it's who I am." The three major categories that underpin the core category are labelled as follows: "The people I work with make all the difference"; "I want to be 'with woman' so I can make a difference"; and "I feel a responsibility to pass on my skills, knowledge and wisdom to the next generation." CONCLUSION: It emerged from the data that midwives' ability to be "with woman" and the difference they feel they make to them, the people they work with and the opportunity to "grow" the next generation together underpin a compelling new middle-range theory of the phenomenon of interest. RELEVANCE TO CLINICAL PRACTICE: The theory that emerged and the insights it provides will be of interest to healthcare leaders, who may wish to use it to help develop midwifery workforce policy and practice, and by extension to optimise midwives' job satisfaction, and facilitate the retention of midwives both locally and across Australia.


Asunto(s)
Actitud del Personal de Salud , Satisfacción en el Trabajo , Enfermeras Obstetrices/psicología , Adulto , Australia , Femenino , Teoría Fundamentada , Humanos , Persona de Mediana Edad , Partería , Enfermeras Obstetrices/provisión & distribución , Embarazo , Investigación Cualitativa
10.
Artículo en Inglés | MEDLINE | ID: mdl-31861269

RESUMEN

Community-level action may be required to achieve the levels of sanitation uptake necessary for health gains. Evidence suggests that collective action is influenced by collective efficacy (CE)-a group's belief in its abilities to organize and execute action to achieve common goals. The extent to which it is necessary to fully contextualize existing CE measurement tools, in order to conduct meaningful assessments of the factors influencing CE perceptions, is not well understood. This study examines the value added of contextualizing an existing CE measurement tool using qualitative formative research. We employed a modified grounded theory approach to develop a contextualized CE framework based on qualitative data from rural Cambodian villages. The resulting framework included sub-constructs that were pertinent for the rural Cambodian context for which an existing, hypothesized framework did not account: perceived risks/benefits, action knowledge, shared needs/benefits, and external accountability. Complex confirmatory factor analyses indicated that contextualized models fit the data better than hypothesized models for women and men. This study demonstrates that inductive, qualitative research allows community-derived factors to enhance existing tools for context-specific CE measurement. Additional research is needed to determine which CE factors transcend contexts and could, thus, form the foundation of a general CE measurement tool.


Asunto(s)
Participación de la Comunidad/estadística & datos numéricos , Higiene , Población Rural/estadística & datos numéricos , Saneamiento/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Cambodia , Femenino , Teoría Fundamentada , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Saneamiento/métodos , Adulto Joven
11.
GMS J Med Educ ; 36(6): Doc76, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31844648

RESUMEN

Objective: Despite the increase in the number of graduates in Human Medicine, it has been predicted that there will not only be a shortage of doctors, but also a shortage of specialists in Germany for the years to come. At the same time there are only a few studies on the factors that influence medical students in their decision to select a specialty. Against this background, a study was conducted at the Medical Faculty in Rostock, to investigate the criteria for deciding on a later field of specialty. Methods: Conducting focus groups of four to seven participants of each year of study, criteria were determined which seemed relevant to the students during their selection of their specialty field. The interviews were transcribed and the answers of the participants classified in super categories. With the data obtained a questionnaire was prepared and sent electronically to all students of Human Medicine. Via exploratory factor analysis important criteria and their correlations were determined. Results: A total of 421 students took part in the questionnaire (31.4% return) and indicated their own clinical experience, but also patient contact and work-life-balance as important criteria for a future selection of specialty field. 44.8% of the participants had already made their choice of specialty at the time of the query, and this for the most part took place in the clinical study phase and most often for the subjects Internal Medicine (15.3%), General Medicine (14.2%), Pediatrics (12.0%) and Surgery (11.5%). For those students who already had made a decision, the size and complexity of the field as well as the opportunity to be able to build relationships with patients, were decisive for selection. Those still undecided indicated that for their choice of specialty family friendliness of the field, leisure time and esteem from others were important. Conclusions: Our results show that the personal clinical experience can be a decisive influential factor for future specialty selection. Early contact with the different disciplines could therefore be structured as an aid to help in the decision making, in order to break down any apprehensions and to stop a pending deficiency in specialists.


