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1.
Nurse Educ Pract ; 55: 103116, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34298403

RESUMO

AIM: This paper aims to describe caring perceptions and behaviors among student nurses in Italy as they progress through their nursing education. BACKGROUND: As nursing students are potential nurses of the future, there is an expectation that in addition to appropriate academic qualifications, they will develop appropriate caring behaviors/attitudes. However, there has been some evidence that the educational process does not always modify their caring perceptions/behaviors or that the direction of the change is not always positive. DESIGN: A qualitative longitudinal design with three data collection points, was performed from October 2013 to October 2016 at the University of Verona, Trento Campus. METHODS: Semi-structured interviews were conducted at the time of entry into a 3-year bachelor's degree program in nursing and at the end of the second and third years. Observation of the students during their clinical practice was carried out at the end of each of the three years of education. Thirty students commenced the study and 24 finished. Data were analyzed using a phenomenological approach. RESULTS: The iterative process of analyzing interviews and observations resulted in nine themes collectively from all three stages: establishing a trusting relationship with the patient, satisfying the patient's needs, paying attention, being respectful, being competent, giving time, being concerned with the emotional dimension, acting within context to facilitate caring actions and giving information. CONCLUSIONS: At the end of the third year the students' concept of caring was enhanced; their initial generic or lay view of caring turned into an intentional, competent, conscious, accountable and realistic caring approach.


Assuntos
Educação em Enfermagem , Estudantes de Enfermagem , Humanos , Itália , Estudos Longitudinais , Pesquisa Qualitativa
2.
Rev Esc Enferm USP ; 55: e03776, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34287487

RESUMO

This is a theoretical analysis of Constructivist Grounded Theory and its application in nursing research. It is organized in three topics: Characteristics of Grounded Theory; Philosophical basis of the constructivist strand; and Constructivist Grounded Theory data analysis particularities. The unique characteristics of Grounded Theory that set it apart from other approaches are simultaneous data collection and analyses, theoretical sampling, constant comparison at each stage of analysis, development of memos for reflexive and comparative analysis, and a coding system with an initial and a focused stage that is flexible and guides the analytical process of building a theory. Before embarking on a Constructivist Grounded Theory study, the literature is reviewed to hone the research question. The philosophical assumptions of symbolic interactionism and social constructivism influence the entire process. Constructivist Grounded Theory emphasizes the construction and interpretation of data recognizing social contexts, interaction, the point of view of participants, and their understandings according to the investigation time, place and situation.


Assuntos
Pesquisa em Enfermagem , Teoria Fundamentada , Humanos , Teoria de Enfermagem
3.
Cardiol Young ; : 1-7, 2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34162456

RESUMO

BACKGROUND: Caring for infants after the first-stage palliative surgery for single-ventricle heart disease bring challenges beyond the usual parenting responsibilities. Current studies fail to capture the nuances of caregivers' experiences during the most critical "interstage" period between the first and second surgery. OBJECTIVES: To explore the perceptions of caregivers about their experiences while transitioning to caregiver roles, including the successes and challenges associated with caregiving during the interstage period. METHODS: Constructivist Grounded Theory methodology guided the collection and analysis of data from in person or telephonic interviews with caregivers after their infants underwent the first-stage palliative surgery for single-ventricle heart disease, and were sent to home for 2-4 months before returning for their second surgery. Symbolic interactionism informed data analyses and interpretation. RESULTS: Our sample included 14 parents, who were interviewed 1-2 times between November, 2019 and July, 2020. Most patients were mothers (71%), Latinx (64%), with household incomes <$30K (42%). Data analysis led to the development of a Grounded Theory called Developing a Sense of Self-Reliance with three categories: (1) Owning caregiving responsibilities despite grave fears, (2) Figuring out how "to make it work" in the interstage period, and (3) Gaining a sense of self-reliance. CONCLUSIONS: Parents transitioned to caregiver roles by developing a sense of self-reliance and, in the process, gained self-confidence and decision-making skills. Our study responded to the key research priority from the AHA Scientific Statement to address the knowledge gap in home monitoring for interstage infants through qualitative research design.

4.
West J Nurs Res ; : 1939459211015894, 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33980070

RESUMO

The purpose of this study was to explore associations between trauma experiences among nurses and nursing perceptions of risk for involuntary job loss and standing in society. This observational study used 2001 data from the Nurses' Health Study II (N = 53,323 female nurses). The outcome variables were nurses' perceptions of their risk for involuntary job loss and their social standing in the United States and within their own community. The exposure variables were childhood and adulthood interpersonal trauma. Nurses reported high levels of emotional (60% childhood; 44% adulthood), physical (45% childhood, 23% adulthood), and sexual trauma (15% childhood, 11% adulthood). Emotional trauma was associated with perception of higher risk for involuntary job loss, but also higher perception of nurse societal standing. Nurses experience high rates of interpersonal trauma, which may influence how they perceive their profession.

5.
Subst Use Misuse ; 56(9): 1352-1362, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34027814

RESUMO

BACKGROUND: In response to the opioid crisis, states and health systems are encouraging clinicians to use risk mitigation strategies aimed at assessing a patient's risk for opioid misuse or abuse: opioid agreements, prescription drug monitoring programs (PDMPs), and urine drug tests (UDT). Objective: The objective of this qualitative study was to understand how clinicians perceived and used risk mitigation strategies for opioid abuse/misuse and identify barriers to implementation. Methods: We interviewed clinicians who prescribe opioid medications in the outpatient setting from 2016-2018 and analyzed the data using Constructivist Grounded Theory methodology. Results: We interviewed 21 primary care clinicians and 12 specialists. Nearly all clinicians reported using the PDMP. Some clinicians (adopters) found the opioid agreement and UDTs to be valuable, but most (non-adopters) did not. Adopters found the agreements and UDTs helpful in treating patients equitably, setting limits, and having objective evidence of misuse; protocols and workflows facilitated the use of the strategies. Non-adopters perceived the strategies as awkward, disruptive to the clinician-patient relationship, and introducing a power differential; they also cited lack of time and resources as barriers to use. Conclusions: Our study demonstrates that clinicians in certain settings have found effective ways to implement and use the PDMP, opioid agreements, and UDT but that other clinicians are less comfortable with their use. Administrators and policymakers should ensure that the strategies are designed in a way that strengthens the clinician-patient relationship while maximizing safety for patients and that clinicians are adequately trained and supported when introducing the strategies.


Assuntos
Transtornos Relacionados ao Uso de Opioides , Programas de Monitoramento de Prescrição de Medicamentos , Analgésicos Opioides/uso terapêutico , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Pesquisa Qualitativa , Detecção do Abuso de Substâncias
6.
Diabetes Res Clin Pract ; 175: 108787, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33845050

RESUMO

AIMS: The purpose of this study was to examine how older Latina women emotionally experience type 2 diabetes mellitus and interactions with care providers using a grounded theory approach. METHODS: Sixteen English-speaking, Latina women, 60 years and older, diagnosed with type 2 diabetes mellitus and experiencing symptoms of depression or anxiety participated in 21 phone interviews guided by a semi-structured interview guide. Data was collected and analyzed using Grounded Theory methodology; theoretical sampling was used to achieve data saturation. RESULTS: Participant data informed the creation of a theory, The Secret Self-Management Loop, with four interconnected phases: 1) having a negative relationship origin story; 2) doubting provider motivation; 3) reacting to doubts about provider; and 4) engaging in secret self-management. These phases reflected participants' lost trust in their providers and the medical system, resulting in undisclosed self-management strategies that complicated clinical management of their type 2 diabetes mellitus diagnosis. Primary sources of loss of trust were interactions that lacked empathy or caused them to question their providers' motivation. CONCLUSION: The Secret Self-Management Loop negatively influences patient disclosure and distorts providers' ability to adequately render care for this group.