Asunto(s)
Selección de Profesión , Especialización , Estudiantes de Medicina/psicología , Estudios Transversales , Análisis Factorial , Grupos Focales , Alemania , Teoría Fundamentada , Humanos , Encuestas y Cuestionarios
12.
Int J Palliat Nurs ; 25(12): 603-609, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31855521

RESUMEN

BACKGROUND: Advance care planning (ACP) is not well implemented in hospital. Implementation theory stresses the importance of knowing what hospitalised palliative patients and their families experience as barriers or as facilitators in the uptake of ACP with their treating physician. AIMS: This study aimed to gain an in-depth understanding of what hospitalised palliative patients and their families experienced as barriers or facilitators for having ACP conversations. METHODS: We used a tape-assisted recall procedure to conduct 29 videotaped interviews with hospitalised patients and their families. We used content analysis based on grounded theory principles. RESULTS: Four major fields of tension were discovered: not knowing what to expect from the treating physician; not being sure the treating physician can be a trusted partner; daring to speak about ACP; and staying loyal to one's own wishes. CONCLUSIONS: Patients and families need physicians who are accessible and can be trusted ACP partners throughout the disease process.


Asunto(s)
Planificación Anticipada de Atención , Necesidades y Demandas de Servicios de Salud , Cuerpo Médico de Hospitales , Cuidados Paliativos , Rol del Médico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Actitud del Personal de Salud , Bélgica , Teoría Fundamentada , Hospitalización , Humanos , Persona de Mediana Edad , Relaciones Médico-Paciente , Relaciones Profesional-Familia , Adulto Joven
13.
PLoS One ; 14(12): e0226359, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31869363

RESUMEN

AIM: To explore the barriers and facilitators perceived by home caregivers regarding their involvement in the home care of people with pressure injuries. BACKGROUND: Although home caregivers are key in the process of caring for people with pressure injuries, little is known about their perceptions regarding their involvement in the same. METHODS: A qualitative study based on grounded theory involving a theoretical sample of 15 home caregivers of people with pressure injuries within the health district of Puertollano, Spain. RESULTS: This study identified three barriers (feminization of care, necessary life adaptations as a home caregiver, and the organization of health services) and three facilitators (the perceived family duty for caring, willingness to provide care, and satisfaction with the care received on behalf of primary care services) associated with caregiver involvement in the home care of pressure injuries. CONCLUSIONS: The care of a person with pressure injuries is perceived as a duty and requires important adaptations affecting the home caregiver's personal, social and work life. The emotional closeness and trust that develops between a patient and the primary care staff equals an involvement which, in turn, also has positive results for both the home caregiver and the patient.


Asunto(s)
Actitud Frente a la Salud , Cuidadores/psicología , Barreras de Comunicación , Úlcera por Presión/enfermería , Atención Primaria de Salud/normas , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Cuidadores/estadística & datos numéricos , Femenino , Teoría Fundamentada , Conocimientos, Actitudes y Práctica en Salud , Servicios de Atención de Salud a Domicilio , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Percepción/fisiología , Investigación Cualitativa , Calidad de la Atención de Salud , Factores Socioeconómicos , España/epidemiología
14.
Rev Lat Am Enfermagem ; 27: e3185, 2019.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-31596418

RESUMEN

OBJECTIVE: to understand the phenomenon of marital violence based on the experience of women in judicial process and network professionals. METHOD: a qualitative study, with theoretical-methodological support in grounded theory. Data collection took place in two regional Courts for Peace in the Home in a municipality of the Brazilian Northeast. Interviews were conducted with 38 participants, who composed two sample groups: women in situations of violence and network professionals. RESULTS: the understanding of marital violence emerged for the phenomenon "Experiencing marital violence as a progressive and cyclical process, with repercussions for health and implications for social relations". CONCLUSION: in recognizing marital violence as a recurring problem in the life of women, with implications for their own health and that of their children, the study points to the relevance of coping strategies based on institutional and social support.