Assuntos
Teoria Fundamentada , Saúde Mental/normas , Idoso , Diabetes Mellitus Tipo 2 , Feminino , Hispano-Americanos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa , Autogestão
7.
Artigo em Inglês | MEDLINE | ID: mdl-33883527

RESUMO

ABSTRACT: The cultural context and precipitants for initiating methamphetamine (MA) using among Chinese men who have sex with men (MSM) are unclear. This qualitative descriptive study, which explores the specific precipitants of MA initiation within a cultural context among MSM in China, was conducted with data from semistructured, face-to-face interviews with 24 MA-using MSM (8 HIV positive). Two themes were identified, internal precipitants included the following: (a) curiosity, (b) desire for maximum sexual pleasure, (c) experience with other drugs, and (d) strong sense of self-control capacity. External precipitants included (a) Xiao (filial piety), (b) peer pressure, (c) negative life events, (d) parental emotional neglect, and (e) experiences of homophobia. Internal precipitants to MA initiation for Chinese MSM are consistent with past research. External precipitants were more culture specific. This exacerbates the vulnerability of MSM to MA initiation and keeps it hidden among this population. Future drug use prevention interventions for MSM should address external precipitants and integrate culture-specific strategies.

8.
JMIR Ment Health ; 8(1): e22575, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33439137

RESUMO

BACKGROUND: Stigma, fear, and lack of knowledge regarding treatment options or where to get help create delays for Latina women in accessing needed mental health help. Story-based media interventions hold appeal for Latina women. Thus, we drew upon the Social Cognitive Theory by Bandura to create an evidence-based, transmedia storytelling web-based app for mental health called Catalina: Confronting My Emotions to connect Latina women to a curated set of mental health resources. Understanding how Latina women perceive various aspects of the web-based app will help design future expansions. OBJECTIVE: A previously published analysis led to the development of a category on how participants related to the lead character (Catalina) in the story line of the web-based app as a real person. However, the purpose of this analysis was to gain an understanding of participants' experiences with the extension of the dramatic story line of the web-based app beyond Catalina to a Latina nurse-therapist character named Veronica, who was featured prominently in the app's interactive content and bonus videos. METHODS: Qualitative analyses were conducted with interview data from a community-based sample of 28 English-speaking Latina women aged between 21 and 50 years who scored above the threshold for anxiety (Generalized Anxiety Disorder-7) and/or depression (Patient Health Questionnaire-9) but were not suicidal at screening. Data were collected 72 hours after participants engaged with our transmedia storytelling web-based app for mental health. Grounded theory methodology guided the analysis and interpretation of data that had been collected telephonically, recorded, and transcribed with identifiers removed. Analyses included initial and focused coding using process codes (gerund form of verbs in codes focused on action), informed by symbolic interactionism, and the development of categories with properties through constant comparison, memo writing, and the use of charts and diagrams. RESULTS: Our participants experienced a multiphase process that was most heavily related to Veronica, the Latina nurse-therapist character in our web-based app, who led them through a process to a place of action. We conceptualized this process as moving from passive viewer to active participant of a transmedia storytelling web-based app intervention. Overall, 3 new conceptual categories provided insight into women's experiences, including encountering a trustworthy nurse-therapist character, taking in messages that dispel old beliefs, and preparing when and how to take action. Each category has nuanced properties that reflect participants' experiences. CONCLUSIONS: Active engagement with our web-based app led our sample to successfully transition from the viewpoint of the observer to the viewpoint of the experiencer, moving from a passive position of watching to active engagement that involved imagining, thinking, reflecting, and acting. Careful development of dramatic material for health-related web-based apps using transmedia story extension and bonus videos needs to be based on input from the target group from the start of development through evaluation and testing.

9.
Rev. Esc. Enferm. USP ; 55: e03776, 2021. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1287938

RESUMO

RESUMO Análise teórica da Teoria Fundamentada Construtivista e sua aplicação na pesquisa em enfermagem. Está organizada em três tópicos: características da Teoria Fundamentada nos Dados; base filosófica da vertente construtivista; e particularidades da análise de dados da Teoria Fundamentada Construtivista. As características exclusivas da Teoria Fundamentada que a diferenciam de outras abordagens são coleta e análise simultâneas de dados, amostragem teórica, comparação constante em cada estágio de análise, desenvolvimento de memorandos para análise reflexiva e comparativa e um sistema de codificação com uma etapa inicial e uma focalizada que é flexível e orienta o processo analítico de construção de uma teoria. Antes de embarcar em um estudo da Teoria Fundamentada Construtivista, a literatura é revisada para aprimorar a questão de pesquisa. Os pressupostos filosóficos do interacionismo simbólico e do construtivismo social influenciam todo o processo. A Teoria Fundamentada Construtivista enfatiza a construção e interpretação de dados reconhecendo contextos sociais, interação, o ponto de vista dos participantes e seus entendimentos de acordo com o tempo, lugar e situação da investigação.


RESUMEN Análisis teórico de la Teoría Fundamentada Constructivista y su aplicación en investigación en enfermería. Se organiza en tres temas: Características de la Teoría Fundamentada; Base Filosófica de Vertiente constructivista; y particularidades del análisis de datos de la teoría fundamentada constructivista. Las características exclusivas de la Teoría Fundamentada que la difieren de otros abordajes son colecta y análisis simultáneos de datos, muestra teórica, comparación constante en cada etapa de análisis, desarrollo de memorandos para análisis reflexivos y comparativos y un sistema de codificación con una etapa inicial, y una enfocada, que es flexible y que orienta el proceso analítico de construcción de una teoría. Antes de empezar en un estudio de la Teoría Fundamentada Constructivista, se revisa la literatura para perfeccionar la cuestión de investigación. Los presupuestos filosóficos del interaccionismo simbólico y del constructivismo social influyen en todo el proceso. La Teoría Fundamentada Constructivista tiene énfasis en la construcción e interpretación de datos que reconocen contextos sociales, interacción, el punto de vista de los participantes y su comprensión de acuerdo con el tiempo, lugar y situación de investigación.


ABSTRACT This is a theoretical analysis of Constructivist Grounded Theory and its application in nursing research. It is organized in three topics: Characteristics of Grounded Theory; Philosophical basis of the constructivist strand; and Constructivist Grounded Theory data analysis particularities. The unique characteristics of Grounded Theory that set it apart from other approaches are simultaneous data collection and analyses, theoretical sampling, constant comparison at each stage of analysis, development of memos for reflexive and comparative analysis, and a coding system with an initial and a focused stage that is flexible and guides the analytical process of building a theory. Before embarking on a Constructivist Grounded Theory study, the literature is reviewed to hone the research question. The philosophical assumptions of symbolic interactionism and social constructivism influence the entire process. Constructivist Grounded Theory emphasizes the construction and interpretation of data recognizing social contexts, interaction, the point of view of participants, and their understandings according to the investigation time, place and situation.


Assuntos
Pesquisa Metodológica em Enfermagem , Pesquisa Qualitativa , Pesquisa , Teoria Fundamentada , Métodos
10.
Artigo em Inglês | MEDLINE | ID: mdl-33165181

RESUMO

HIV self-testing (HIVST) could increase HIV testing. However, HIVST uptake rate among Chinese men who have sex with men (MSM) is low. We conducted qualitative interviews with 23 MSM, 4 workers from community-based organizations, and 7 officials from both provincial Centers for Disease Control and Prevention and affiliated city-level Centers for Disease Control and Preventions to explore facilitators and barriers of HIVST among Chinese MSM. Eight barriers were identified, including fear of being duped by a fake test, concern for cost, fear of disclosing sexual orientation, limited access, lack of consulting services, biosafety concerns, lack of policy support, and concern for lost opportunities to link men to care. Five facilitators were identified, including convenience, confidentiality, easy operation, partner HIV testing, and peers' influence. Officials and scholars should urgently address structural barriers and provide accessible, affordable, and high-quality HIVST services that are accompanied by counseling to develop culturally appropriate HIVST guidelines.