Asunto(s)
Red Social , Apoyo Social , Maltrato Conyugal/psicología , Adulto , Anciano , Actitud del Personal de Salud , Brasil , Femenino , Teoría Fundamentada , Humanos , Persona de Mediana Edad , Maltrato Conyugal/prevención & control , Maltrato Conyugal/estadística & datos numéricos
15.
Artículo en Inglés | MEDLINE | ID: mdl-31614511

RESUMEN

Residents in the Eastern Region, Ghana with access to improved water sources (e.g., boreholes and covered wells) often choose to collect water from unimproved sources (e.g., rivers and uncovered wells). To assess why, we conducted two field studies to coincide with Ghana's rainy and dry seasons. During the rainy season, we conducted semi-structured in-depth interviews among a convenience sample of 26 women in four rural communities (including one woman in the dry season). We asked each participant about their attitudes and perceptions of water sources. During the dry season, we observed four women for ≤4 days each to provide context for water collection and water source choice. We used a grounded theory approach considering the multiple household water sources and uses approach to identify three themes informing water source choice: collection of and access to water, water quality perception, and the dynamic interaction of these. Women selected water sources based on multiple factors, including season, accessibility, religious/spiritual messaging, community messaging (e.g., health risks), and ease-of-use (e.g., physical burden). Gender and power dynamics created structural barriers that affected the use of unimproved water sources. A larger role for women in water management and supply decision-making could advance population health goals.


Asunto(s)
Agua Potable , Población Rural/estadística & datos numéricos , Calidad del Agua , Abastecimiento de Agua , Mujeres/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Ghana , Teoría Fundamentada , Humanos , Persona de Mediana Edad , Estaciones del Año
16.
J Clin Nurs ; 28(23-24): 4606-4620, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31512328

RESUMEN

OBJECTIVE: To identify and classify the barriers and facilitators of the individualisation process of the standardised care plan in hospitalisation wards. BACKGROUND: The administration of individualised care is one of the features of the nursing process. Care plans are the structured record of the diagnosis, planning and evaluation stages of the nursing process. Although the creation of standardised care plan has made recording easier, it is still necessary to record the individualisation of the care. It is important to study the elements that influence the individualisation process from the nurses' perspective. DESIGN: Qualitative study with the grounded theory approach developed by Strauss and Corbin. METHODS: Thirty-nine nurses from three hospitals participated by way of theoretical sampling. In-depth interviews were conducted, as well as participant observation, document analysis and focus group discussion. The analysis consisted of open, axial and selective coding until data saturation was reached. EQUATOR guidelines for qualitative research (COREQ) were applied. RESULTS: For both barriers and facilitators, three thematic categories emerged related to organisational, professional and individual aspects. The identified barriers included routines acquired in the wards, the tradition of narrative records, lack of knowledge and limited interest in individualisation. The identified facilitators included holding clinical care sessions, use of standardised care plan and an interface terminology, the nurse's expertise and willingness to individualise. CONCLUSION: The individualisation process of the standardised care plan involves multiple barriers and facilitators, which influence its degree of accuracy. RELEVANCE TO CLINICAL PRACTICE: Implementing strategies at an organisational level, professional level and individual level to improve the way the process is carried out would encourage individualising the standardised care plan in a manner that is consistent with the needs of the patient and family; it would improve the quality of care and patient satisfaction.


Asunto(s)
Enfermería de Cuidados Críticos/organización & administración , Planificación de Atención al Paciente/organización & administración , Adulto , Femenino , Grupos Focales , Teoría Fundamentada , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Adulto Joven
17.
BMC Health Serv Res ; 19(1): 557, 2019 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-31399088

RESUMEN

BACKGROUND: Male partner involvement has been shown to increase mothers' uptake of Prevention of Mother-to-Child Transmission of HIV (PMTCT) and improve maternal and infant HIV treatment outcomes. Currently, male involvement in PMTCT is measured primarily through men's attendance at HIV testing and counselling which may not be a true reflection of their engagement. This study therefore set out to explore the meaning of male partner involvement and propose a definition and theoretical model of this concept in PMTCT in Uganda. METHODS: Eight focus group discussions and five in-depth interviews were conducted with couples at three public health facilities and community members in the health facility catchment areas in Uganda. The study employed a grounded theory approach underpinned by the pragmatic philosophical paradigm. Data were analyzed using the constant comparative method, performing three levels of open, axial, and selective coding. RESULTS: Of the 61 participants, 29 (48%) were male and the majority 39 (63.9%) were in long term marital relationships, while about half were self-employed 29 (47.5%). Three themes emerged for the meaning of male involvement in PMTCT (a) HIV treatment support (b) economic support and (c) psychosocial support. HIV treatment support included adherence support, couples' HIV counseling and testing, and clinic attendance during and after pregnancy. Participants expressed that men were engaged in PMTCT when they offered economic support by providing basic needs and finances or when they included their female partners in financial planning for the family. Psychosocial support arose from the female participants who defined male involvement as family support, perceived societal recognition and emotional support. Emotional support also included the absence of harm resulting from women's disclosure of HIV test results to their male partner. CONCLUSIONS: This study proposes a new definition for male partner involvement in PMTCT in Uganda. The definition extends beyond men's clinic attendance and HIV testing and counselling. Further research should seek to develop and validate tools to accurately measure male partner involvement as the next step in the development of interventions to improve PMTCT outcomes.