11.
Epilepsy Behav ; 109: 107091, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32417384

RESUMO

OBJECTIVE: The purpose of this study was to explore how subjective perceptions of illness severity were described by a sample of participants with drug-resistant epilepsy (DRE) who were considering surgery. METHODS: A qualitative methodology, constructivist grounded theory, guided all aspects of the study. Data were collected via 51 semi-structured interviews with 35 adults in our multiethnic sample. At interview, the 20 women (57%) and 15 men (43%) ranged in age from 18 to 68 years (mean = 35.6 years) and had lived with epilepsy for an average of 15.4 y (range = 2-44 years). RESULTS: A grounded theory with four interrelated categories was developed to reflect the process by which participants arrived at an explanation of illness severity. Illness severity for participants evolved as participants reflected upon the burdensome impact of uncontrolled seizures on self and others. Epilepsy, when compared with other chronic conditions, was described as less serious, and participants imagined that other peoples' seizures were comparatively worse than their own. Illness severity was not uppermost in participants' minds but emerged as a concept that was both relative and linked to social burden. Perceptions of overall disease severity expanded upon determinants of seizure severity to offer a more complete explanation of what patients themselves did about longstanding, uncontrolled epilepsy. CONCLUSIONS: Perceptions of illness severity played a vital role in treatment decision-making with the potential to impact the illness trajectory. How to measure components of illness severity represents a new challenge for outcomes research in DRE.


Assuntos
Epilepsia Resistente a Medicamentos/psicologia , Epilepsia do Lobo Temporal/psicologia , Autoimagem , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Doença Crônica , Epilepsia Resistente a Medicamentos/diagnóstico , Epilepsia Resistente a Medicamentos/cirurgia , Epilepsia do Lobo Temporal/diagnóstico , Epilepsia do Lobo Temporal/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
12.
J Am Psychiatr Nurses Assoc ; 26(4): 340-343, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32340586

RESUMO

The novel coronavirus (COVID-19) pandemic has created an unprecedented global health challenge. There is risk that the outbreak will create a "second pandemic" of mental health crises in health systems and communities. Thus, a comprehensive public health response to the pandemic must include (a) attention to the psychological aspects of hospitalization for patients, families, and staff affected by COVID-19; (b) planning for emergency and acute psychiatric patient care if hospitals become overwhelmed with COVID-19 patients; and (c) innovations for providing mental health care in communities while social distancing is required and health system resources are strained. Nurses and nurse leaders must anticipate these mental health challenges, assist with preparedness in health systems and communities, and advocate for a coordinated response to promote mental wellness and resilience.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/psicologia , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Pneumonia Viral/complicações , Pneumonia Viral/psicologia , COVID-19 , Humanos , Transtornos Mentais/psicologia , Pandemias , SARS-CoV-2
13.
Pain Med ; 21(11): 3187-3198, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32186728

RESUMO

OBJECTIVE: Given the changing political and social climate around opioids, we examined how clinicians in the outpatient setting made decisions about managing opioid prescriptions for new patients already on long-term opioid therapy. METHODS: We conducted in-depth interviews with 32 clinicians in Southern California who prescribed opioid medications in the outpatient setting for chronic pain. The study design, interview guides, and coding for this qualitative study were guided by constructivist grounded theory methodology. RESULTS: We identified three approaches to assuming a new patient's opioid prescriptions. Staunch Opposers, mostly clinicians with specialized training in pain medicine, were averse to continuing opioid prescriptions for new patients and often screened outpatients seeking opioids. Cautious and Conflicted Prescribers were wary about prescribing opioids but were willing to refill prescriptions if they perceived the patient as trustworthy and the medication fell within their comfort zone. Clinicians in the first two groups felt resentful about other clinicians "dumping" patients on opioids on them. Rapport Builders, mostly primary care physicians, were the most willing to assume opioid prescriptions and were strategic in their approach to transitioning patients to safer doses. CONCLUSIONS: Clinicians with the most training in pain management were the least willing to assume responsibility for opioid prescriptions for patients already on long-term opioid therapy. In contrast, primary care clinicians were the most willing to assume this responsibility. However, primary care clinicians face barriers to providing high-quality care for patients with complex pain conditions, such as short visit times and less specialized training.


Assuntos
Dor Crônica , Médicos de Atenção Primária , Analgésicos Opioides/uso terapêutico , Dor Crônica/tratamento farmacológico , Prescrições de Medicamentos , Humanos , Manejo da Dor , Padrões de Prática Médica , Prescrições
14.
Hisp Health Care Int ; 18(2): 98-104, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31722557

RESUMO

INTRODUCTION: Insufficient physical activity (PA) and obesity-related health conditions have reached epidemic proportions worldwide. Mexican American women (MAW) report low leisure time physical activity. Few studies examine activities beyond leisure time. Qualitative research suggests that partner support influence provides a cultural approach relevant to PA among MAW. METHOD: This cross-sectional study used an ecological model to investigate community (the physical environment), interpersonal (partner support, attitudinal familism), and intrapersonal (age, health conditions, acculturation, employment, and body mass index) factors associated with PA among 112 MAW. Community-based participatory research recommendations guided the preparatory phase of the study and the face-to-face interviews. Frequencies and descriptive statistics were computed. Multivariable linear regression analyses were used to examine associations between study variables. RESULTS: Moderate to high PA levels were found based on combined activities performed during leisure time, transportation, household tasks, and occupational duties. Women with greater partner support reported higher PA levels. Although acculturation levels were low among women, those with higher acculturation were found to be more physically active. CONCLUSIONS: Future studies should examine strategies to increase partner support and address acculturation within intervention programs to enhance overall PA among MAW.

15.
Am J Crit Care ; 28(5): 354-360, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31474605

RESUMO

BACKGROUND: Early diagnosis of complex congenital heart disease and advances in surgical interventions have resulted in remarkable improvements in prognoses and hospital survival. Although studies have provided insight into children's experiences with complex congenital heart disease after hospitalization, few have addressed parents' experiences providing care for infants with complex congenital heart disease who are discharged home with complex care needs after surgical palliation. OBJECTIVES: To describe the perceptions and lived experiences of mothers of infants who were discharged from the hospital after surgery for complex congenital heart disease but were then readmitted to the hospital. METHODS: Data collection and analysis for this pilot study were guided by grounded theory. From February through October 2017, interviews were conducted with 10 mothers about their experiences caring for their infants at home after surgery for complex congenital heart disease. RESULTS: Analyses led to development of 1 category, "having to be the one," which had 3 properties: having no choice but to provide complex care at home, handling unexpected roles, and grappling with the possibility of death. CONCLUSIONS: The category of "having to be the one" highlighted mothers' experiences providing medicalized care at home to their infants after complex cardiac surgery while managing other responsibilities, such as employment, busy households, and parenting other school-age children. The role of the caregiver is vital but demanding. Mothers' caregiving at home may be enhanced by nursing interventions such as routine screening for infant distress plus assessment for alterations in family coping or relational challenges that threaten family function.