Asunto(s)
Teoría Fundamentada , Infecciones por VIH/prevención & control , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Parejas Sexuales/psicología , Adulto , Consejo , Femenino , Grupos Focales , Humanos , Masculino , Embarazo , Uganda
18.
Nurse Res ; 27(1): 22-26, 2019 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-31468832

RESUMEN

BACKGROUND: Developing a conceptual framework to underpin the design of qualitative research is often regarded as integral in enhancing its trustworthiness. However, this can often present a challenge to the novice researcher. AIM: To discuss the approach taken to develop the conceptual framework underpinning a constructivist grounded theory doctoral research study. DISCUSSION: Drawing on a clear and accessible approach can help researchers to develop a conceptual framework to underpin qualitative research. A recognised example of such an approach requires the researcher to address three main elements: personal interest, topical research and the theoretical framework. Constructing a conceptual framework to underpin qualitative research can afford it structure and lay the foundations to support trustworthiness. Conceptual frameworks are often developed through a dynamic and iterative process that evolves throughout the research process. CONCLUSION: Using an accessible and unambiguous approach to support the development of a conceptual framework can benefit novice researchers and minimise the challenges they may encounter. One such approach guides researchers to clarify a personal interest in the topic, undertake a topical review of the literature informing the area of investigation and articulate the theoretical perspectives that influence their worldview. IMPLICATIONS FOR PRACTICE: The discussion presented in this paper offers a valuable contribution to help novice researchers to construct conceptual frameworks.


Asunto(s)
Empatía , Atención de Enfermería/psicología , Investigación en Enfermería/métodos , Personal de Enfermería/psicología , Teoría Fundamentada , Humanos , Teoría de Enfermería , Investigación Cualitativa , Proyectos de Investigación
19.
Artículo en Inglés | MEDLINE | ID: mdl-31426408

RESUMEN

Many parents experience "fever phobia", based on misconceptions regarding the repercussions of fever in their children. The aim of this paper was to explore the conceptualizations of parents who are health professionals and parents without health qualifications on childhood fever. This qualitative study was based on grounded theory using a triangulated sample (theoretical sampling and snowball sampling) of parents of children aged 0 to 12 years old who received care for fever in the Emergency Primary Care Services two in Spanish municipalities. Data collection was based on focus groups segmented by gender, place of residence and education. Data analysis followed the constant comparative method and involved a coding process. Results show that independently of the parents' place of residence or education, their perceptions of fever were somewhat ambivalent, beneficial at times, but also harmful. Parents acknowledged feelings of concern, fear, being overwhelmed, freezing up and relief once the fever was controlled. Health professional parents considered they had an extra responsibility for caring. Finally, parents without health education demanded more information from professionals. These results provide key information for the design of interventions directed at the management of fever in children.


Asunto(s)
Fiebre/psicología , Padres/psicología , Adulto , Niño , Preescolar , Formación de Concepto , Emociones , Femenino , Grupos Focales , Teoría Fundamentada , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Recién Nacido , Masculino , Padres/educación , Investigación Cualitativa
20.
Stud Health Technol Inform ; 264: 1980-1981, 2019 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-31438438

RESUMEN

Vital Sign Data Quality is essential for successful implementation of clinical decision support systems in emergency care. Studies have shown that data quality is inadequate and needs improvement. This study shows that data quality is dependent on both technical and human factors and provides a conceptual model of data quality governance and improvement in the emergency department.


Asunto(s)
Exactitud de los Datos , Signos Vitales , Servicio de Urgencia en Hospital , Teoría Fundamentada , Humanos , Suecia
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