Assuntos
Cuidadores/psicologia , Cardiopatias Congênitas/enfermagem , Assistência Domiciliar/métodos , Assistência Domiciliar/psicologia , Mães/psicologia , Adulto , Feminino , Teoria Fundamentada , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Masculino , Projetos Piloto , Adulto Jovem
16.
J Gerontol Nurs ; 45(2): 35-41, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30690652

RESUMO

Some researchers attribute the excess rates of diabetes complications among African American older adults compared to other racial/ethnic subgroups to low diabetes knowledge. Diabetes knowledge measures have a biomedical orientation, including knowledge of glycemic control and using diet and exercise to control blood sugar. Measures do not assess informal knowledge that patients obtain outside of the clinical environment. The distinction between formal and informal knowledge is meaningful for cultural groups such as African American individuals who have historically transferred knowledge about maintaining their health "through the grapevine." A qualitative approach was used to understand participants' informal diabetes knowledge. Three major themes identified addressed the threat that participants perceived when diagnosed, the social construction of diabetes knowledge through their lived and observed experiences, and the limited role that clinicians played in participants' diabetes knowledge acquisition. Findings reveal ways nurses can individualize the diabetes education they provide to African American older adults based on their experiential understanding. [Journal of Gerontological Nursing, 45(2), 35-41.].


Assuntos
Afro-Americanos , Diabetes Mellitus/enfermagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto
17.
Support Care Cancer ; 27(2): 623-630, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30043264

RESUMO

PURPOSE: Despite the prevalence of hematological malignancies in early adulthood, very little is known about hematopoietic cell transplantation among adolescents and young adults, and even less is known about their transition from the completion of therapy to early survivorship. In this qualitative study, we investigated the impact of the cancer experience on sense of life potential and perception of the future from the perspectives of adolescents and young adults after hematopoietic cell transplantation. METHODS: In-depth interviews were conducted with adolescents and young adults who underwent allogeneic or autologous hematopoietic cell transplantation between the ages of 15-29 years and were 6-60 months post-treatment. Interview transcripts were systematically coded based on constructivist grounded theory. RESULTS: Eighteen adolescents and young adults participated and described how they came to understand the lifelong, chronic nature of cancer survivorship. "Improving to where?" was a question raised in the post-treatment period that reflected participants' confusion about the goals of treatment and expectations for survivorship. Participants reported bracing themselves for "something bad" to deal with the uncertainty of medical and psychosocial effects of treatment. They struggled to move forward with their lives given their substantial health risks and found it necessary to "roll with the punches" in order to adjust to this new reality. CONCLUSIONS: Adolescents and young adults who undergo hematopoietic cell transplantation are at significant risk for long-term and late effects in survivorship. Age-appropriate interventions are needed to support these survivors as they manage their fears about the future while enhancing health and well-being.


Assuntos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Neoplasias/terapia , Condicionamento Pré-Transplante/efeitos adversos , Adolescente , Adulto , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Neoplasias/patologia , Risco , Condicionamento Pré-Transplante/métodos , Adulto Jovem
18.
J Med Internet Res ; 20(5): e10028, 2018 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-29720357

RESUMO

BACKGROUND: Transmedia storytelling was used to attract English-speaking Latina women with elevated symptoms of depression and anxiety to engage in an intervention that included videos and a webpage with links to symptom management resources. However, a main character for the storyline who was considered dynamic, compelling, and relatable by the target group was needed. OBJECTIVE: We conducted interviews with 28 English-speaking Latinas (target group) with elevated symptoms of depression or anxiety who participated in an Internet-accessible transmedia storytelling intervention. The objective of this study was to examine participants' perceptions of the lead character of the story. Development of this character was informed by deidentified data from previous studies with members of the target group. Critique of the character from a panel of therapists informed editing, as did input from women of the target group. METHODS: All interviews were conducted via telephone, audio-recorded, and transcribed. Data analysis was guided by grounded theory methodology. RESULTS: Participants embraced the main character, Catalina, related to her as a person with an emotional life and a temporal reality, reported that they learned from her and wanted more episodes that featured her and her life. Grounded theory analysis led to the development of one category (She "just felt so real": relating to Catalina as a real person with a past, present, and future) with 4 properties. Properties included (1) relating emotionally to Catalina's vulnerability, (2) recognizing shared experiences, (3) needing to support others while simultaneously lacking self-support, and (4) using Catalina as a springboard for imagining alternative futures. Participants found Catalina's efforts to pursue mental health treatment to be meaningful and led them to compare themselves to her and consider how they might pursue treatment themselves. CONCLUSIONS: When creating a story-based mental health intervention to be delivered through an app, regardless of type, careful development of the main character is valuable. Theoretical guidance, previous deidentified data from the target group, critique from key stakeholders and members of the target group, and preliminary testing are likely to enhance the main character's relatability and appropriateness, which can increase sustained engagement.


Assuntos
Teoria Fundamentada , Saúde Mental/tendências , Mídias Sociais/tendências , Adulto , Feminino , Hispano-Americanos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa , Adulto Jovem
19.
J Obstet Gynecol Neonatal Nurs ; 47(6): 862-873, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29777665

RESUMO

OBJECTIVE: To assess the acceptability and feasibility of S2S, a newly adapted behavior intervention to address high-risk sexual behavior. DESIGN: Pilot randomized controlled trial. SETTING: The Internet and text messages with no in-person interactions. PARTICIPANTS: Eighty-eight Black women, ages 18 to 24 years, were randomly assigned to the intervention or control groups and self-enrolled in the respective text message program. METHODS: Participants in the intervention group were sent text messages about sexual health, whereas those in the control group were sent text messages about diet and/or exercise. Participants in each group received 24 text messages, including text-only messages, memes, and infopics. Participants in the intervention group also received videos links. All text messages were sent three times per week for 8 weeks. Quantitative methods were used to analyze data from the message and video platform reports. Quantitative and qualitative methods were used to analyze participants' responses to an acceptability and feasibility survey. RESULTS: Overall, the delivery of health promotion text messages was viewed as acceptable and feasible by participants in both groups. Most of the short answer responses from participants were favorable, and responses to the acceptability and feasibility survey yielded a total mean score of 4.01 on a 5-point scale. CONCLUSION: Results from this study support the idea that evidence-based interventions can be adapted for delivery by text message. This delivery modality is acceptable to young adult Black women and may help decrease barriers that would otherwise prevent them from receiving health promotion messages.


Assuntos
Educação em Saúde/métodos , Promoção da Saúde/métodos , Saúde Sexual/etnologia , Envio de Mensagens de Texto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Atenção à Saúde/métodos , Feminino , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde , Comportamento Sexual/etnologia , Adulto Jovem
20.
Hisp Health Care Int ; 16(1): 29-35, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29623739

RESUMO

INTRODUCTION: Little is known of late adolescent Texas Latinas' prenatal care perceptions or how these perceptions predict timely prenatal care initiation or adequate utilization. Hence, the purpose of this study is to describe and compare these perceptions between participants with timely versus late prenatal care initiation and adequate, intermediate, and inadequate prenatal care utilization; and to determine predictors of timely prenatal care initiation and adequate utilization. METHODS: Fifty-four postpartum Latinas were recruited through social media. Eligibility criteria were 18 to 21 years old, Texas-born, primiparous, uncomplicated pregnancy/delivery, and English literate. Prenatal care perceptions were measured with the Revised Better Babies Survey and Access Barriers to Care Index. RESULTS: Participants had favorable views of prenatal care benefits; however, not living with the baby's father predicted inadequate prenatal care, Wald χ2(1) = 4.93, p = .026. Perceived benefits of timely and adequate prenatal care predicted timely prenatal care initiation, χ2(1) = 7.47, p = .006. Self-reported depression during pregnancy predicted timely entry into prenatal care, χ2(1) = 4.73, p = .03. CONCLUSION: Participants' positive prenatal care perceptions did not predict adequate prenatal care utilization, indicating that barriers serve as powerful obstacles in late adolescent Texas Latinas.


Assuntos
Atitude , Hispano-Americanos , Aceitação pelo Paciente de Cuidados de Saúde , Cuidado Pré-Natal , Adolescente , Adulto , Pai , Feminino , Acesso aos Serviços de Saúde , Humanos , Gravidez , Texas , Adulto Jovem
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